Differences in Roles Among RNs, LVNs, and UAPs

Registered Nurses

A registered nurse (RN) is an important component of a medical facility’s healthcare team, be it in a hospital setting, private clinic, patient’s home, or a nursing facility for the elderly. While most nurses work in acute care hospitals as hospital nurses, they also care for patients at hospital bedside, private clinics, and in private homes.  In hospitals, they are expected to perform the following tasks:

Provide bedside care for hospital in-patients;
Monitor all aspects of patient care, including diet and physical activity;
Administer treatment and give medications to patients under the direction of physicians;
Observe the patient, assess and record symptoms, and note reactions and progress; and
Develop and manage nursing care plans and instruct patients and caregivers in how to perform tasks they can do themselves.

Registered nurses may also work in clinics and patient’s homes, acting as an intermediary between the physician, hospital staff, and the patient.  They may also supervise other home health workers, including licensed vocational nurses (LVN) and unlicensed assistive personnel (UAP).  Registered nurses have to complete a Bachelor’s degree in Nursing, take and pass the National Council Licensing Examination (NCLEX), and secure a license for nurses at the California Board of Registered Nursing, if they intend to practice nursing in California.

Licensed Vocational Nurse.  A licensed vocational nurse or LVN is an entry-level health care provider responsible for rendering basic nursing care.   Anyone who wishes to become an LVN has to attend a nursing school offering LVN, which is normally shorter and less comprehensive than a regular course for registered nurses.  After completing the academic and practical requirements of course, she can take a state board examination to practice the profession.   LVNs care for the sick, injured, convalescent, and disable under the direction of physicians and registered nurses.

LPNs provide basic bedside care, taking vital signs such as temperature, blood pressure, pulse, and respiration. They also prepare and give injections and enemas, monitor catheters, apply dressings, treat bedsores, and give alcohol rubs and massages. LVNs monitor their patients and report adverse reactions to medications or treatments. They collect samples for testing, perform routine laboratory tests, feed patients, and record food and fluid intake and output. To help keep patients comfortable, LPNs assist with bathing, dressing, and personal hygiene. Some LPNs help deliver, care for, and feed infants. Experienced LPNs may also supervise nursing assistants and aides.

Unlicensed Assistive Personnel.  The term unlicensed assistive personnel (UAP) is a common one. A UAP is better known as a caregiver.  Examples of UAP include, but are not limited to, certified nursing assistants, home health aides, and patient care technicians.  Direct patient care activities are delegated by the registered nurse and assist the patient/client in meeting basic human needs. This includes activities related to feeding, drinking, positioning, ambulating, grooming, toileting, dressing and socializing and may involve the collect ting, reporting and documentation of data related to these activities.

Indirect patient care activities focus on maintaining the environment and the systems in which nursing care is delivered. These activities assist in providing a clean, efficient, and safe patient care environment and typically encompass categories such as housekeeping and transporting, clerical, stocking and maintenance supplies.  Many people, specially the elderly, find it desirable to seek non-traditional unlicensed in such settings as assisted living, adult day care, and home care.

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