The short answer
A registered nurse (RN) has the broadest training and is responsible for assessing residents, care planning and supervising. A licensed practical nurse (LPN) works under the direction of an RN or physician and typically gives medications and treatments. The charge nurse is whichever licensed nurse is in charge of a unit on a given shift. Many nursing home units are run day to day by LPNs, with an RN supervisor covering the building.
Registered nurse (RN)
- Performs and is accountable for nursing assessments
- Coordinates the MDS and care plans
- Assesses changes in condition and calls the physician
- Often serves as unit manager, supervisor or director of nursing
Federal rules require an RN on duty at least eight consecutive hours a day, seven days a week.
Licensed practical nurse (LPN)
- Gives medications and treatments, documented on the MAR and TAR
- Monitors residents and reports changes
- Often serves as charge nurse and supervises the CNAs on a unit
Charge nurse
Federal rules require a licensed nurse to serve as charge nurse on each shift. The charge nurse is the first person to ask about how a resident is doing that day, about medications, and about anything a CNA has reported.
Why it matters
When a resident has a change in condition, such as a fall, fever, new confusion, a new wound or not eating, a nurse must assess the resident and notify the physician and family. Ask who assessed the resident and what was done.
The rules behind this
- 42 C.F.R. § 483.35(a)–(b) (nursing staff, charge nurse and RN coverage)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.