In California, the LPN or Licensed Vocational Nurse (LVN) is no longer utilized in acute care settings (due to the Nurse to Patient Ratio Laws) and are being replaced by Medical Assistance (MA) in ambulatory care settings. LVNs however are utilized to a high degree in Skilled Nursing Facilities , and Long Term Care as TEAM LEADERS and to lesser degrees, in Hospice, Memory Care and Home Health as a back-up to RN Case Managers. By California state laws and the Nurse Practices Act, LVNs must be supervised by an RN at all times, and are required to collaborate with an RN Supervisor whenever there is/are change(s) in a patients' condition. These collaborations are documented by the LVN in the patient's EMR (Electronic Medical Record), generally via a check off formatted page.
LVNs are highly regarded in California and are highly skilled in medication administration, wound care, trach and oral suctioning, and venipuncture.