LVN Supervisor Unit Manager Careers

Licensed vocational nurses (LVN) -- also called licensed practical nurses -- provide nursing care under the clinical supervision of a registered nurse (RN). Depending on their state's scope of practice regulations, LVNs can perform most nursing interventions, including giving injections, drawing blood, administering medications and checking vital signs. However, because they are not allowed to make clinical assessments or create plans of care, and because they are legally supposed to be supervised by RNs, there are few medical settings that allow LVNs to be supervisors. Unit management roles are rarely, if ever, found in hospital units. However, there are certain medical settings in which LVNs can be in charge of a unit or team.

Assisted-Living Facilities

• Assisted-living facilities (ALF) offer seniors a level of care between living independently and residing in a nursing home. ALF residents have their own rooms and small apartments, with services available to help them with tasks and functions with which they may have difficulty. They also have basic medical services available to them on-site. Many ALF operators allow LVNs to manage their nursing and caretaking units.

  The key to making this arrangement legal is that the LVN supervisor can manage LVNs, certified nursing assistants and non-licensed caretaking staff fully, but she cannot give any clinical direction to her RN staff members. LVNs can manage RNs in a personnel sense -- scheduling them, holding them accountable for completing work and handling their pay issues. However, as LVNs, they must defer to the clinical direction of their RNs.

Home Health Agencies

• Many home health agencies use LVNs as supervisors. In many cases, LVNs own and operate home health agencies. All of this is legal. As managers of home health agency operations, LVNs schedule medical staff, interact with clients, oversee billing and act as supervisors to all clinical employees. However, under Medicare regulations and most states' laws, home health agencies must have an RN or physician on hand as a clinical supervisor. Therefore, LVN supervisors must be careful not to give clinical direction.

Case Management

• Hospitals and insurance companies use clinical case managers to review and oversee insurance benefit utilization of patients receiving care. On the hospital side, case managers work with nurses, physicians and discharge planners to make sure patients receive their full medical benefits. Case managers often advocate to insurers on the patients' behalf to get approvals for needed treatments.

  On the insurance side, nurse case managers try to balance paying for needed services with saving their insurance companies money by reviewing medical claims to prevent over-utilization. While both hospitals and insurance companies want currently licensed RNs and LVNs to perform this work, there is no direct patient care involved. Therefore, LVNs can become unit managers overseeing both RNs and LVNs without conflicting with state scope of practice statutes.