What Can an RN Not Delegate to an LPN?

The short answer

An RN can hand off tasks. An RN cannot hand off the judgment. Assessing a patient, deciding what the nursing problem is, writing the care plan, and evaluating whether that plan is working are the pieces regulators describe as requiring the registered nurse's own judgment — New York's board states flatly that a licensed practical nurse may not determine nursing diagnoses, develop the nursing care plan, triage, or practice independently (NYSED Office of the Professions). The exact list of what may and may not be delegated is written state by state, so your own nurse practice act is the document that governs you.

What "delegation" actually means

Delegation is when a nurse who holds the responsibility for a piece of care asks someone else to carry out part of it. The word matters, because it implies something stays behind: the delegating nurse remains accountable for the decision to delegate and for the outcome of the care overall. Professional scope-of-practice standards treat that accountability as inseparable from the license itself (American Nurses Association).

So "can I delegate this?" is really two questions at once. Is the task itself within the other person's legal scope? And is this particular patient, at this particular moment, predictable enough that someone else can safely carry the task out with the supervision actually available?

The pieces that usually stay with the RN

Across states, the work that tends to be reserved for the registered nurse clusters around the same four things:

• The initial assessment. Not taking vital signs — the clinical interpretation of what a patient's overall picture means at the start of care or when something changes.
• The nursing diagnosis. Naming the problem the nursing plan will address.
• Developing and revising the plan of care. Including the decision to change course.
• Evaluating the response. Judging whether the plan worked and what to do next.

Teaching often sits in a gray area. Reinforcing instruction the RN has already given is commonly assignable; building the teaching plan from an assessment usually is not. And in most frameworks, the delegate can't re-delegate — an LPN who has been assigned a task generally can't pass it on to someone else.

What LPNs are commonly assigned

The flip side is a large, real body of work. Tasks that are routine, that have a predictable outcome, and that don't require a fresh clinical judgment in the moment — gathering data, routine treatments, documentation, much medication administration — are the everyday substance of practical nursing. An LPN contributes observations that feed the RN's assessment; what the LPN doesn't do is make the assessment the plan is built on. If you want the broader version of that comparison, see what an RN can do that an LPN cannot.

Employer policy narrows it further

Here's the part people miss. Your state sets the outer boundary; your employer draws a line somewhere inside it. A hospital can decide that a task legally within LPN scope still requires an RN on that unit, for that patient population, or without a specific competency check-off. The facility policy is the one you'll be held to day to day, and it is never more permissive than the practice act.

How to check your own state

Don't take a message board's word for it, and don't assume the rules you learned in one state traveled with you. Every state's board of nursing publishes its practice act, its regulations, and usually a set of practice advisories or FAQs on delegation — the NCSBN maintains a directory of U.S. boards of nursing with contact details for each one. Look specifically for language about "delegation," "assignment," and "supervision," which are three different concepts in most acts.

If you're weighing the two licenses rather than working under them, the plain-English version of the difference is over at LPN vs RN.