LVN scope of practice in Texas: assessments, IVs and care plans under the Texas BON
Written and reviewed by Rachel Goldberg, MSN, RN, CEN · 4 min read · Updated November 2026
Checked against official sources: November 2026
Rules, fees and deadlines differ by state and change without notice. Check with your state board of nursing before you rely on them.
Short answer
In Texas the LVN has a directed scope of practice: you work under an RN, APRN, physician, PA, podiatrist or dentist, perform focused assessments rather than comprehensive ones, contribute to the RN's care plan, and may start IVs only after a validation course. The Texas BON explains this in Position Statement 15.27.
What a directed scope means in Texas
The Texas Occupations Code, section 301.002(5), defines vocational nursing as a directed scope that excludes medical diagnosis and prescribing. It lists the LVN's work as collecting data and performing focused nursing assessments, participating in planning, participating in developing and changing the care plan, participating in health teaching, and assisting in evaluating the patient's response.
Position Statement 15.27, last revised January 2022, adds that the LVN may not practice in a completely independent manner, but direct on-site supervision is not required in every setting. The LVN and the clinical supervisor decide how close supervision must be. The board recommends that new LVNs spend 12 to 18 months in structured settings such as hospitals, nursing homes or clinics before moving to settings where the supervisor is off site.
Can Texas LVNs do assessments?
Texas LVNs do focused assessments only. The board's practice FAQ defines a focused assessment as an appraisal of the patient's status and the situation at hand that contributes to the RN's comprehensive assessment, while the comprehensive assessment includes synthesizing the whole picture and making nursing diagnoses, which is RN work under Board Rule 217.11(3).
Two FAQ answers catch people out. The board does not define an initial or admission assessment, so whether an LVN may do one depends on other regulators such as Texas Health and Human Services; if they require an RN, the LVN cannot do it. And where a comprehensive assessment is required, the LVN may not do a focused one and leave the RN to fill gaps. The board also calls triage, telephone triage and on-call assessment beyond LVN scope.
Can LVNs start IVs in Texas?
Yes, after training. Position Statement 15.3 says LVN school does not have to teach IV insertion, so the board's opinion is that an LVN should not do venipuncture, give IV fluids or give IV push drugs until completing a validation course in IV therapy. The board does not define or set qualifications for that course or for any LVN IV certification.
Which IV drugs an LVN gives, including piggyback, push and drips that need titration, is left to facility policy. One line is fixed by the board: inserting or removing PICC lines and midline catheters is beyond LVN scope, and the board says continuing education short of an RN program cannot change that.
LVN scope of practice vs RN in Texas
Position Statement 15.27 walks through each step of the nursing process for both licenses. The table below condenses it with the board's FAQ; the board describes these as minimum competencies that also set limits on each license regardless of experience.
| Step | LVN | RN |
|---|---|---|
| Assessment | Focused assessment; collects data, recognizes changes and reports them | Comprehensive assessment that lays the foundation of the nursing process |
| Diagnosis and planning | Reports data; participates in planning; may not initiate the care plan | Makes nursing diagnoses and develops the initial nursing care plan |
| Implementation | Implements parts of the plan; may assign tasks to LVNs and aides but may not delegate to aides | Overall responsibility to coordinate care; generally supervises LVN practice and aide tasks |
| Evaluation | Reports changes in response and suggests changes to the plan | Develops the plan that the LVN's suggested changes go to |
| Supervision | May not supervise an RN; in nursing homes may supervise other LVNs under RN oversight | Supervises LVN practice |
Medication work sits inside the implementation row. Position Statement 15.25 says LVNs are educationally prepared to give medications and treatments ordered by a physician, podiatrist, dentist or other authorized prescriber, including PA and APRN orders under the related position statements.
Sources
Texas Board of Nursing Position Statements 15.3, 15.25 and 15.27. Directed scope definition, supervisors, structured settings for 12 to 18 months, focused assessment, IV validation course, PICC and midline limits, medication administration, nursing process comparison, revision January 2022
Texas Board of Nursing, Nursing Practice FAQ. Initial assessments, focused vs comprehensive assessment definitions, LVNs may not initiate care plans, triage beyond LVN scope
Common questions
Can a Texas LVN write a nursing care plan?
Not the initial one. The Texas BON FAQ says LVNs may not initiate care plans but may contribute to planning and carrying out the plan. Only the RN develops the initial plan and makes nursing diagnoses.
Can a Texas LVN do telephone triage?
The board's practice FAQ says it believes triage, telephone triage and being on call for urgent issues are beyond LVN scope, because they require independent assessment that LVN education does not prepare for.
Which tool does the Texas BON want LVNs to use for a new task?
Position Statement 15.27 recommends the board's Scope of Practice Decision-Making Model whenever you are unsure whether a job, policy or assignment is safe and legal for an LVN.