Reference check questions for licensed practical nurses

In long-term care, the licensed practical nurse may give every scheduled medication on a hall, do the treatments and act as the nurse in charge. In home health and clinics, they carry out much of the care an RN or provider has planned. The license shows the candidate passed the licensing exam. It does not show whether their medication pass is accurate, whether the count balances when they hand over the keys, or whether a resident’s change in condition reaches the RN in time.

The people who worked with the candidate can tell you those things, and one thing more that matters in this role: whether the candidate knows where an LPN’s practice ends. Ask each reference what they saw the candidate do, on which shifts and for how long, and give the most weight to the RN who directed their work.

Who to ask

• The RN who directed their work, such as a nursing supervisor or director of nursing, who knows which problems the candidate brought to them, and how early.
• A nurse who took report from the candidate at shift change, for the state of the cart, the count and the residents handed over.
• A nursing assistant they led on a hall, when you are hiring a charge nurse.
• For a new graduate, a clinical instructor from their practical nursing program.

Questions to ask, by competency

Choose the competencies that matter most for the position and two or three questions from each. Ask every reference the same set, and when an answer is a rating, ask for the example behind it.

Medication pass and controlled substances

The LPN often gives the scheduled medications for a whole hall in one pass, against the clock and with constant interruptions. The controlled substance count at shift change is where an error, or a loss, first comes to light.

1. Walk me through the candidate’s medication pass on a full hall. How did they keep to the times without skipping checks?
2. What did the candidate do when a resident refused a medication or could no longer swallow tablets?
3. Did the controlled substance count ever fail to balance at a shift change the candidate was part of? What did they do before signing?
4. How would you rate the accuracy of the candidate’s medication administration records, compared with other LPNs you have supervised? (rating)

Scope of practice and escalation

The Bureau of Labor Statistics notes that LPN and LVN duties vary by state, for example in whether they may start IV drips, and that states decide how closely they must be supervised. A safe LPN knows where their own practice ends and brings in the RN or provider early.

1. When a resident’s condition changed on the candidate’s shift, what did they report to the RN or provider, and how soon? Can you describe one time?
2. Have you seen the candidate asked to take on a task outside an LPN’s scope? What did they say?
3. How did the candidate handle a verbal or telephone order from a provider, from the read-back to the chart?
4. If the candidate made home visits, how did they keep the supervising RN informed between the RN’s own visits?

Treatments and documentation

Dressing changes, wound care and the notes that go with them are how the RN and the provider judge whether a plan of care is working. A treatment that was done but never charted looks the same as one that was missed.

1. How reliably did the candidate complete treatments, such as dressing changes, on time, and describe the wound when they charted it?
2. If a treatment or medication was late or missed on their shift, how did the candidate record it, and who did they tell?
3. When you audited charts on the candidate’s hall, what did you find in their notes and treatment records?

Leading nursing assistants

In long-term care the LPN is often the nurse in charge of a hall, assigning nursing assistants, checking their work and answering to the RN supervisor.

1. How did the candidate assign and check on nursing assistants’ work during a short-staffed shift?
2. When a nursing assistant reported something about a resident, such as a new bruise or an untouched meal tray, what did the candidate do with it?

Close the reference

End every reference the same way: ask whether they would hire or work with the candidate again and why, what support would help the candidate do their best work, and whether there is anything else you should know. The general question bank explains why the first of these matters most.

Checks a reference does not replace

• Permission to work in the destination state. Before assigning LPN or LVN duties, confirm an active license covering the work state or an applicable active Nurse Licensure Compact privilege. Check restrictions and public discipline with the relevant board of nursing and Nursys QuickConfirm. Its authorization-to-practice map shows coverage from participating boards; for a compact privilege, verify the home-state multistate license and active privilege in the state where care will be provided. A valid single-state license issued elsewhere does not authorize practice in your state.
• What your state lets an LPN do. Read your board of nursing’s rules before assigning work such as IV therapy. The candidate’s last state may have drawn the line somewhere else.
• The federal exclusion list. Search the HHS Office of Inspector General’s List of Excluded Individuals/Entities before the candidate starts. OIG’s guidance advises checking it before employing someone and periodically after that.

Warning signs to follow up

• A reference describes tasks that exceeded the candidate’s authorized scope under the rules where and when they were performed. Do not flag lawful work elsewhere merely because your state draws the line differently; separately confirm the candidate understands your state’s limits.
• Count discrepancies, missing signatures or unexplained waste on the candidate’s shifts.
• No RN or provider among the references, only peers or a staffing coordinator who never saw the candidate work.
• Vague answers about changes in condition, such as "they would tell someone", with no example of an actual call.

One warning sign is a reason to ask another question, not a verdict. Reference check red flags covers how to check a concern fairly.

Questions to leave out

Ask only about the work. Before an offer, the EEOC’s guidance says an employer may not ask a third party, such as a former employer, any question it could not ask the candidate directly. Leave out health, medical leave, age, family plans and other protected characteristics. What to leave out has the full list.

This article is general information, not legal advice. Confirm the requirements that apply to your organization, and in your state, with your counsel or HR policy office.