Changes to Respiratory Care Scope of Practice Effective 10/01/2025

The Board of Vocational Nursing and Psychiatric Technicians (BVNPT) would like to inform licensees, employers and educators of regulations adopted by the Respiratory Care Board (RCB) impacting the scope of practice licensed vocational nurses (LVNs) going into effect on October 1, 2025.

These regulations impact the LVN scope of practice with various changes, as described below. BVNPT licensees, employers and educators are expected to comply with the regulations.

LVNs CAN perform the following:

  • Patient data collection.
  • Application and monitoring of a pulse oximeter.
  • Medication administration by aerosol that does not require manipulation of an invasive or non-invasive mechanical ventilator.
  • Heat moisture exchanger (HME) and oxygen tank replacement for patients who are using non-invasive mechanical ventilation.
  • Hygiene care including replacement of tracheostomy ties and gauze and cleaning of the stoma sites.
  • Use of a manual resuscitation device and other cardio-pulmonary resuscitation technical skills (basic life support level) in the event of an emergency.
  • Documentation of care provided, which includes data retrieved from performing a breath count or transcribing data from an invasive or non-invasive ventilator interface.
  • Observing and gathering data from chest auscultation.

LVNs CANNOT perform the following:

  • Manipulation of an invasive or non-invasive ventilator.
  • Assessment or evaluation of observed and gathered data from chest auscultation, palpation, and percussion.
  • Pre-treatment or post-treatment assessment.
  • Use of medical gas mixtures other than oxygen.
  • Preoxygenation or endotracheal or nasal suctioning.
  • Initial setup, change out, or replacement of a breathing circuit or adjustment of oxygen liter flow or oxygen concentration.
  • Tracheal suctioning, cuff inflation/deflation, use or removal of an external speaking valve, or removal and replacement of the tracheostomy tube or inner cannula.

Important Note: The Vocational Nursing Practice Act authorizes LVNs to perform services under the direction of only licensed physicians, registered nurses (including nurse practitioners [NP]) and naturopathic doctors. LVNs work with Respiratory Care Practitioners as part of patient care team members but shall only work under the direction of a licensed physician, registered nurse (including NPs) and naturopathic doctors.

Additional Resources and Information

  1. SCHOOL NURSE EXEMPTION:
    With Governor Newsom's signature, SB 389 (Ochoa-Bogh) will continue the current authorization in Education Code Section 49423.5 for LVNs working under the supervision of a credentialed school nurse to perform suctioning and other basic respiratory tasks/services for students as part of their school-day care. Please see SB-389 Pupil health: individuals with exceptional needs: respiratory services: licensed vocational nurses for more information and updates on the bill's status.
  2. LVN EDUCATORS:
    California schools for Vocational Nursing are urged to continue providing the curriculum approved by the Board of Vocational Nursing and Psychiatric Technicians, including the respiratory system and care of patients. The National Council Licensing Examination for Practical and Vocational Nursing (NCLEX-PN) will continue to include this subject matter.
  3. RCB INFORMATIONAL WEBPAGES