[Inkat]

Originally I began reading allnurses forums when I was in college for my LPN certificate. I have achieved that and am now working on my LPN-to-RN, which I will complete in December of this year. In the meantime, I am working on an acute care floor at one of our area hospitals. I was given strict instructions and a list of what I could do as an LPN versus an RN. I have tried to adhere to that list. However, I am finding that after sending me to a 6-hour class for "IV certification" where we got basically the same info (on a LPN level) I was considered "competent" to manage IVs. Now mind you, I had never physically started an IV on a live person. I am then placed on the floor and expected to not only start IVs but "monitor" morphine drips, insulin drips, and blood transfusions. I questioned my assignments to these patients and was told that I couldn't "start," aka push the button on the pump, but I could "monitor" after it was started.

I say all this not to try to cause problems or an outcry of "you shouldn't be doing this", but rather to ask for some help with information. I am learning more each week during my schooling but I want to be sure that I am keeping the patients safe until I am actually taught about these various IV treatments. I tried to ask the nurses on my floor but the result was a bad evaluation for questioning my assignments and "saying I can't do anything." I was shocked and now understand I need to find alternate methods to obtain my needed information because work obviously isn't the place to find out without repercussions. I need some basic information on what to watch for while "monitoring" the patient on morphine or insulin drips and during blood transfusions. I know the side effects, however, many of the side effects can be the result of other disease processes or medications.

I guess I am needing practical information from experienced nurses. I love nursing and I want to be an outstanding nurse. And I want my patients to be safe. Can anyone please give me some help?

And thanks in advance.........I have learned there is just about nothing more reliable than experience.

[ktwlpn]

You are still functioning as an LPN,correct? Go to your state BON web site and look up your scope of practice.Then go to your facilities policy and procedures manual and do the same (in my experience they tend to differ)
Make sure you have fast and easy access to educational materials on the unit and utilize your charge nurse also if you are unsure of anything.The IV room on your unit is the first place to start -most have easily read charts and posters hanging up for you to refer to.
What specifically would you be looking for with these drips besides infiltration? Think about the meds,their actions and the side effects. Think about fluid overload in the case of transfusions What action do you take right away if you detect trouble? Remember your ABC's. Your facility policy and procedure manual will spell all of this out.You have learned all of this as an LPN-ypu know this stuff. You are preparing to go more in depth into this route then you have and it seems a little scary because it is alot of info at once-break it down into smaller bites for easier digestion.
I also received on the job IV certification at an acute care facility and was expected to apply my new knowledge on the unit right away-the more IV starts you attempt the faster you'll become proficient.In my state an RN must be at bedside the first 15mins of a blood transfusion then an LPN can continue monitoring the pt. Same for insulin,morphine,dopamine (for renal perfusion on the floor)
Take a deep breath and take smaller bites-good luck

[Fiona59]

My training included the function of monitoring IV infusions. It was covered in our clinicals. At that time we could hang new bags but nothing medicated.

Things change and we are now hanging our own IV meds, starting heparin drips and insulin drips with a co-signing RN.

Just know your local practice regulations and you'll be fine. Does your facility employ nurse educators? Ask one to follow you on your shift. That is their job. To ensure competent practice of all staff.