Are nursing students allowed to give IV push meds?

mom2michael, MSN, RN, NP · Sep 18, 2005

We can give any drug we feel comfortable giving as long as our instructor is present and she also feels comfortable with us giving it to the patient. I'm in my 2nd semester and I've done 30 or so IVP.

LPNs where I work (ER) are not allowed to do IVP or hang blood because it is outside their scoop of practice for the state I live in.

Murse901, MSN, RN · Sep 18, 2005

In Tennessee, LPN's can be trained and certified by the facility they are working at to start IV's and push meds, but the training is not included in LPN school. After certification, they still need RN supervision.

GrnHonu99, RN · Sep 19, 2005

oooh i see! thanks guys...we have been giving IVP meds..in fact it was the first med I ever gave...syntroid IVP...all went well im glad to say...

I guess the rationale behind why an LPN cant push meds makes sense..but it seems that you could do just as much damage through IV?...can they adm. narcs? Im pretty sure we as nursing students arent allowed...although the other day at clincals the nurse that was assigned to my pt. was still in training...so there were tech. two nurses..her and her preceptor, and when it came time for my pts. pain meds, they asked if I wanted to give it...I said no, bc for one she already had it drawn up and two, I didnt think we were allowed to give narcs...better safe than sorry...I let her give it.

christvs, DNP, RN, NP · Sep 19, 2005

I was just wondering if nursing students are allowed to give IV push meds during clinicals..Is it true that LPN's are not allowed to give IV push meds? if it is what is the rationale behind that? Thanks.

I would say it depends on where you live. I live in Mass & when I was a nursing student (graduated in May!) I could give IV pushes, but that was cuz I was an RN student. The LPNs & LPN students can't give IV pushes in my state. I don't know why-it seems silly to me! I work with LPNs & they are all very capable-I think it's just a state board regulation thing.

MQ Edna · Sep 19, 2005

I'm in TX here, as an LVN student, we could do saline flushes but no IV push meds....once I got my LVN, the facility I work at I can push almost any drug..including cardizem, dig, narcs etc......i'm ACLS certified and can run a code but cannot push most of the code drugs (except epi and atropine).....lopressor and a few other iv push drugs can't be given by LVN's but most can here. We can also take pt's on Dopamine, Cardizem and heparin drips on telemon monitors, and pca pumps. Our restrictions here as LVN's include spiking blood, admission assessment, and removal of PICC's, central lines and IJ's, but we can assist in insertion of them. From what I have been told we can remove chest tubes. I work on a cardiovascular intermediate care (step down CCU) unit.

MQ Edna · Sep 19, 2005

I went for my RN BSN and I gave IV push meds from the start. I am in pa and had clinicals in de and pa. The only time we weren't allowed to was in our peds rotation but that was the hospitals rules...we couldn't give any IV med. LPNS are not allowed to push IV meds in either state also. I think its because of how dangerous iv push meds are and the side effects that can result from them. And like above it is def not in their scope of practice but that doesn't mean anything at some facilities.. believe me I've seen it with my own eyes!

I don't know about training in your state, but I being one, and work with many LVN's who have great assessment skills and great knowledge. Most the LVN's are who everyone goes to with questions, including RN's. If an LVN cannot monitor for adverse reactions of IV push meds, how are they to know the adverse reactions of other meds? State laws regulate everything, but do not regulate how good of a nurse someone is.

AuntieRN · Sep 19, 2005

I am in SC and in my third semester of a 5 semester program. We are allowed to push IV drugs with our instructor present. LPN's are not allowed to give IV meds here either. Seems to me there was also something about NARCs and LPNs too but I am not sure exactly what it is. I cannot remember if the pain med the LPN couldn't give was IV or not.

elizabells, BSN, RN · Sep 19, 2005

In some hospitals in NY, RNs can't give some IVP meds either. The rationale is supposedly that there is very little time to catch a mistake once the med has been pushed, but if it's injected into a bag of fluids like NS, there's more time to fudge.

Spatialized · Sep 19, 2005

In our 2 year program we've been pushing IV meds since day 1. Our first time our instructor had to be present, then after that as long as we were with the nurse (and they were ok with it), we could push meds. I've done a bit, from narcs to saline and it really is great experience. We can also flush lines, PICCs, centrals, was able to work with on art-line once in ICU, so we get a great variety. Here too (AZ), LPNs can't push meds, but can hang piggy-backs and the sort. It really is state by state.

Tom

Thunderwolf, MSN, RN · Sep 19, 2005

So, general consensus is, thus far, LPNs/LVNs, have set limitations (by most states) by how a med can be given IV...certain IVPB and saline flushes ok, but no IVP or blood products. What is also clear is that a facility can not go beyond the set limit imposed by that state.

RN students can give all IV forms (depending upon student readiness), but under direct supervision by their instructor...since it is done under the supervising RN's license.

Just a rehash to pull it all together.

Good discussion, folks.

Wolfie

pyxeduhst5282 · Sep 19, 2005

I think that depends on which state you are in...and which hospital you have your clinicals in. I remember when I was in nursing school....we weren't allowed to push ANYTHING at one of the hospitals...yet another one let us push meds....so I think it varies from hospital to hospital.

I was just wondering if nursing students are allowed to give IV push meds during clinicals..Is it true that LPN's are not allowed to give IV push meds? if it is what is the rationale behind that? Thanks.

Thunderwolf, MSN, RN · Sep 19, 2005

I remember when I was in nursing school....we weren't allowed to push ANYTHING at one of the hospitals...yet another one let us push meds....so I think it varies from hospital to hospital.

Very good point. A facility can "choose to limit certain clinical practices" in their setting, but...."can not exceed" that state's standards. This accounts for some of the variability one may see from one facility to another. One facility may authorize an RN to remove a triple lumen and another may not...but again, only if the state specifies that removal falls within the RN practice to remove them in the first place. The state sets the standard. Regardling nursing students, a facility may limit further, depending upon their own comfort level with students and their own sense of liability towards the patient(s).