The Texas Board of Vocational Nurse Examiners' General Statement on the Scope of Vocational Nurse Practice
Texas does not have a practice act for vocational nurses. The law which governs vocational nursing in Texas (Occupational Code, Chapter 302) is a title act; therefore, specific nursing interventions and clinical skills relative to licensed vocational nurses (LVNs) are not delineated.
The patient care responsibilities of vocational nurses should be within the parameters of their educational preparation and their demonstrated abilities. The clinically intensive vocational nursing program prepares entry-level bedside nurses to provide direct nursing care to acutely and chronically ill patients, with predictable health outcomes, in structured health care settings. LVNs may expand their practice through continuing education.
LVNs and health care employers have a joint responsibility to assure that LVNs practice within the scope of their educational bases and demonstrated abilities. If employers assign LVNs patient care responsibilities that are beyond the basic nursing preparation, the employers should: 1) validate and appropriately document that LVNs are competent to perform the assigned patient care responsibilities, and 2) include the expanded practices in the LVN job description.
LVNs shall accept patient care assignments with due regard for the safety of the patients and sound health care practices.
BVNE/Scope (General Statement) Rev. 01/28/92
Role of the LVN in Intravenous Therapy Inclusive of Venipuncture
The licensed vocational nurse who is participating in intravenous therapy, has been instructed and has demonstrated competencies in the nursing interventions and clinical skills related to the maintenance of peripheral venous catheters is, in the opinion of the board, acting within the scope of vocational nursing.
It is the opinion of the board that the LVN shall not perform venipuncture, administration of intravenous fluids, intravenous medications and intravenous push medications until completion of a validation course which includes specific competencies for performance of venipuncture, administration of intravenous fluids, intravenous medications and intravenous push medications, to include patient assessment, monitoring and evaluation.
Further, it is the opinion of the board that the LVN shall not manage central venous catheters until completion of a validation course which includes specific competencies for central venous catheters, to include patient assessment, monitoring and evaluation.
All interventions and skills related to both peripheral and central lines must be completed in accordance with the orders of the authorizing physician and within the guidelines of the written policies, procedures and job descriptions approved by the health care employers.
Adopted June 13, 1995, Rev. September 14, 1999
Further info at:www.bvne.state.tx.us.