IV Therapy for LPN's differences in standards

Nurses General Nursing

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Greetings All Nurses,

I just had a telephone interview with 2 nurse managers in WI for a hospital posiotion. Wow, what a difference a few states and a Nurse Practice Act makes! In Wi and there hospital an IV certification course is not required and LPN's can do so more after the orientation process than LPN's here in Ohio can do with the IV certification! There we can hang blood and blood products, piggy backs, push meds, do add mixtures and everything that goes with IV's. Here most of what I just said is not the case an Limited Therapy IV cert LPN can only start, hang fluids that are without add mixtures (hydration), no piggy backs, push saline or heparin for a hep lock, and BLOOD NO WAY! For those not cert we can only monitor, assess the site, adjust flow rates, and d/c IV's. I am in the latter group! What a difference a few 100 miles makes. This maybe a true selling point, for the position. The interview was for a Neuro/Ortho floor and a Cardic Step Down floor, not my first choice but for the IV experience alone I may just take this job! I am still looking though, today for those who may know or want a good LPN! :D

Peace,

Jami :)

ornurse2001

60 Posts

Hi Jami ! I had a simialr experience as an LPN when I moved from Illinois to NC back in 1991.In Illinois, LPN's are very limited-could not even hang plain, non-medicated IV fluids, much less do piggy backs or pushes.An LPN could not even start an IV there back then.I moved from there to NC and LPN's were catagorized as level I and level II, the latter having taken an in house IV training program.As an LPN II after your hospital's training program, you could start IV's, give IV push drugs with no exclusions, hang blood and blood products, manage cardiac drips etc.(of course under supervision of an RN charge nurse on the unit).I worked in a general ICU there and we typically had LPN's as the majority doing the assigned patient load, and sometimes had only one RN in the unit as a charge person whom would oversee the patient care and had no patient care assignments.The experience I gained in that position was invaluable to me when I later became an RN.Take all the opportunity for learning experiences that you can, it will definatly make you a more marketable resource!

Sue D

22 Posts

I was very interested to read this. In the UK HCA's (the LPN equivalent) are not permitted to administer any drug in any form. Sorry if I am being ignorant here but is an LPN more like our old Enrolled Nurse than a Health Care Assistant?

ornurse2001

60 Posts

Sue D-We have a variety of practice laws in this country that are not standardized nationwide;rather each state's board of nursing determines what is acceptable practice for different levels of nursing education.I'm sure that this is confusing for people not practicing or new to practice here in the good ole' USA-it is often confusing for us the practicing nurses.Nursing assistants(sometimes called PCA(patient care assistants)can take a certification course that varies some in duration but is basic to learning things such as giving bed baths, taking VS, feeding techniques, preventive skin care(such as turning and repositioning), etc.Some states have levels of nursing assistants that can do additional things such as insert foley catheters, set up oxygen, and add formula to existing TF bags.LPN's are further educated with an increased focus in the clinical realm to perform duties such as inserting feeding tubes, foley catheters, giving medications, documenting in the patient record....again-LPN practice varies state to state.Education for an LPN is usually a very intense FT training program lasting 10 months to 2 yrs in some states.They are also referred to as Licensed Vocational Nurses since education at this level is ua=sually obtained in a vocation school, rather than a college.There are various different practice models used in various facilities.In some facilities for instance; they may practice team nursing where which an RN would oversee the care performed by LPN and CNA(PCA)'s with the RN serving as a supervisor and coordintaor of care( and in some states all the IV therapy), the LPN passing medications, performing fingerstick Blood sugar checks, documenting nursing care in the chart...etc., and the CNA would obtain VS, give bed baths,etc.In the ideal situation these roles should meld and function as a team assisting one another where able and within the scope of their education and training to provide the highest quality care possible to a group of patients.*smile*I hope this helps.

P_RN, ADN, RN

6,011 Posts

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

The enrolled nurse in the UK and Au is very similar to our LPN/LVN. (Licensed Practical or Vocational Nurse). It's a 12-18 month program in a technical or hospital school usually.

In SC, the LPN is allowed to start IV needles, start and discontinue IV and IV fluids up to 20 nEQ of potassium in a minimum of 500 cc fluid. If over 20mEQ or under 500 cc the RN has to do it. Two of our best "stickers" were LPNs.

They can give IV antibiotics and H2 blockers like Cimetidine etc. They cannot give blood, but they can discontinue the site. They cannot give chemotherapy, or direct medication bolus other than Heparin 10mg/ml to keep IV patent. The cannot give Heparin for DVT IV, but can Subcut.

Now Sue tell us about nursing in the UK. Don't leave out a thing :)

Brownms46

1 Article; 2,394 Posts

Specializes in Everything except surgery.
Originally posted by P_RN:

The enrolled nurse in the UK and Au is very similar to our LPN/LVN. (Licensed Practical or Vocational Nurse). It's a 12-18 month program in a technical or hospital school usually.

In SC, the LPN is allowed to start IV needles, start and discontinue IV and IV fluids up to 20 nEQ of potassium in a minimum of 500 cc fluid. If over 20mEQ or under 500 cc the RN has to do it. Two of our best "stickers" were LPNs.

They can give IV antibiotics and H2 blockers like Cimetidine etc. They cannot give blood, but they can discontinue the site. They cannot give chemotherapy, or direct medication bolus other than Heparin 10mg/ml to keep IV patent. The cannot give Heparin for DVT IV, but can Subcut.

Now Sue tell us about nursing in the UK. Don't leave out a thing :)

I'm very sorry to disagree with you P_RN, but there are no such stipulations governing an LPN's practice in S. C. The nurse practice act only requires that the LPN receive appropriate, and documented education in whatever extended practice the LPN is to be allowed to preform. :D I worked as a travel nurse from Beaufort to Columbia, and the only restrictions where those imposed by the facility I worked in during my 4yrs there.

Sorry ..I don't mean to be rude, just felt I needed to give a different perspective. :D

Brownie :D

gsands

6 Posts

Hello Jami--I'm glad you found this hospital. But it is different around the state. I work at a VA Hospital who jsut received magnest Status and LPNs are not even allowed on the floor unless they take the name "health Tech". They are not allowed to administer meds, touch IVs--heaven forbid they even look at blood. In the ED they have special certification and can start IVs, draw, etc. As an LPN returning for RN education I can say that if I were to stay an LPN I would not work in Madison....it's just no fun any more!

Good luck to you. I have many great LPN friends who are so good at what they USE to be able to do.!

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