LPN IV Push

Qwiigley, BSN, MSN, DNP, RN, CRNA · Jul 18, 2002

Remember when you are looking at this issue, you are not looking at the "task", you are looking at the education and critical thinking behind the issue. LPNs are NOT RNs. They do not have the education and do not have the license to do everything a RN does. There are roles for each team member; don't muddy them up. Even if they have a "class", it does not make them educated enough. No, in California they are not permitted to do IVP. Where I work, they are not even hired into Critical Care Units, as they still need a RN to do their assessments, and give their meds.

Home Health Columnist / Guide · Jul 18, 2002

The LPN practice act is different for each state. LPN's can only perform the activities permitted by the state board of nursing they are currently practicing and licensed in. LPN's practice under physican or RN supervision and are permitted to perform those tasks delegated to them by these professionals as long as stat law DOES NOT prohibit them.

See these interesting articles:

NURSING INTERVENTIONS REVISITED

http://nursingworld.org/ojin/tpclg/leg_11.htm

MEDICATION ADMINISTRATION INTERVENTIONS THAT MUST BE PERFORMED BY A REGISTERED NURSE

Greer Glazer RN, CNP, PhD, FAAN

Legislative Editor

Glazer, G. (February 28, 2002). NursingWorld | OJIN: Legislative Column: "Medication Administration Interventions That Must Be Performed By A Registered Nurse" Online Journal of Issues in Nursing.

http://www.nursingworld.org/ojin/tpclg/leg_12.htm

WHAT MAKES SOMETHING A NURSING ACTIVITY OR TASK

Greer Glazer RN, CNP, PhD, FAAN

Legislative Editor

Glazer, Greer. (June 23, 2000). NursingWorld | OJIN: Legislative Column: What Makes Something a Nursing Activity or Task Online Journal of Issues in Nursing Available http://www.nursingworld.org/ojin/tpclg/leg_9.htm

In PA, LPNs can accept verbal orders only if immediate intervention needed; otherwise not permitted. ( Trying to get this changed x 10 years).

RE IV MEds

(f) The LPN may perform venipuncture and administer and withdraw intravenous fluids only if the following conditions are met:

(1) The LPN has received and satisfactorily completed a Board approved educational program which requires study and supervised clinical practice intended to provide training necessary for the performance of venipuncture and the administration and withdrawal of intravenous fluids as authorized by this section.

(2) A specific written order has been issued by a licensed physician for an individual patient under the care of a licensed physician.

(3) The LPN complies with written policies and procedures which are established by a committee of nurses, physicians, pharmacists and the administration of the agency or institution employing or having jurisdiction over the LPN and which set forth standards, requirements and guidelines for the performance of venipuncture by the LPN and for the administration and withdrawal of intravenous fluids by the LPN. A current copy of the policies and procedures shall be provided to the LPN at least once every 12 months. The policies and procedures shall include standards, requirements and guidelines which:

(i) List, identify and describe the intravenous fluids which may be administered by the LPN. The LPN is not authorized to administer the following intravenous fluids:

(A) Antineoplastic agents.

(B) Blood and blood products.

(D) Titrated medications and intravenous push medications other than heparin flush.

(ii) List, identify and describe the circumstances under which venipuncture may be performed, including technical and clinical indications.

(iii) List, identify, describe and explain principles, including technical and clinical indications, necessary for the identification and treatment of possible adverse reactions.

(iv) Provide for and require inservice instruction and supervised practice to insure competent performance of venipuncture and competent administration and withdrawal of intravenous fluids.

(4) An accurate record is made...

(g) The Board will issue annually to the LPN definitive information describing the nature, scope and extent of authorized functions and practice concerning immunization, skin testing, venipuncture and the administration and withdrawal of intravenous fluids.

http://www.pacode.com/secure/data/049/chapter21/subchapBtoc.html

**canoehead, BSN, RN** · Jul 18, 2002

Geeez, if an LPN can hang blood and give IVP meds what do they need RN's for?

sunnygirl272 · Jul 18, 2002

in nys, an lpn cannot do ivp, but can hang iv meds and start said iv...also cannot hang blood, but can monitor said blood...i will also admit i once gave epi down an et tube, under direct sprvsn of md & rns...i was the only one near enough w/ a free hand to do it...

stressedlpn · Jul 23, 2002

in my area LPNs can start and maintain IVs, hang piggybacks and any other IV med we can flush HLs ect however we cannot do IVP, we monitor hung bld ect. well I dont mind RNS went to school longer than I did, I always try to look at it as just one less med to give and move on to my next task. Besides I get perverse pleasure out of telling this one RN who really spends the whole 12 hours we are on duty in one spot, that I am not allowed to do the pushes, the sour look on her face makes our night. There is a silver lining around every cloud

Agnus · Jul 23, 2002

stressedlpn,

love yor perversity!

Love-A-Nurse · Jul 23, 2002

Originally posted by stressedlpn
in my area LPNs can start and maintain IVs, hang piggybacks and any other IV med we can flush HLs ect however we cannot do IVP, we monitor hung bld ect. well I dont mind RNS went to school longer than I did, I always try to look at it as just one less med to give and move on to my next task. Besides I get perverse pleasure out of telling this one RN who really spends the whole 12 hours we are on duty in one spot, that I am not allowed to do the pushes, the sour look on her face makes our night. There is a silver lining around every cloud

:)

P_RN, ADN, RN · Jul 23, 2002

In SC it's pretty much the same as NRSKarenRN listed. I don't know what I would have done without our excellent LPNs at times.

Oh when you say "push" you DO mean a bolus dose?

Some places I have been, minibags were referred to as "push."

OrthoNutter · Jul 23, 2002

Originally posted by canoehead
Geeez, if an LPN can hang blood and give IVP meds what do they need RN's for?

I'm with you on that one bud...:chuckle

OrthoNutter · Jul 23, 2002

Originally posted by nrw350
Please humor my stupidity lol. What is the big deal about a lpn administering iv drugs? I mean, I understand that you would probaly no wanting them administering diprivan (or other drugs such as that) without an MD or Anesthesiaologist nearby. Also, what is so hard about injecting something via iv into someone?

Thanks

Nick

lmao oh boy....please tell me you're not a nurse! I suppose to be simplistic, there's nothing hard about it but some IV drugs can't be pushed, they have to be done as an infusion. Others can be pushed but have potential for extravasation of the vein. Others yet again, can be pushed into a CVC but not a peripheral. Plus there's the holistic picture as well...side effects, adverse reactions, monitoring needs, documentation, titration etc etc and so forth.

It's a lot more complex than just shoving some water in a vial, shaking it up and sticking it in someone's vein. Nothing in any job is simple, let alone nursing.

Flo1216 · Jul 23, 2002

Where I live LPNS only go to school for 1 year. I don't know how it is anywhere else. They don't have to take all of the science classes that RNS have to take. The RN program I attend is 3 years, Monday-Friday 9-3. Clincal days we start at 7:30. In the hospital where I work, LPNS cannot do IV push, hang blood, do anything invloving a PICC or a port(except hang piggybacks) and they certainly cannot do dialysis. They also cannot work in the units or ER. Why not just let CNAS start IVS and insert foleys as well? Sure it might be more convienient for the RN, but would you want someone who went to school for a year to push medicine through an IV that goes directly into the heart, if someone you loved was a pt?Students aren't allowed to do it either. The scope of practice SHOULD be different , otherwise why should there be different scopes of practice? Why not just tell everyone to go to school for one year? Just an opinion. Sorry. Don't kill me.

Fgr8Out · Jul 23, 2002

quote:

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Originally posted by canoehead

Geeez, if an LPN can hang blood and give IVP meds what do they need RN's for?

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Originally posted by OrthoNutter

I'm with you on that one bud...:chuckle

Ditto....

Not to start WWIII but, when RN's become so willing to give up those areas of Nursing that are uniquely our scope... we're opening up ourselves to being replaced. I respect ALL the staff I work with, but I'm not willing to give up what I've worked so hard to attain.

Peace:)