please respond.

  1. I have a very serious question. I have been looking on the internet for answers and asking around but no one really has a definate answer for me. I recently started working in a physicians office, a walk in,urgent care clinic. I just took this job for extra money until I can complete my RN degree. However, I am a LPN and am usually the only licensed personnel in the clinic other than the doctor. There are mostly medical assistants and medical lab tech students. They give IM meds, start and maintain IV's, answer medication and nurse questions/calls. My question is are Medical Lab Tech's and Medical assistants certified and covered to perform these tasks ,mostly I am concerned with IV therapy. MLT's to my knowledge do not have pharmacology and the student MLT's do not have any other type of formal training to be safely administering medications. I just do not want people working under my license, if that is the case, that could possibly endanger patients and my license. Does anyone know the scope of practice or limitations or am I reading way too much into this situation?
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  2. 9 Comments

  3. by   Charles S. Smith, RN, MS
    Originally posted by dixiechic:
    I have a very serious question. I have been looking on the internet for answers and asking around but no one really has a definate answer for me. I recently started working in a physicians office, a walk in,urgent care clinic. I just took this job for extra money until I can complete my RN degree. However, I am a LPN and am usually the only licensed personnel in the clinic other than the doctor. There are mostly medical assistants and medical lab tech students. They give IM meds, start and maintain IV's, answer medication and nurse questions/calls. My question is are Medical Lab Tech's and Medical assistants certified and covered to perform these tasks ,mostly I am concerned with IV therapy. MLT's to my knowledge do not have pharmacology and the student MLT's do not have any other type of formal training to be safely administering medications. I just do not want people working under my license, if that is the case, that could possibly endanger patients and my license. Does anyone know the scope of practice or limitations or am I reading way too much into this situation?
    Clearly, check with the Georgia Board of Nursing for scope of your responsibilities. Ask them directly. You will get the appropriate answer.

    regards and best of luck
    Chas

  4. by   lorrie
    dixie
    this is very odd but this is exactly something i have been up against myself now for a while. it is very scary that unlicensed personnel are perfoming the exact same tasks as a nurse. a person off the street could watch a doctor do a cardiac cath for five years, eight hours a day and probably go through the motions himself after a while, but not knowing why he was doing what he was doing, or the consequences of a wrong move. i just feel a little uncomfortable with people "going through the motions" but having no idea why. i am currently putting in phone calls and e-mails regarding the legality of the situation and will definately keep you posted on the findings.
  5. by   puzzler
    Dixie

    Contact your state board as soon as possible. I would hate to think that the persons in that office are working under your license. It is always better to be safe than sorry.

    When you get an answer, please post it so we will all know the outcome.

    ------------------
    Sheryl
    If you enjoy word puzzles come visit me at www.CrosswordsForNurses.com
  6. by   NRSKarenRN
    DIXIECHIC:
    What forms did you sign for employment? Do you have a copy of your job description? These are starter places to look for answers to your questions which should have been explicitly stated at your interview. Who owns or manages this clinic?? If not owned by a single party e.g. physician, there should be a policy and procedure manual somewhere....MAKE SURE YOU READ IT!!! As an LPN in most states, you can only funcion under the direct supervision of an RN or licensed physician. If you are the only licensed personal on duty; are unable to get answers to your questions from the above mentioned sources, then you should gently inquire from the supervising physician level of responsibilities AND report your concerns--keep a note in a logbook of your concerns at home. Many people fall into sloppy habbits. If your job description does not state that you are responsible for unlicensed personnel, then any probleems that occur with passing innaccurate/incomplete orders falls on the physicans shoulders. Many private Drs. offices use assistive personnal to call in orders UNDER the physicians license. If this clinic is receiving federal funding AND the clinic is allowing theese unlicensed personal to pass them selves off as nurses, they could be in for BIG fines. Know that by discussing this, you might cause shock waves or be suprised Drs unaware of fron desk actions. If your concerns aren't taken seriously and if you feel this is serious problem, you need to leave AND report this to Clinic owners. Good Luck.

    [This message has been edited by NRSKarenRN (edited January 24, 2001).]
  7. by   purplemania
    Contact your state nursing board for the definite answer. They are working under the MD's license now, not yours. Once you get your RN you NEED TO KNOW how to delegate work so you will need to know who can legally do what job.In some states IV therapy can be started by unlicensed personnel if MD is on site. I recommend you find out from Nursing Board. Local University or nursing school can give names/addresses of who to contact also. Good luck!
  8. by   christihendry
    Dixie,
    It is a good idea to check with your state board there in Georgia. However, I know for a fact that in IL, IN, MO, WI, that only LPN and RN can pass any kinds of medication. CNA's and Techs cannot. If the agency gets in a bind it is your license on the line. It is the same for IV's. In fact, in these states RN's must start the IV's and give IV pushes. LPN's can only hang bags and change tubing. I would be very leary allowing people you don't trust to function on your license. If you are the only licensed nurse in the facility it is your license they can take away. Be cautious!!!
  9. by   LOPAIDNURSE
    A CORRECTION IS NEEDED FOR THE LPN SCOPE OF PRACTICE IN INDIANA. WE CAN START IV THERAPY, PUSH SOME IV MEDS, HANG BLOOD AFTER IT HAS BEEN CHECKED BY 2 NURSES, ONE AN RN, AND DRAW BLOOD FROM ART LINES. THERE REALLY IS NOT MUCH EXCEPY PAY THAT MARKS THE DIFFERENCE. I HAVE BEEN AN LPN FOR 23 YEARS AND HAVE SEEN MY SKILLS BEING ELEVATED AS THE CRISIS CONTINUES.
  10. by   duckie
    I agree with "lopaidnurse". I am an LPN in Indiana, have been for over 20 years and am qualified to start IV's. To do this we must have further education, but we are qualified once we complete it.
  11. by   Natalie25
    I have heard of Medical Assistants giving po, IM or SQ meds. Never IV meds. Where I work now LPNs can't even give IV meds. just saline. or maintenance IVs. I think it's ok for LPNs to give IV medications as long as they know the side effects or complications of the medication they are giving and are able to properly assess a patient's condition. Where I work, RNs are the only nurses allowed to do daily assessments.

    But if you don't know your scope of practice it's your responsibility to read the policy book

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