Worried About I.v.'s

  1. here in CA, there is a push for LVN's to be able to hang i.v. meds. i'm not worried about my job, i'm worried that i will be asked to supervise any number of LVN's while they hang i.v. meds, most without the knowledge base to know proper doses, proper uses (micro),. infiltration, phelbitis, drugs that need to be diluted (K), drugs very hard on the veins....etc. etc. etc.....if hanging i.v. meds is just about programming the pump (as some of my pt. think), then why don't we just let the pt. hang their own. ....am i wrong to want to keep i.v. meds something that just rn's can do. worried about my license hanging on more than one lvn, as they go about doing a highly skilled job. thoughts. p.s. i love the lvn's that i team lead, and i am not a control freak, and i realize that there are highly educated lvn's out there.....i just worry about my license.....
    •  
  2. 25 Comments

  3. by   P_RN
    Our LPNs (South Carolina)have been giving IV meds for 20+ years. I learned some of my best techniques from LPNs. There certainly should be some intense special training, but I have no problem with their giving any approved meds.

    There are certain restrictions. Over 40meq Kcl in less than 1000cc, blood, chemo, amphotericin B, about 15-20 meds as of 2 years ago

    And here many patients do indeed give their own antibiotics at home.
  4. by   ktwlpn
    Originally posted by cokie
    here in CA, there is a push for LVN's to be able to hang i.v. meds. i'm not worried about my job, i'm worried that i will be asked to supervise any number of LVN's while they hang i.v. meds, most without the knowledge base to know proper doses, proper uses (micro),. infiltration, phelbitis, drugs that need to be diluted (K), drugs very hard on the veins....etc. etc. etc.....if hanging i.v. meds is just about programming the pump (as some of my pt. think), then why don't we just let the pt. hang their own. ....am i wrong to want to keep i.v. meds something that just rn's can do. worried about my license hanging on more than one lvn, as they go about doing a highly skilled job. thoughts. p.s. i love the lvn's that i team lead, and i am not a control freak, and i realize that there are highly educated lvn's out there.....i just worry about my license.....
    The LVN's currently working in your state will certainly need to be trained to do so and IV training will be added to the curriculum of their programs.I think that you can rest assured that they will not just start mixing piggies and stabbing patients blindly.It took several years here in Pa to implement this and there are some restrictions still on LPN's here.You can help by going to your staff education dept now and offering to help implement a training program for your co-workers...Feel the love..
  5. by   NRSKarenRN
    Part of the concern in Calif, is LVN's are now permitted perform IV push med administration according to the following Board of LVN regulations in Dialysis and blood bank settings--including directly into Quinton CVP type catheters---UNDER RN or MD direction or in "close vicinity approximation" which we KNOW will be stretched to the limit.


    Check out these links:

    "This proposal will add new language in regulation to permit licensed vocational nurses who are Board-certified in intravenous therapy to administer specified intravenous medications in hemodialysis, pheresis and blood bank" settings.http://www.bvnpt.ca.gov/pdf/regchange.pdf

    Law approved 1/29/03: http://www.bvnpt.ca.gov/pdf/availsecmodtext.pdf

    Comments:
    http://www.bvnpt.ca.gov/pdf/fsr12.03.02.pdf
    Last edit by NRSKarenRN on Apr 26, '03
  6. by   ktwlpn
    [QUOTE]Originally posted by NRSKarenRN
    [B]Part of the concern in Calif, is LVN's are now permitted perform IV push med administration according to the following Board of LVN regulations in Dialyis and lood bank settings--including directly into Quinton CVP type catheters---UNDER RN or MD direction or in "close vincinty proximation" which we KNOW will be stretched to the limit.

    >>I know that here in Pa techs are performing those functions under the direction of an RN or physician....non-sensical,isn't it?
  7. by   Jay-Jay
    This is scary!! In Ontario, RPN's (registered practical nurses) are allowed to give hydration therapy. When I was last in for surgery, the RPN was running the IV at 125 an hour. She did have orders to decrease it to KVO when/if I was drinking and peeing well. I had to BEG her to decrease it as I was going into fluid overload (borderline hypertensive, AND losing control of my overloaded bladder!) I think an RN would have had the judgement skills to have reduced it WITHOUT being asked.

    RPN's/LVN's giving IV meds, esp. IV push meds?? Scares the daylights out of me!!
  8. by   ktwlpn
    Originally posted by Jay-Jay
    This is scary!! In Ontario, RPN's (registered practical nurses) are allowed to give hydration therapy. When I was last in for surgery, the RPN was running the IV at 125 an hour. She did have orders to decrease it to KVO when/if I was drinking and peeing well. I had to BEG her to decrease it as I was going into fluid overload (borderline hypertensive, AND losing control of my overloaded bladder!) I think an RN would have had the judgement skills to have reduced it WITHOUT being asked.

    RPN's/LVN's giving IV meds, esp. IV push meds?? Scares the daylights out of me!!
    I would hate to see this thread turning into THAT debate so I'll just say-I have worked with several NURSES whom were seriously lacking in common sense....
    Last edit by ktwlpn on Apr 27, '03
  9. by   sueb
    I don't necessesarily think that an RN, just because he/she has those initials, would have know to slow down the I.V. Every LPN that I know has to go through an IV course just like the RNs do. Where I live IV Therapy is not a part of the RN education, it is taught by the facility the nurse works at.I know RNs who cannot touch an IV because they are not certified. RN or LPN, I think IV therapy is a skill that can and should be taught to both.
  10. by   MishlB
    I don't think you are giving enough credit to LPN's. Obviously training will be required...doesn't scare me at all. Don't want to debate RN vs LPN...
  11. by   nurse2002
    Originally posted by Jay-Jay
    This is scary!! In Ontario, RPN's (registered practical nurses) are allowed to give hydration therapy. When I was last in for surgery, the RPN was running the IV at 125 an hour. She did have orders to decrease it to KVO when/if I was drinking and peeing well. I had to BEG her to decrease it as I was going into fluid overload (borderline hypertensive, AND losing control of my overloaded bladder!) I think an RN would have had the judgement skills to have reduced it WITHOUT being asked.

    RPN's/LVN's giving IV meds, esp. IV push meds?? Scares the daylights out of me!!
  12. by   nurse2002
    Originally posted by Jay-Jay
    This is scary!! In Ontario, RPN's (registered practical nurses) are allowed to give hydration therapy. When I was last in for surgery, the RPN was running the IV at 125 an hour. She did have orders to decrease it to KVO when/if I was drinking and peeing well. I had to BEG her to decrease it as I was going into fluid overload (borderline hypertensive, AND losing control of my overloaded bladder!) I think an RN would have had the judgement skills to have reduced it WITHOUT being asked.

    RPN's/LVN's giving IV meds, esp. IV push meds?? Scares the daylights out of me!!
    Sorry, but being a nurse, a lpn, if I even thought I was hypertensive an in fluid overload and the nurse would not kvo me, I would do it myself.
  13. by   cokie
    back to the argument that there is much much more to i.v. therapy than there is to being i.v. certified. i.v. certification means that one observes proper technique when starting an i.v. line. running i.v. meds is another story. as far as teaching someone the skill of running i.v. meds, ok, start with pharmo, then take micro, a and p, then and only then do i truly believe that one can have the big picture.....also, study the effects of drugs on the renal system, and the liver....oh my, does this sound like the r.n. curriculum,,,,,bingo.....like i said, it's a lot more than just programming the pump. as far as pt. doing their own i.v. therapy, no guess work there...doctor orders the meds..they hang them. in our area an rn comes by once a day to check the site.
  14. by   nurse2002
    Originally posted by cokie
    back to the argument that there is much much more to i.v. therapy than there is to being i.v. certified. i.v. certification means that one observes proper technique when starting an i.v. line. running i.v. meds is another story. as far as teaching someone the skill of running i.v. meds, ok, start with pharmo, then take micro, a and p, then and only then do i truly believe that one can have the big picture.....also, study the effects of drugs on the renal system, and the liver....oh my, does this sound like the r.n. curriculum,,,,,bingo.....like i said, it's a lot more than just programming the pump. as far as pt. doing their own i.v. therapy, no guess work there...doctor orders the meds..they hang them. in our area an rn comes by once a day to check the site.
    The LPN program I went to we had to take micro and AetP, study the effects of drugs on the renal system and liver. The IV therapy course I had to take was very intense. We had to take the micro and AetP before entering the program.( IV therapy was taken during the program). We had to study why electrolytes are given and which ones are given for what. What labs constitute renal failure and why someone might have elevated liver enzymes. Also what meds should or should not be given to these patients IV or any other way. Yadda, Yadda, Yadda

    Then I move to the state I am in now. They wanted me to take their IV therapy class. (They take IV therapy AFTER they get out of the nursing program) So, I took it. To me it was like taking a kindergarden class. (I swear Im not trying to offend anyone).
    Just the basics. Look at the order, hang whatever it is and get familiar with the pump. I could not understand this. They did go over transfusion reactions, I will give them credit for that.
    Im sure these nurses that took this as their only IV course will learn something new everyday about IV therapy and everything else. I do. As nurses our educaton is an everyday ongoing thing.
    Im sure there are just as many RNs as there are LPNs that learn something new about this subject (and others) every time they go to work.


    Well, time to stop beating that dead horse (You know the one)

close