Are you allowed to give IV push meds at clinicals?

[twintoo]

I always understood the policy at our school to be "you can only give IV push meds with a licensed person" UM I learned today that you can only give IV push with the instructor! I was helping an RN and she asked me to draw up this med. I drew it up and then she said, "you can give it." I said "me?" b/c it wasn't my client and then she said yes and then after you give it I will let you tell me why *I* wouldn't give it. So...dum-de-dumdum I give it! Then she asked me "so why wouldn't *I* give that med?" I said "b/c I drew it up". DING DING DING I was right! LOL She runs to the instructor to brag on how well I did...Uh oh! Here comes my instructor red faced and shaky and asks me about it. I really didn't think I did wrong but I did! BIG TIME!!! Now, I am thinking she is going to give me a ZERO for part of my grade!

SO, my last clinical of the semester and my first screw up since day one...I am glad that I didn't kill anyone but gosh, I feel like CRAPOLA!

**Susan, if you are reading this...yes this is me!! LOL**

[Kudra]

good luck, twintoo! :)

beth

[colleen10]

Hi Twin Too,

Sorry for your predicament. Did your instructor ever tell you that you are not to administer meds. without them present?

I know in my program, in a way, we were sort of thrown to the wolves so to speak. No one ever outlined what we could or couldn't do in clinical and honestly, with my clincial instructor, what you did would have been ok if you had at least once given an IV push med. with her to ensure that you could do it correctly.

Seems clinical "unsafes" are subject to the instructors interpretation and they vary widely in my program.

Our instructor must be present when we administer scheduled meds. but with the prn meds. it's ok for us to give them with the nurse assigned to the patient. Usually though, I'll walk by my instructor and just run it by her and say that my patient has such and such a med. prn for pain and I'll give it with the nurse.

I think sometimes nurses and instructors forget that we're new and eager to please everyone. Sometimes it's hard to figure out who to listen to when you have an instructor that you sometimes can't find, a nurse assigned to the patient a doctor and/or physical therapists, resp. therapists, etc. all giving advice and telling you what to do.

Good luck and don't feel too badly about what happened, it's how we learn.

[Hooligan]

We are not allowed to do IV Pushes at all. It's not our school's policy but the policy of the particular institution we are doing our clinicals at.

[Thelto]

Actually, the school should follow that particular hospital policy where you are doing your clinicals. In my case, some hospitals allowed the students to do IV push, others didn't. It was up to your instructor to make it CRYSTAL CLEAR on your scope of practice. Don't be mad at yourself-it was a good learning experience and you will be a better nurse for it!

[lovinghands]

We were allowed to do IV pushs, boluses, hang blood (if 2 RN's did the verification) as long as the instructor or RN was present. I am glad my school was this way because I was well practiced when I began my preceptorship. The first day my preceptor watched my medication/iv skills to make sure I was doing them right then I did meds on my own. Of course, I asked questions when anything new came up. I agree, its very interesting to see the differences in schools.

[bluesky, BSN, RN]

at Univ of MD, we are not allowed to do IV push meds. it is written in big BOLD letters in our syllabus.

Ditto. I go to UMD too. I did find that when doing my practicum many of the nurses sort of pushed me to do it (I never did, ON the record) to show their confidence in me. It was really an uncomfortable situation.

Besides, lets get to the bottom line here. The technique isn't that hard, push slowly and dilute with a compatible IVF if the drug burns (ala Ativan) going in. The risks are all related to thinking about drug compatibilities and how fast the drug can have a deleterious effect, NOT the difficulty of the procedure. I was very glad when my program made that rule.

[nurseshanti]

At our school, we are not allowed to do IV pushes at all. My understanding of the reason is that a number of years ago, when students were allowed to, a student from the school made a MAJOR med error when doing an IV push. I'm not going to say the name of the med she pushed because it's something the school tries to keep on the downlow and I don't want to spread that kind of info on a public message board.

We are allowed to hang IV meds on a secondary line and IV fluids on a primary line and we are allowed to do saline or hep flushes, provided our instructor or our co-assigned RN is present. As for other skills like po meds and injections and dressings, etc., our instructor watches us the first time, sometimes the first two times, and then we're on our own. Of course, she is always on the unit if we need her or if we have any questions about anything to do with our patients.

[nurseshanti]

At our school, we are not allowed to do IV pushes at all. My understanding of the reason is that a number of years ago, when students were allowed to, a student from the school made a MAJOR med error when doing an IV push. I'm not going to say the name of the med she pushed because it's something the school tries to keep on the downlow and I don't want to spread that kind of info on a public message board.

We are allowed to hang IV meds on a secondary line and IV fluids on a primary line and we are allowed to do saline or hep flushes, provided our instructor or our co-assigned RN is present. As for other skills like po meds and injections and dressings, etc., our instructor watches us the first time, sometimes the first two times, and then we're on our own. Of course, she is always on the unit if we need her or if we have any questions about anything to do with our patients.

[Jen2]

We have alot of freedom. Our instructors have to watch us the first time we do anything and then after that we are allowed to do it on our own. The only thing we are not allowed to do is give blood products including rhogam. Did you show your instructor the rule yet?

[Jen2]

We have alot of freedom. Our instructors have to watch us the first time we do anything and then after that we are allowed to do it on our own. The only thing we are not allowed to do is give blood products including rhogam. Did you show your instructor the rule yet?

[Zans]

As an instructor I see that side. I have had a student push a narc when a physician asked him to. the client coded. bad deal for everyone. I am currently trying to figure out what most colleges do with this skill. Students can so easily be led astray by staff. Staff is trying to help, but may not realize the repercussions for the college and the student.

If the student thinks they are now "checked off" on that skill they may do it alone. IV push meds are all different -- since it is only a route of administration. the drugs are all different with different effects.

from reading your posts I think you have a fantastic attitude! I wish you were one of my students you seem very caring and dedicated.

You will make a good nurse!

Zans

[GeminiTwinRN, BSN]

When I was in nursing school, not only did we give IV pushes, we as students were often assigned to LPN's and therefore gave THEIR pushes (which of course they weren't permitted to do!)! Talk about twilight zone!