I.V pushes

I do IV pushes where I work. On my unit LPN's can push everything accept drugs like vasotec and adenocard unless an RN, MD, or PA is in the room. We don't typically flush our lines with Heparin unless it's to lock off a port-a-cath. If we have a PICC or other type central line to get "clogged" the RN supervisor has to deal with it.

My first job was on a medical/telemetry unit and I was allowed to give all IVP meds except cardiac meds. I was also allowed to access central lines.

In my current job we have a list of meds with dosage limit that LVNs are allowed to push. E.g Demerol up to 50mg, Phenergan up to 25mg, Vasotech up to 1.25mg, ..... I'm also not allowed to access/flush central lines or even do central line dressing changes. I do however change fluid bags on central lines or piggy bag abx into running fluids.

In PA we can't push anything.. we also cannot titrate or hang blood or blood products, or chemo.

As a LPN in South Ga, I can push IV drugs,( except for major cardiac drugs that are used in a code.)

I can flush central lines, picc line, change dressings on these line. I can also draw blood from these type lines.

The only thing I can not do is Spike and Hang Blood, but I can be one of 2 nurses, one being an Rn that can check off blood and watch for a reaction. Once the Rn spikes and hangs the blood, I can do everything else , even take the blood set up down.

Also I can't give any chemo drugs, but I have very few chemo patients on the med-surg floor where I work.

I get to push morhpine, demerol, phenergan, lopressor etc. I can even push D50 for hypoglycemia.

Of course I have been trained on all of the above and have to do annual skills lab to keep up to date on any changes on P&P.

Here in Louisiana, we are not allowed to do IVP or hang blood products. At one facility i worked at we were not allowed to even give IV meds.

I think that each state and facility somehow need to get on the same page. This not knowing what we can and can't do from facility to different states is ridiculous. I think we as LPN's need to figure out how to get some type of uniformed scope of practice instead of this alittle here, allittle there crap. Who would you contact and what could we do to get this accomplished, since we as LPN's have no voice in what we can and can't do. Do we fight with the hospitals or each individual state or both. I just get so sick of the whole BS. I think I need another career that is a little more organized and defined.

Your state law is going to tell you exactly what you can and can't push IV. However, each facility is permitted to develop policies and procedures that may or may not place restrictions on what you can or can't do. Often facilities bend to the advice of their insurance carriers. Because your state law says you can do something as an LPN doesn't mean that the facility in which you work has to allow you to do it. They the boss.

LVNs in California with IV certification can start IVs, hang non-medicated fluids, and hang blood, but cannot do ANY IV push meds, hang piggybacks, or hang medicated fluids (eg 0.9% NaCl with K+ added).

Without the certification, LVNs can monitor IV infusions and hang non-medicated fluids. C'est tout.

In NY, we cannot push any drugs by the scope of practice. I am sure that there may be facilities that have accomodated this, but there must be training and certification in this, and maybe some proficency tests. It seems to me that it depends on the population, the availability of RNs (a result of the nursing shortage, I am sure). Because we work under the auspice of an RN, one must at least be present in case of complications.