What makes IVP meds so scary?

Nurses LPN/LVN

Published

So I interviewed today for a PRN position within the hospital network I am currently employed through. This department is going to try using LPNs again after a 9 year hiatus from favoring an all RN staff.

In opening these new LPN spots the department will determine the LPNs scope of practice since the state and hospital scopes are so broad. The major limitation currently thought of is only the RN can give IVP narcotics.

I thought this was highly unusual since just a few miles down the road in the ER I give IVP Dilaudid, morphine, Ativan, fentanyl, on a VERY regular basis. While I understand the med administrations are determined by the individual departments I wonder why one dept vs another would have different rules of medication administration when both are under the same hospital umbrella. In particular the patients in ED are of a much higher acuity!

From my understanding this is not uncommon to restrict LPNs from administering IVP narcotics or even ALL IVP meds. Is IV therapy that scary? While it can be dangerous if done improperly, every ASN and every BSN I have talked to learned IVP times and skills on the job. They all did the same training I did as an LPN in hospital orientation.

Now I am going to be getting ahead of myself, but that is ok. No need to inform me of that fact but do you think after I am hired I could create a formalized and professional report after a little bit of time has passed to discuss the LPN scope of practice in this particular dept (outpatient surgery) and convince them to allow LPNs to give IVP narcotics using hospital policy and evidence from the floor LPNs and ER LPNs as proof of safe IVP administration of narcs by LPNs.

Or how many ppl actually think IVP narcs or even IVP meds in general are just totally out of the question? If so, what (specifically) makes the RN more capable in your state?

For the LPNs that live in states requiring an IV cert, do u give meds IVP or are you simply allowed to start a saline lock, or can u meet half way and hang something as long as its not pushed? Do RNs need an IV cert or is it just on the job training for them?

What does one learn in an IV cert class and what did u manage to take away and how much of it is used in the real world? How long was the class to cert up and how much is a ball park figure?

What about LPNs who are ACLS/PALS... Is that pointless to say your ACLS/PALS if you can't push the med?

Sorry, now I'm just thinking out loud I suppose

That sort of thing is generally regulated by the State, not the hospital. But generally, it's just another way the RNs guarantee their job security.

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