Why?

  1. I've seen this a few times and don't understand it. Why aren't some of you allowed to give a PRN med without approval from an RN?? I mean, the MD/DO order is already there, and you can certainly tell if your patient needs it, so why in the world do you need permission to give it?? Gosh, I can't imagine being the pt and having to wait for my PRN pain med until the RN gets a chance to approve......then again, I work in a facility where there might only be one RN in the building. The LPN's are in charge of their units and only call the RN if they're unsure, need help, or something is outside their scope of practice (IV push, etc.)
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  2. 17 Comments

  3. by   jmgrn65
    Never heard of that. Is it a faciltiy rule?
  4. by   Jules A
    I've also never heard of having to get an RN to sign off on PRN meds.
  5. by   sleepyndopey
    I have never heard of such a thing. With all the prns I give at my facility those RNs would really be busy.
  6. by   CoffeeRTC
    Please give us more info. This must be a facility rule and it looks like you work in LTC? I don't know how a building would function....LPNs are doing all the work and it would take forever to find an RN in some of the buildings.
    In PA LTC all I need to do is the push meds for the LPNs.
  7. by   Fiona59
    Doesn't happen in my part of the world. The RNs on my unit would laugh their socks off if we had to do it.

    A licensed nurse is expected to know when to administer PRN meds.
  8. by   caliotter3
    Sounds pretty stupid to me. I've never been anywhere where this was required. The RNs have enough to do without this babysitting function.
  9. by   linzz
    I have not had this experience in a hospital or LTC ever, however there was an article in the LPN Ontario journal written by someone who experienced this sort of thing but they may have been referring to a situation where IV push was required. Other than IV push drugs, LPN's here in Ontario are able to give any PRN med, SC, IM or simply po.
  10. by   ohmeowzer RN
    i'm a RN and have never had a LPN ask me for approval to give a PRN . do you have to do this where you work?
  11. by   Rexie68
    Quote from michelle126
    Please give us more info. This must be a facility rule and it looks like you work in LTC? I don't know how a building would function....LPNs are doing all the work and it would take forever to find an RN in some of the buildings.
    In PA LTC all I need to do is the push meds for the LPNs.
    I'm sorry...I should have been more specific. I don't have to get approval, but I've seen more then a few posts (I think in the forums where people were asking the difference between RNs and LPNs) who stated that they do have to get approval from an RN before giving a PRN. I've never heard of that before. You're right....there's no way it would work in LTC! Sometimes there's 1 RN in the building and 139 patients. We only call her when we need the IV push meds given, someone pronounced dead, or if we're in need of help. Again, I'm sorry if I confused anyone. Thanks for all of your input!!
  12. by   Virgo_RN
    I can give PRNs and IV push (though peripheral lines only and limited to certain drug classes) without an RN's permission.
  13. by   pagandeva2000
    While this sounds insane, I am not surprized. I have to have an RN screen patients for flu and pneumococcal vaccinations even if there is an order from the MD. It is if we are too stupid to ask if a person has allergies to eggs or check the history to see if they have adverse reactions. It slows up the clinic, overwhelms the RNs and inconsiderate to the patients. I think that it is another device where the ANA tries to have a foothold on nursing.
  14. by   swee2000
    Well, I guess I'll be the oddball to say "I've heard of it" because I have to do it.

    At the hospital I work at, whether I'm assigned with an RN but primarying my own patients or working under the charge RN, and regardless of there being an MD order, I still need an "ok" from them BEFORE I can give any PRN med. The reason for this is, even though I am able to get the med myself from the PYXIS machine & chart it under my name, the RN is still the one ultimately in charge and therefore has to approve what I give, how much, etc.

    Besides, even if it wasn't facility policy, I can't see any of the RNs on my unit being ok with me(or any other LPN) administering PRN meds as I see fit & w/o asking them. Not because they don't trust me or my judgement. Rather, they wouldn't be able to rub in my face the attitude of "I'm boss and the one who calls the shots around here". Now before anyone yells back at or has a few choice words for me, let me reinforce that my last comment was not referencing or directed at all RNs...just some of the ones who work on my unit. Unfortunately, they really look down on LPNs and treat them like subservient people. Thank God I don't work night shift(although I have and that's how I know they act like this)!!!

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