LPN Scope of practice/Picc lines-just moved to Indiana

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    I Just moved from California were LVN's there are IV certified but we were only able to hang NS w/ 20 k and blood...NOTHING else. Now in Indiana I was told we can do every thing but hang blood. I don't know what to do know how do I get certified to hang atibiotics and use Picc lines if I have never done so...I called the indiana state board they referred me to ANA and they only deal with RN's..they gave me a number for LPN's and they said to call the state..I told them I had already and she said she couldn't help me. I am at a loss I don't want to go back to work to a unit with half the patients have PICC lines and the RN gets mad when I tell her I have never done PICC lines before...Can any please please give me advice.
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  4. 21 Comments so far...

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    Let them know when you get a job and they should give you the training or classes needed to do the other things if it is in your scope of practice.
  6. 0
    I would contact the Education dept. where you work AND the nurse manager (in writing) to tell them you need training. Do not risk your license on their inefficiency. If they have a risk management dept. you might contact them as well.
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    I don't know any place outside of the military that allows an LPN to hang blood or blood products. In NY I know an IV certified LPN can start an IV with the standard fliuds. If an IV sol'n needs K+ added it must be done by an RN. LPNs can mix ABX. LPNs may not administer chemotherapeutic agents or experimental drugs nor may they do any IV push or IC meds. That leaves alot of space for practice. To get back on track most places do not allow an LPN to touch central or PICC lines.
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    LPN'S in louisiana are allowed to hang blood
  9. 0
    i just want to make sure my information is right

    each state seems to have a different practice act. here is louisiana:
    http://www.lsbpne.com/scope_of_practice.htm

    the practice of practical nursing is defined in section 961 of chapter 11, louisiana revised statutes of 1950. according to this law, practical nursing is the performance, for pay, of acts in the care, treatment or observation of the ill and for the maintenance of the health of others and the promotion of health care. practical nurses may train and/or supervise other nurses, and subordinate personnel. they may also instruct patients.

    a licensed practical nurse must practice under the direction of one of the following: licensed physician, optometrist, dentist, psychologist, or registered nurse. a licensed practical nurse may perform duties consistent with his/her educational preparation. the licensed practical nurse may also, with appropriate training (which is approved by this board, and documented), perform additional specified acts which are authorized by the board of practical nurse examiners when directed to do so by the licensed physician, optometrist, dentist, psychologist, or registered nurse.

    the louisiana state board of practical nurse examiners (lsbpne) has no "laundry list" of tasks/skills an lpn can perform. such lists tend to limit practice. scope of practice is a fluid concept. it changes as knowledge and technology expand. lpns must possess the knowledge, skill, and ability to perform their duties, therefore, scope of practice comes down to the competency of the individual lpn.
    following are some of the tasks (those most frequently inquired about) an lpn may perform when the above conditions are met (note: this list is not inclusive of all of lpn practice and should not be used to define or limit practice):

    ~~initiate and maintain iv therapy and administer iv medications by ivpb and/or ivp (including hyperalimentation, blood and blood products)~~
    reinsertion of suprapubic catheters
    accept verbal/phone orders directly from the prescriber (an optometrist, advanced practice registered nurse, physician, dentist, or psychologist)
    perform heparinization during hemodialysis
    serve as first surgical assistant (but may not suture, dissect or cauterize)
    maintain and administer meds via heparin locks
    pap smears/gc cultures/iud string checks/fundal heart tones/leopolds maneuvers
    apply unna boots
    load/monitor pca machines
    care for clients with external venous catheters (including hickman, groshong, brovia) and specifically: obtain blood specimens/connect and monitor iv fluids/connect ivpb, provide site care (including dressing changes)
    care for clients with internal venous access devices (including port-a-cath, life port) and specifically: access with and/or remove huber needle/draw blood/connect and monitor iv fluids and provide site care (including dressing changes)
    insert a feeding tube in a neonate
    reinsert a tracheostomy tube in an established tract
    remove sheaths in a cardiac cath lab and later d/c these lines
    perform tasks which promote pulmonary health and hygiene (administer oxygen, aerosol and ippb treatments, suction, perform cpt, etc.). lpns may not hold themselves out as respiratory therapists or respiratory therapy technicians.
    perform "head to toe" physical assessments

    please call or write the board if you require further clarification.
    louisiana state board of practical nurse examiners
    3421 north causeway blvd., suite 505
    metairie, la 70002
    (504) 838-5791 fax (504) 838-5279
    Last edit by Godswill on Jul 2, '04
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    I am sure where ever you work will have you take an IV course to certify you in Indiana.
    Ask your employer....and most nurses probably wouldn't get mad at you if you explain to them the circumstances...at least the ones who have shown me never did!
    Best of all to you!
  12. 0
    Quote from Jailhouse RN
    I don't know any place outside of the military that allows an LPN to hang blood or blood products. In NY I know an IV certified LPN can start an IV with the standard fliuds. If an IV sol'n needs K+ added it must be done by an RN. LPNs can mix ABX. LPNs may not administer chemotherapeutic agents or experimental drugs nor may they do any IV push or IC meds. That leaves alot of space for practice. To get back on track most places do not allow an LPN to touch central or PICC lines.


    There are quite a few states that allow LPNs to hang blood, blood products, IV push meds, cardiac outputs, withdraw blood, and utilize central and PICC lines. It would be interesting to see each states practice.
    And then, some states don't allow LPNs to take orders... Lots of differences.
  13. 0
    Hi Krissee,,
    What part of Indiana? I am in Indianapolis. You should be able to tell whoever hired you that you need training in PICC lines. At my hospital, we have many PICC and central lines, and LPN's can work with them all. If your hospital does not want to train you (which, if they are unwilling too, I would think about quitting...that's awful!) and you live close to Indy, I could meet with you one day and try to teach you what I know. I could probably get a few supplies from my work too, as long as it's OK with my boss. If you need me to do that, please let me know, email me at: kacylynn@yahoo.com.
    Good luck!!
    Kacy
    P.S... LPN's in Indiana ARE permitted to hang blood!


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