Originally Posted by LPNalmost! Hi, all. I've been working as an LPN for less than 3 weeks now. I started training on the med cart this weekend and part of my training was pushing meds such as phenegran and nubain. All the LPN's in my hospital do it, so I accepted it as a normal part of my training. But today I was looking at the TN BON website and stumbled onto the board's amended policy regarding LPN's and IV therapy. Basically, it states that the LPN must have a minimum of 3 years experience or 2 years experience with completion of a formal IV training program at their facility in order to administer IV push medications. I have neither as I have been a LPN only since the 13th of this month and IV therapy is not included in the curriculum in TN LPN schools! I guess one of my questions would be: are any of you LPN's pushing IV meds without meeting the above conditions? Also, I did sign off on meds I pushed while training this weekend...is my tail end going to end up in the frying pan for this? And if this is standard policy at my facility, even though it is outside my scope of practice, what should I do? Am I interpreting "IV push" correctly when I assume it refers to any medication installed into the vein via the IV port? I'm really confused and concerned on how to address this with my new employer. All suggestions are appreciated.
First thing I have to say is breath and relax.
Yes you are right on what an "IV push" is. Yes it is something that I would bring up with someone above you. Most facilities also have someone that it's there job to know the rules and regs of all the licences and if they don't know it's their job to look it up. For the time being untill the issue is clearified, i would defenetly cover you butt....a very good practice to learn now. When you come across a medication that is to be pushed, simply let your team leader/ orientator know that you are not allowed to push these meds yet, and politly ask them to do it for you. If they are a good nurse they won't ask questions or give you a hard time, but understand that you are limited being a new nurse, and they will do it.......just be nice about it. Just remember that untill you are comfortable doing something get help with it. Nobody should give you a hard time about asking a question or asking for assistance. They teach us a lot in school, but there is so much to learn out on the floors that isn't taught.
Another thing to check into is a loop hole I had when I was in NY where we can't push any med no matter how long you've been a nurse. If you take the med and dilute it into a 10cc syringe and hook it up to the secdary port on the IV pump and then run it at 100cc/hr. It goes in just a little slower that a normal push, but faster than hanging it.....and with morphine most patients prefer this (doesn't hurt as bad). This is concidered a Piggyback in NY. So check for down here. I'll be working here soon too, i'm just waiting for my licence to transfer.
Hope it all works out for you. Good Luck!
New LPN with BIG concern over TN scope of practice re: IV Push
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