Can non-licensed person start an IV?

[carol72]

Just have to ask this question. Can a non-licensed person (not an LVN LPN or RN) insert a Hep-Lock /start an IV? Is there any "special certification" for a medical assistant to obtain which would enable them to do this procedure? If not, what if you had knowledge of this happening at a specific medical practice - what would you do?? Assume you don't work there, your friend does & she does not want to make waves.

Thanks for all info and opinions.

[flightnurse2b, LPN]

Anyone can pretty much do anything an MD/DO tells them to in their office because they work under their license. If they want to pick a homeless person off the street and train them to start IVs, they can.

I was pretty freaked out the first time I saw a girl at my work, who started as a secretary and is now an MA by training, I suppose, doing an IV push (of Demerol, mind you), but she said, "it's OK, Dr. J told me to, I do it all the time" so I left it alone.

Whatever happens, it will continue to happen. But I do wonder how many of these doctors would back them up when something goes wrong.

[iluvivt, BSN, RN]

In California, and I believe in most states (I will check on that), they CANNOT perform intravenous insertion or medication or, for that matter, have anything to do with IV Therapy. They are considered medical assistants or unlicensed assistive personnel. They may only perform basic clerical, administrative, and technical tasks. They may not perform anything invasive and/or anything that requires an assessment. With special certifications and in conjunction with the MD, the practice may perform certain things like medication administration (but no IV) and simple dressing changes, and obtaining VS, of course. Even if an MD says it is OK, it is not. What state are we talking about? Most states will have position statements. Check with your board. Now, what to do? You must first find out the exact requirements in your state, and if they state they cannot perform IV starts, the person that is aware of this MUST present this to the MD. The safety of the patient as a consumer is put at great risk. Let me know the state, please. Also, be aware that some military facilities are under different guidelines in some practice areas.

[Abbies]

I have one for you.

What about an MD's office in Oregon? Can a medical assistant that is phlebotomy certified start an IV? (this person does not do admin of meds).

[jb2u, ASN, RN]

IV starts are not about medication delivery. The reason unlicensed personnel may do phlebotomy sticks but not IV starts is because the IV stays in longer. This is a bigger risk for infection if the employee does not use a sterile technique. When I worked as a CMA, we had an LPN in the office to start any IVs for the doctor.

[WoofyMutt80]

I am a CMA, and I found a book (Intravenous Infusion Therapy for Medical Assistants) online after "googling" this topic. It was put out by the American Association of Medical Assistants in 2006. This book has a test at the end for CEU credit and says to check with your state Board of Nursing and facility policy on MA's starting and maintaining IVs. I live in Mass, and I have yet to find out if it is OK for me to do so or not. I heard CMA's in Florida can go for their IV certification. Here in Mass, they can get IV certified. I am reading this book, but if I want to go for IV training and other nursing skills, not in the Medical Assisting Scope of Practice, I might as well go for my RN!

[classicdame, MSN, EdD]

It is not universally true that ANYONE can start IV under an MD license and supervision. In Texas, many skills are protected by the Nurse Practice Act so as also to protect the public. EMTs & Paramedics may start IVs. I suppose it depends on the setting and the situation, such as military vs. civilian. Better check with your state BON to be sure or with risk management.

[salpal92]

I'm currently in NC, and what I have been "TOLD" by people is that the CMA practices under the doctor's license and, therefore, they can do it, "b/c the doctor said so," I have not really investigated further. I do know some private offices have CMAs doing their infusions, though! I work in Rheumatology and infuse Remicade, Orencia, Rituxan, and a few for osteoporosis as well. My office has all RNs in the infusions suite, but other practices have CMAs starting IV lines and administering these biological agents!:uhoh21:

Difficult for me to swallow.

[salpal92]

I know in NC, they can pretty much do whatever the Dr. asks of them. They work under a doctor's license.

I know of practices that have CMA's infusing IV meds like Remicade, which is known to cause anaphylaxis in addition to other types of infusion reactions, mild to severe! No offense, but I want a trained NURSE monitoring me for that!

[fmoore723]

WOW--the MA that pushed Demerol--- that's scary. Im currently an LPN--in school for RN and cant push IV meds PERIOD (Nurse Practice Act) and wouldn't want to without the proper training to counteract the effects (MA). I don't so much agree with the statement that anyone can do anything the MD asks--because if something happens, you can still be held liable for the damage that's done, and if brought to court, you can't just say--"Well,, the MD told me to." I used to work for a Perinatologist who also did advising for Malpractice Court Cases---I learned ALOT from him in the CYA ballfield. Basically, what I learned from him is to act as if every patient's chart will be taken to court someday, and you will have to testify as to what you did and why--and make sure that information is there so that you can explain it thoroughly. It made us work a little harder--but it probably would save our butts in court if needed.

I suppose a MA or the like can take a class to become IV certified but not actually be licensed.

[salpal92]

fmoore723 said:

WOW--the MA that pushed Demerol--- that's scary. Im currently an LPN--in school for RN and cant push IV meds PERIOD (Nurse Practice Act) and wouldn't want to without the proper training to counteract the effects (MA). I don't so much agree with the statement that anyone can do anything the MD asks--because if something happens, you can still be held liable for the damage that's done, and if brought to court, you can't just say--"Well,, the MD told me to." I used to work for a Perinatologist who also did advising for Malpractice Court Cases---I learned ALOT from him in the CYA ballfield. Basically, what I learned from him is to act as if every patient's chart will be taken to court someday, and you will have to testify as to what you did and why--and make sure that information is there so that you can explain it thoroughly. It made us work a little harder--but it probably would save our butts in court if needed.

I suppose a MA or the like can take a class to become IV certified but not actually be licensed.

Absolutely!! Licensed nurses (LPN and RN) are held accountable for their own actions.

[piccemrn1]

You might want to check with your State Board to identify what your scope of practice is. It will be even harder to swallow if you get called to court. In California only an RN can push meds through an IV. "because the doctor said to" will not save you when on a witness stand.