LPN IV Push - page 6

Good day one and all. Does your facility have a policy that limits the drugs that an LPN can give IV after attending an IV push class? I have polled several hospitals in our area and had a variety of... Read More

  1. by   fadingyouth
    Each state board has its own criteria and whether you are an LPN/LVN or RN the hospital further regulates your job skills/tasks/ performance.
    Having ACLS, Chemo cert., BMT cert, a critical care course, advanced iv therapy, etc., does not necessarily mean that as an LVN/LPN one can work in any hospital anywhere.
    While I am allowed to work in the critical care areas here (inc. ER and ICU), I have found that some states prohibit it.
    There are hospitals that "allow" you to be a licensed aide or just a med nurse, while others allow you to be a nurse.
    In the past I have found that errors are not created by the number of years in your field or by the initials behind your name.
    I have seen pepcid,lasix , dilantin, adenocard given wrongly.
    I have known Tele RN's to argue about what the rythmn was and refuse to accept an LVn's input. I have had patients in pain needing to wait till the RN was available to give the med.
    Thank goodness that I presently do not work in a facility such as that described above, but work in one that allows LVN's to further their skills, appreciate their abilities, and where both the RN coordinator and the M.D. listen to your input.
    I have always maintained that it is not necessarily the title, but the person behind it upon which judgment is made.
  2. by   mattsmom81
    "I have always maintained it is not necessarily the title, but the person behind it ...' Fading Youth

    So very true! Haven't we all known butthead docs we never would go to see because of their lousy attitude? And a lazy RN who sits at the desk and won't move off her/his azz to help even if there was a fire under 'em? I've worked with RN's who needed me to hold their hand with every procedure, and LPN's who were confident, competent and self sufficient !

    Some LPN's are happily competent doing the 'minimum', and don't want the extra responsibilities...and that may be why they chose the LPN route. This is cool...'know thy limits...to thine own self be true' and all that jazz. Some competent LPN's want to learn and grow, do MORE...which is also cool. BOTH are good LPN's!!

    I was the 2nd kind of LPN myself, and felt quite limited as an LPN in Minnesota, so I continued on to RN. If I'd been in Texas then, I might have stayed an LPN because of the liberal practice here. I'm glad ambitious LPN's have these opportunities available for them in Texas.

    Also gotta say I've worked with some top notch NA's whose judgment, perception , observation, and communication skills are better than a few nurses I put up...er...work with. LOL!

    Now this being said, we are fools if we don't know the limits imposed by our states and facilities. For our individual practice, AND those we supervise. If we choose to work outside these limits, we're in for bigtime trouble down the line, as it will catch up with us one day. :stone
    Last edit by mattsmom81 on Aug 6, '02
  3. by   stressedlpn
    I had thought about moving up north however after reading all of these post heck no!!! I'll just stay down south where I actually get to use my training HA! anyway we LPNs are not all trying to just do things we have no clue about whats up. Personally if I am asked to do something I dont know how I go ask someone who does and go from there, and vice versa. we are a team even if we dont always act like it.brownie and mattsmom ya'll are my heroes. love to all kelli
  4. by   Brownms46
    stressedlpn...what ya talking about gurl...you're my hero..along with a lot of awesome nurses on this BB!!! You guys ROCK!!

    And don't you dare take those awesome skills up north....cause they will just make you waste them!! Now go to bed...:chuckle
  5. by   Youda
    An early post said the difference was education, not the actual performing of the task. It is not difficult to do an IV push. But, does an LPN have the training, critical thinking skills, etc., to understand what CAN do wrong and what to do if it does go wrong? Does the LPN understand what exact medication is being given, the chemical properties and ramifications, the artery they're putting it into, the possible response of the heart, pulmonary system, etc.? These are just a couple of the possible "complications" that can occur that I learned as an RN that I was never taught as an LPN. I'm not saying LPNs are ignorant. I'm saying they haven't had AS MUCH training and needs, therefore, to have some limitations on licensure as a safety issue for the client. Those limitations determined by their State Boards, based upon the curriculums of the schools in that state.
  6. by   dianas
    Youda I realize what you are saying maybe not all LPN programs are alike but when I went to school for an LPN I had to attend for 18 months. I should of just went to RN school Then I would have had only 6 months left. But I learned an awful lot the complications what to do, what the coponets of the drug was etc. When I finally went back to RN school I did the bridge program I really didn't learn much more unless for the fact that I had worked as an LPN that I learned this along the way. I also learned I should of just did the RN program and not waste time
  7. by   Patrick M6
    Quote from dianas
    I am an LPN I orignally started my nursing in Virginia. I could do all I pushes in that facility. I could hang blood. I also could do dialysis We did exactly as the RN once we were IV certified. In Florida LPN's can't do much. Its like you are not even a nurse just a tech. In Virginia I could also take c-lines, and picc lines out I could insert porta cath huber needles. I sure wish I was an RN now that I live in Fl
    I've been an LVN/LPN for about 3 years. I've worked at several different hospitals in TX and GA. Now I work in FL and have just finished the IV course here. I have the broadest scope of practice now that I've had since becoming an LVN/LPN. I was never even able to take telephone/verbal orders in the past. As far as IV stuff goes, we can do basically anything except chemo drugs, plasma expanders, push investigational drugs, mix solutions (we can give solutions mixed in the pharmacy, or meds from the minibag plus system). I've got conflicting information about IV push meds. Depending on who you ask, you either can't give it at all, or you can give it as long as there's an RN nearby. We can't DC PICC lines though. It just depends a lot on what hospital you work at.
  8. by   DR2004RN
    At my facility, LPN's cannot hang blood, or be the second signature, they can go and get the blood though, anyone can go and get it at our facility. Even the unit secretaries go and get it. LPN's can maintain it once the RN has started it. They cannot flush any piccs,cvc's, or ports(they cannot access ports either); nor hang any abx that go into those lines (heparin and potassium included.)They can hang certain abx that go into piv's. Broad spectrum abx, yes, vanco and gent no. Any ivp meds are a no-no. Sub Q's yes. No chemo, no orders. They cannot be in charge. They can have patients on telemetry and call to check on their monitors. They can d/c peripheral iv's, assess the pt.and do admission paperwork. As far as d/cing piccs even the RN's on the floor are not allowed to d/c those. It has to be a nurse specially trained in Piccs or an MD. We are fortunate enough to have some really good LPN's. My MIL is an LPN and she is an exceptional nurse. But I can think of one LPN though who does attempt to step out of her scope of practice and attempt to do things, like heparin gtts, ivp meds and has tried to hang K ivpb. Also our LPN's cannot do anything with a PCA pump. Whenever possible though, the charge RN will try to make the assignment out so that the LPN does not have the PCA's ports, picc cvc's etc. It is not always possible, but they do try. The RN covering with the LPN then has more to do, but hey thats the way it goes sometimes, so you just have to do the best you can. I have no problem with LPN's and I am thankful that we have them, they are nurses too. They for whatever reason chose to be an LPN and I respect that. I was going to go to school for my LPN first, but the school didn't have an LPN course, so I just went for my RN. Then my last semester of school what do they add to the college? Thats right an LPN program! I love my job and love the people I work with whether they are RN or LPN we are all there for the good of the patient.
  9. by   freakyaye
    to mee, LPN means liscenced practical nurse. AN RN has more education to detect subtle changes when hanging drugs etc that a lpn doesnt. Rns are trained to detect and catch problems in absense of MD
  10. by   norinradd
    Youda said:

    "An early post said the difference was education, not the actual performing of the task. It is not difficult to do an IV push. But, does an LPN have the training, critical thinking skills, etc., to understand what CAN do wrong and what to do if it does go wrong? Does the LPN understand what exact medication is being given, the chemical properties and ramifications, the artery they're putting it into..."

    In my case, I would hope so for all of the RNs I have precepted in the last 13yrs as an LPN/LVN. Not to mention the RNs that have my name on the back of their ACLS cards. BTW, you do know most IVPs are given in veins... not arteries?
  11. by   CyndieRN2007
    I havent come accross anything I couldnt push. However, I know I cant hang blood at the hospital where I work at. Other than that, I have pushed alot of meds. I'm an LVN.
  12. by   nurse-ry
    my american instructor told me that LPNs can give IV meds with the exception of chemotherapeutics or meds which can cause extravasation. they cannot as well administer iv meds through central lines or any other invasive lines except for purely peripheral iv line.
  13. by   Drysolong
    I'm a little confused. I am a new LPN (charge nurse in a LTC) and three of my patients are on antibiotics (Vancomycin & Timentin). I administer the drugs via PICC line using SASH procedure. I have not had IV training and my training on these patients consisted of being shown 4 times by supervisors how to do it and doing it with them about two times. Since then, I've been on my own. In school, I was told that as an LPN, I would not be doing IV pushes, etc. So I was surprised when these patients were transferred to my floor. All the LPN's in my facility are expected to do this.
    What do you other nurses think about me doing this at my current stage (LPN for 8 weeks)?