giving iv meds

Nurses General Nursing

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I am looking for advice. In the small hospital where I work we have a skilled nursing home next to us. Administration has been asking us to leave our assignment at the hospital and go over to push IV meds, i.e. Demerol, phenergan, Vanco, etc. I do not feel comfortable doing this. We do not stay with the patient after giving the drug. An LPN is available but they also have 30 some patients to watch as well at the nursing home. Do any of you have suggestions? Administration says they are working on the issue but it has been about a year. Thanks.

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Is this for real??? If so, I say don't do it! DO NOT. Do you work at that SNF? Probably not. Why would you risk your licences because they tell/ask you to? Say no, and if they try to threaten you into it tell them no anyway. Then report this practice to your state official agency (department of health?)If you work for this place, then you have to remain there to monitor theraputic effects. I'm surprised they don't ask the LPN's to do this (or do they?)

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Is this for real??? If so, I say don't do it! DO NOT. Do you work at that SNF? Probably not. Why would you risk your licences because they tell/ask you to? Say no, and if they try to threaten you into it tell them no anyway. Then report this practice to your state official agency (department of health?)If you work for this place, then you have to remain there to monitor theraputic effects. I'm surprised they don't ask the LPN's to do this (or do they?)

No way! They need to get an RN in their building STAT.

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Umm, no way would I be doing this. Simply refuse, you have that right and if they fire you I would say you are better off not working there. :(

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I'm with the others. This seems like an extreme practice!! I do IV home infusion and there are very few meds we give IV push. Vanco, that you mentioned, should NEVER be given IV push. Also, the narcotics would make me nervous. We have to have written anaphalaxis protocols too.

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Specializes in Med-surg; OB/Well baby; pulmonology; RTS.

I wouldn't do that....nope.

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Specializes in Med/Surg, Ortho.

Nope wouldnt do it. We have a Transitional care facility in our hospital and we cant go down there and push meds. LTC or Transitional care facilities fall under completely different regs. I would even wonder if their or your would even be effective if something were to happen. I can only compare it to walking into my hospital unit and giving an iv push med on a day i wasnt on duty. NO WAY!

I think id make them show me the written policies and any changes they have made to your job description category first. Then and only then would i agree.

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You have got to be kidding! :uhoh3: :uhoh3: :uhoh3:

This is what happens when administration is left to think for themselves...

It borders on asking you to abandon your patients. What if something happened to one of your patients while you were gone?? What if something happens to one of the patients you gave the IV push to after you leave??

MHO is this is administration's problem - let them deal with it. The nursing home is responsible for their own staffing. If they can't find, hire, and maintain their own staff of RNs then they should not be providing skilled care.

By the way, that reminds me - skilled care almost always intermingles with Medicare at some point or another. I thought in order to be a "skilled care" facility, in the eyes of Medicare, there had to be RNs supervising the plan of care. That would mean on staff and in-house at all times! Sounds like they could be venturing into the realm of Medicare fraud to me -- I would not get my license involved in THAT mess - NO WAY!

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Nope wouldnt do it. We have a Transitional care facility in our hospital and we cant go down there and push meds. LTC or Transitional care facilities fall under completely different regs. I would even wonder if their or your malpractice insurance would even be effective if something were to happen. I can only compare it to walking into my hospital unit and giving an iv push med on a day i wasnt on duty. NO WAY!

I think id make them show me the written policies and any changes they have made to your job description category first. Then and only then would i agree.

Very good point meownsmile - I had forgotten all about that aspect. Everywhere I have worked, where skilled care was in-house, the patients have to be discharged from the hospital and then admitted to the skilled care units because they are under different regulations. It sounds even less on the level when you consider that aspect.
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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

ummmm nope.

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Perhaps I'm missing something here....I work at nights in a nursing home, but we NEVER have an RN on duty during the night shift. Only a couple of LPN's and a handfull of cna's. And we are a "medicare skilled" facility....certified for medicare and medicaid. Are they supposed to have an RN on the nights, too? If so, I'd hate to be the one to tell them!

You have got to be kidding! :uhoh3: :uhoh3: :uhoh3:

This is what happens when administration is left to think for themselves...

It borders on asking you to abandon your patients. What if something happened to one of your patients while you were gone?? What if something happens to one of the patients you gave the IV push to after you leave??

MHO is this is administration's problem - let them deal with it. The nursing home is responsible for their own staffing. If they can't find, hire, and maintain their own staff of RNs then they should not be providing skilled care.

By the way, that reminds me - skilled care almost always intermingles with Medicare at some point or another. I thought in order to be a "skilled care" facility, in the eyes of Medicare, there had to be RNs supervising the plan of care. That would mean on staff and in-house at all times! Sounds like they could be venturing into the realm of Medicare fraud to me -- I would not get my license involved in THAT mess - NO WAY!

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Perhaps I'm missing something here....I work at nights in a nursing home, but we NEVER have an RN on duty during the night shift. Only a couple of LPN's and a handfull of cna's. And we are a "medicare skilled" facility....certified for medicare and medicaid. Are they supposed to have an RN on the nights, too? If so, I'd hate to be the one to tell them!
When I worked there the regs said an RN had to oversee the careplan (be on duty) for at least 8 hrs out of 24. BUT when I left long term care (last fall) they hadn't put it in writing... but they were pushing for 24 hour coverage especially if your facility has not had a good reputation with the previous inspectors. You also need to keep in mind, the state board of nursing is NOT going to accept this as acceptable standard of practice. CYA!!!! They will put you on probation at best for this. Stand up to administration and say NO WAY!!! As long as you guys are doing this they will be in no hurry to fill that vacancy. This is all about dollars and not patient care. They are saving a bundle by not having a full time RN on duty and still getting the Medicare and Private Ins. dollars. There is only one way to spell FRAUD!!!!! Get out of that sinking ship NOW!!!! Further more, what is protecting the on duty lpn (at the skilled facility) by having someone else administer HER patients meds? As a nurse on that unit, I would not stand for it. I don't allow it in my hospital. Everyone knows to stay away from my patients. Just think about this... who is going to be sitting on that court bench with you when the sky falls in??? Good luck.. but remember you gotta look out for you!!!

Wanda

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