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.

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

I wouldn't either. However would home infusion or visiting nurse be approved for IV meds by Medicare? I haven't worked Medicare patients in years, but I think I remember this being done.

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Specializes in Gerontological Nursing, Acute Rehab.
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. 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

In every skilled/subacute facility I worked in there had to be an RN in house at all times, but I also think I remember hearing the "8/24" reg, too, so I'm not sure what the actual reg is, but thank goodness the facilities that are around me always have an RN super on board. Another good point you made is someone else giving meds to "my" patients....I certainly wouldn't let someone from the "outside" come in and administer IV meds.......is this LPN even IV certified and trained to catch s/s of IV related complications? Or complications of IV med administration? Not good....they need to get an RN in there and leave the hospital personnel out of this. AND make sure that the staff they do have on duty is at least IV certified.....LPN's can hang IV meds, just not push the drugs.....and WHO THE HECK gives VANCO IV push????

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In every skilled/subacute facility I worked in there had to be an RN in house at all times, but I also think I remember hearing the "8/24" reg, too, so I'm not sure what the actual reg is, but thank goodness the facilities that are around me always have an RN super on board. Another good point you made is someone else giving meds to "my" patients....I certainly wouldn't let someone from the "outside" come in and administer IV meds.......is this LPN even IV certified and trained to catch s/s of IV related complications? Or complications of IV med administration? Not good....they need to get an RN in there and leave the hospital personnel out of this. AND make sure that the staff they do have on duty is at least IV certified.....LPN's can hang IV meds, just not push the drugs.....and WHO THE HECK gives VANCO IV push????

But even if the LPN's were IV certified or if you got RN's on staff there, you still couldn't give those LPN's or RN's 30 patients and then ask them to give IV push meds and monitor them properly like in the hospital setting where you wouldn't have so many patients to look after.

That's why those things are supposed to be done in the acute care setting.

Just like in Med/Surg there are things that cannot be given to patients there that must be done in ICU because you can't give a nurse 6 patients and then expect them to titrate and monitor cardiac drips, etc.

Of course I shouldn't say that because it seems that they expect us all to do more and more every day.

I just couldn't walk over to a facility, push some meds and then walk out the door hoping that the staff LPN's would monitor and intervene if needed.

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Specializes in Med-Surg, Wound Care.

If a patient is requiring IV push medications they shouldn't be in a skilled facility!!

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Absolutely no way. So many adverse reactions can occur... administering medications includes the follow-up and patient response. If you are not there to assess responses...but have signed for those meds??? I believe this is grossly unfair to you and inappropriate of administration to expect. What next..."drive through window" med administration?

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Absolutely no way. So many adverse reactions can occur... administering medications includes the follow-up and patient response. If you are not there to assess responses...but have signed for those meds??? I believe this is grossly unfair to you and inappropriate of administration to expect. What next..."drive through window" med administration?

It's coming!! To be administered by someone with no healthcare background who took a two week pharmacology course.

Don't worry, there will be a nurse to peek in on them every now and then.

Why save people when you can save money?

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Absolutely no way. So many adverse reactions can occur... administering medications includes the follow-up and patient response. If you are not there to assess responses...but have signed for those meds??? I believe this is grossly unfair to you and inappropriate of administration to expect. What next..."drive through window" med administration?
I wouldn't be surprised. We could put up a sign around where the speaker is (we'd use the speaker to ask them if they have any allergies, etc - no matter if we can't understand them or they can't understand us). telling them to drop trou so we could throw the injection out the window like a dart. Healthcare at its finest. :rolleyes:
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I have a Idea......The DON has A RN lic. ..Page her/him to come over and push your meds...the DON can monitor these meds. :rotfl:

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Thanks for your advice. I do not work for the SNF. I hired in with the hospital. They do not have the LPN's do this, only the RN's. I do not feel comfortable in doing it and have told them so. Other RN's have been doing it though. Thanks,again

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what a horror story. Contact your BNE to see if there is a safe harbor law that would allow you to refuse the "assignment" without losing your job.

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: DON Being RN to give meds and monitor...

In the state of Virginia, the only time that is allowed by the state or by medicare is if the facility has less than 60 beds (not residents...if you have 100 beds and only 59 residents... it doesn't fly). On our last inspection, they nailed adm. because our DON was filling in on the floor to keep from calling agency. They sited the facility on multiple days with no RN staff for 8 hr shifts... wound up being a substandard.. due to the number of days she had worked. Damned if you do... damned if you don't...

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Specializes in Gerontological Nursing, Acute Rehab.
If a patient is requiring IV push medications they shouldn't be in a skilled facility!!

Why not?? I have worked in skilled facility for 9 plus years and have safely given IV push meds.....heck, in one place we had a patient and a Dobutamine (sp) drip. There's no problem with IV push meds as long that there's qualified staff to monitor the resident.

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