LPN duties in the acute care setting

AimersTriageRN · Jan 12, 2004

At my facility, LPNs cannot hang blood or give IV push meds...but they do all their own assesments, IV starts, IV fluids and some IV antibiotics and K riders...they can also do PICC dressing changes.

ragingmomster, BSN, MSN, RN · Jan 12, 2004

I started on a 40 bed medical floor almost a year ago now. LPN's do all their own everything except push IV meds. We are allowed to push Lasix, Solu-medrol and one other that escapes me now. When I started it was required that the RN do the admission work-up. LPN's had been doing them for years, but policy was RN only. I stood up and got the policy changed. Not sure if that is a good thing though... I hate admissions. LOL.

Good luck.

KacyLynnRN · Jul 23, 2004

I am an LPN on a med/surg unit. I can push most meds (exceptions: cardizem, labetalol), hang blood, start IV's, draw blood, do assessments (RN must check off) take verbal orders, etc...etc... In Indiana, there's not a lot actue care LPN's can not do without appropriate training. :specs:

mattsmom81 · Jul 23, 2004

Depends totally and 1)state regulations and 2) facility policy.

Texas allows LPN's to do anything they are competent to do by facility policy. So...i work side by side with LPN's in critical care who DO hang their own blood, DO admissions, give IV pushes, etc....everything I do as a staff nurse. Only thing they are not allowed to do in MY ICU is be in charge.

NannaNurse · Jul 24, 2004

I was limited to 3 things: 1.initiate blood trans 2.iv push meds (all) 3. initiate a code.

I agree with some of the statements here........Each state has different rules and if you have any questions, contact your BON BEFORE you set out to do anything you have to stop and ask.........'can I do this'???

It's better to be safe than sorry!! Where as one facility may permit you to initiate a blood trans, another may 'can you and boot you out the door'.

I personally think that a LPN should be able to become certified to do more things, if they so chose. I took a long, hard class to be IV certified. RN's are not required to do this, I think they should.

I think that certification classes should be strict, hard and require a 100% passing grade and include blood transfusions, 'some' IV push meds, etc. Just my opinion here.

ayndim · Jul 24, 2004

I was limited to 3 things: 1.initiate blood trans 2.iv push meds (all) 3. initiate a code.
I agree with some of the statements here........Each state has different rules and if you have any questions, contact your BON BEFORE you set out to do anything you have to stop and ask.........'can I do this'???
It's better to be safe than sorry!! Where as one facility may permit you to initiate a blood trans, another may 'can you and boot you out the door'.
I personally think that a LPN should be able to become certified to do more things, if they so chose. I took a long, hard class to be IV certified. RN's are not required to do this, I think they should.
I think that certification classes should be strict, hard and require a 100% passing grade and include blood transfusions, 'some' IV push meds, etc. Just my opinion here.

It is my understanding that the additional year for RN already includes the IV class. Am I wrong? I know at my school we must pass a med admin test with 100% every semester.

RN34TX · Jul 24, 2004

It is my understanding that the additional year for RN already includes the IV class. Am I wrong? I know at my school we must pass a med admin test with 100% every semester.

My LPN program required a med test every semester and you couldn't move on to clinical without passing I think 95%. Most LPN's I've worked with tell me that's the way their programs went as well.

I agree with Nannanurse because even though the RN's get the additional training, they still need to at least be assessed in orientation if they can safely do these things because a lot of graduates slip through the cracks.

Example:

I recently worked with a BSN grad who got a bag of blood from the blood bank and then let it sit at the nurses station while tending to other things. When I asked him about it (thinking that maybe he forgot about it) he told me that he would hang the blood when he had time. Apparantly either no one told him in his BSN program or maybe he was absent the day that they tell nursing students that you can't let a bag of blood just sit there and hang it whenever you get around to it.

Another RN I worked with saw some old orders for when the patient was in the special procedures lab getting a procedure done and decided to give the patient some IV Versed to calm him down because that's what he got in the special procedures lab. Apparantly no one in his RN program talked about conscious sedation protocol or the fact that IV Versed is not an appropriate drug to give to a med/surg floor patient to calm him down.

Yes, the RN's definitely need those IV therapy classes as well.

casper1 · Jul 24, 2004

In my facility a LPN cannot hang blood, but may monitor a transfusion in progress.

They may not give IV push meds. but may hang a IVSS. they cannont draw blood from a central line. They cannot flush a central line. They cannot administer medication

thru a central line, but can monitor fluids or meds being administered thru a central line. They cannot hang TPN. They cannot do any central line dressing changes.

LPN's are not allowed to take verbal orders. Nor are they allowed to take off orders.

They may do assessments and admissions, but must have them co-signed by a RN.

ayndim · Jul 24, 2004

My LPN program required a med test every semester and you couldn't move on to clinical without passing I think 95%. Most LPN's I've worked with tell me that's the way their programs went as well.
I agree with Nannanurse because even though the RN's get the additional training, they still need to at least be assessed in orientation if they can safely do these things because a lot of graduates slip through the cracks.
Example:
I recently worked with a BSN grad who got a bag of blood from the blood bank and then let it sit at the nurses station while tending to other things. When I asked him about it (thinking that maybe he forgot about it) he told me that he would hang the blood when he had time. Apparantly either no one told him in his BSN program or maybe he was absent the day that they tell nursing students that you can't let a bag of blood just sit there and hang it whenever you get around to it.
Another RN I worked with saw some old orders for when the patient was in the special procedures lab getting a procedure done and decided to give the patient some IV Versed to calm him down because that's what he got in the special procedures lab. Apparantly no one in his RN program talked about conscious sedation protocol or the fact that IV Versed is not an appropriate drug to give to a med/surg floor patient to calm him down.
Yes, the RN's definitely need those IV therapy classes as well.

The first year of my program is the LPN portion and then you can exit or continue on to an RN. So LPN's must also pass med admin with 100% too.