LPN IV Push

[2rntish]

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 answers. Our facility has about 15 drugs the LPN can push. Other hospitals let them push everything with a few exceptions. How do you do it?

Atleast 1 hospital also let the LPN hang blood...

[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.

[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

[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?

[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.

[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.

[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)?

[grammyr]

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)?

I think you should probably check your nurse practice act to see what is within your scope of practice.

[Drysolong]

I think you should probably check your nurse practice act to see what is within your scope of practice.

I got further clarification from a nurse at work. I now understand that what I am doing is not a IV medication push. I think I understand it to be a drip rather than an IV push

[P_RN, ADN, RN]

The best and actually only official source is the Board of Nursing for your own state. There's a list of all their websites here on allnurses.com

https://allnurses.com/Boards_of_Nursing/

[marylyric]

What is the difference between an IV Push and having a drug administered via IV?

Thanks.

Nick

IV PUSH GOES DIRECTLY INTO CIRCULATION, WHERE IN THE IV HANGING IS TIMED, AND USUALLY DRIPS SLOWLY INTO CIRCULATION. I WOULD ASSUME, THERE IS A SMALL AMT OF TIME TO STOP THE IV DRIP, AND CATCH THE ERROR, AS OPPOSE TO IV PUSH ALL MEDICATION GOES STRAIGHT INTO THE BLOOD STREAM ALL AT ONCE.

[Amyjosonata]

"Where I live LPNS only go to school for 1 year. I don't know how it is anywhere else. They don't have to take all of the science classes that RNS have to take. The RN program I attend is 3 years, Monday-Friday 9-3. Clincal days we start at 7:30. In the hospital where I work, LPNS cannot do IV push, hang blood, do anything invloving a PICC or a port(except hang piggybacks) and they certainly cannot do dialysis. They also cannot work in the units or ER. Why not just let CNAS start IVS and insert foleys as well? Sure it might be more convienient for the RN, but would you want someone who went to school for a year to push medicine through an IV that goes directly into the heart, if someone you loved was a pt?Students aren't allowed to do it either. The scope of practice SHOULD be different , otherwise why should there be different scopes of practice? Why not just tell everyone to go to school for one year? Just an opinion. Sorry. Don't kill me."

I think you are taking that "going to school for a year" very lightly. I have worked to get all of the SAME prereqs as an RN and although I am in school for JUST a year. I am there EVERYDAY sometimes until four and in clinical twice a week. Starting at 6 am. Please don't minimize my one year of school it took two years of prereqs to get here and it is ALOT of work. Some CNA's can complete their program by going to school once a week for seven weeks or every day for two weeks and we are trained much more extensively. We are not the same. I only have one year after this until I have my RN. Have a little love for the LPN.

[SmilingBluEyes]

LPNs do not do IV push of any sort where I work. They can hang blood, after the two-nurse verification process is complete.