LVN limitations in TX

[txnurse2014]

Can someone tell me exactly where I can find what LVNs can and cant do?BON is very nonspecific.I was told at work there are certain drugs I cant give etc.I know I cant give any IV push meds or blood products but unsure of other restrictions.

[THELIVINGWORST, ASN, RN]

The Nurse Practice act of your state

[TheCommuter, BSN, RN]

The Nurse Practice act of your state

Texas' NPA is very nonspecific. Essentially, it allows LVNs to perform virtually any skill in which they are competent as long as the policy of their employers permits it. In other words, LVNs have a wide scope of practice in Texas.

LVNs are legally allowed to give blood products in TX, but individual facility policies of the employer usually forbid them from doing so. LVNs are allowed to administer all medications via IV push and IVPB in TX, but again, it is usually the policy of the facility that places limits on what LVNs can do.

LVNs are not allowed to make pronouncements of death in TX.

[txnurse2014]

i learned in school we cant hang blood products but can monitor them.I was told by a coworker lvns cant administer TPN.is that true?

[TheCommuter, BSN, RN]

i learned in school we cant hang blood products but can monitor them.I was told by a coworker lvns cant administer TPN.is that true?

As I previously mentioned, Texas' nurse practice act (NPA) is very nonspecific, basically allowing LVNs to perform virtually any skill in which they are competent as long as the policy of their employers permits it.

Perhaps your coworker is telling you that LVNs cannot administer TPN because that is the individual policy of the workplace that employs both of you. Many healthcare facilities in Texas disallow LVNs from administering blood and TPN, although the TX BON's position statement is very nonspecific on this matter.

[HouTx, BSN, MSN, EdD]

Sorry you're encountering such a confusing mish-mash of information.

What a licensed person can - or can't do - is governed by the Scope of Practice for that license. In Tx, there are only 2 hard & fast rules for LVNs.... 1. You MUST work under the immediate supervision of an RN, MD, PA, Podiatrist or Dentist. 2. You can't perform any tasks for which you have not been prepared & found to be competent. It is the responsibility of your clinical supervisor (and the organization for which they work) to ensure your competency before they delegate/assign a task to you. However, it is also YOUR responsibility to refuse to perform a task if you are not competent... clear as mud, right?

The biggest cause of this confusion is the wide variability among LVN programs. Programs only have to be "approved" by the TxBON - accreditation is not required. The process of Accreditation forces standardization because these programs are meant to result in transferable, interchangeable college credits. But approved programs are structured on a "clock hour" (tech school) format and allowed much greater leeway, as long as they meet all of the basic instructional elements... these courses are not directly transferable, to another school.

Take a look at this Position Paper - you may even want to print out a copy for future reference. It is a collection of all the relevant TXBON documents that impact your practice. In the meantime, you'll need to make sure that (with each and every job) you are absolutely crystal clear on your employer's policies that outline what you are permitted to do. Don't simply let anyone 'dump' inappropriate tasks on you without additional training and/or preparation.

[txnurse2014]

great ,thanks!