Medical orders for lidocaine for IV starts

[bosswheadache]

Hello all. In my conservative state a physician's order is required for an RN to use lidocaine for local anesthesia prior to peripheral IV starts. I have been reading the many posts about nursing advocacy for patients as rational for using the lidocaine. I also recognize the rationale behind those who believe the lidoaine is a second 'poke' thus nonsensical. I believe in applying clinical judgment to each unique patient encounter, so I see the wisdom in each approach. Help me. Do your hospitals have 'preprinted order sets' (or protocols) for RNs to use the lidocaine with IV starts? Ant help would be appreciated. (PS I know states vary in regard to nursing practice statutes. I am interested in how this is handled widely). Thanks in advance!

[CuttingEdgeRN]

I work in the OR and we are allowed to use lidocaine for IV starts (and always do if 18g, sometimes even for 20's). Our pharmacy has them pre drawn up and labled in the holding area IV cart.