New LPN with BIG concern over TN scope of practice re: IV Push

explorer · Oct 26, 2004

I posted this in the TN Nurse's Forum, but since that one doesn't get a lot of traffic, I thought it would be a good idea to post it here as well. Here goes: I've been working as an LPN for less than 3 weeks now. I started training on the med cart this weekend and part of my training was pushing meds such as phenegran and nubain. All the LPN's in my hospital do it, so I accepted it as a normal part of my training. But today I was looking at the TN BON website and stumbled onto the board's amended policy regarding LPN's and IV therapy. Basically, it states that the LPN must have a minimum of 3 years experience or 2 years experience with completion of a formal IV training program at their facility in order to administer IV push medications. I have neither as I have been a LPN only since the 13th of this month and IV therapy is not included in the curriculum in TN LPN schools! I guess one of my questions would be: are any of you LPN's pushing IV meds without meeting the above conditions? Also, I did sign off on meds I pushed while training this weekend...is my tail end going to end up in the frying pan for this? And if this is standard policy at my facility, even though it is outside my scope of practice, what should I do? Am I interpreting "IV push" correctly when I assume it refers to any medication installed into the vein via the IV port? I'm really confused and concerned on how to address this with my new employer. All suggestions are appreciated.

In Missouri LPN's aren't allowed to push meds even if you have completed the IV Theraphy course.

NurseforPreggers · Oct 26, 2004

I read this to mean that you may administer IV medications such as mainline fluids and IVPB drugs. I would be very careful about the push medications. I suggest that you print out the page on the TN BON website and give it to your superior explaining that you do not yet meet these criteria and will not be able to administer any more IV push meds.

Being a new nurse you have a higher potential of making a drug error (I'm a new nurse too) and losing your license if you are working outside of your scope. You worked very hard to get your license and I think you should do everything you can to protect it. If you employer doesn't agree I would say bye bye. Nothing is worth losing your license over.

HappyNurse2005, RN · Oct 27, 2004

oh, don't do it. show them the LPN scope of practice you found. Now that you know that it is out of your scope of practice, and you do it, thats not cool. If you were to do something wrong in the pushing of the med, and someone found out you knew you weren't supposed to do it, but you did it anyways? see my point?

anyways, i live in Virginia and LPN's here don't do IV push either. im not sure about any course they can take, b/c i am a RN student (who just started doing IV push meds myself this semester) but i was told that LPN's don't do IV push.

hope it all works out!

virmm1, LPN · Oct 27, 2004

I read this to mean that you may administer IV medications such as mainline fluids and IVPB drugs. I would be very careful about the push medications. I suggest that you print out the page on the TN BON website and give it to your superior explaining that you do not yet meet these criteria and will not be able to administer any more IV push meds.
Being a new nurse you have a higher potential of making a drug error (I'm a new nurse too) and losing your license if you are working outside of your scope. You worked very hard to get your license and I think you should do everything you can to protect it. If you employer doesn't agree I would say bye bye. Nothing is worth losing your license over.

DITTO, Well put NurseforPreggers

virmm1, LPN · Oct 27, 2004

I read this to mean that you may administer IV medications such as mainline fluids and IVPB drugs. I would be very careful about the push medications. I suggest that you print out the page on the TN BON website and give it to your superior explaining that you do not yet meet these criteria and will not be able to administer any more IV push meds.
Being a new nurse you have a higher potential of making a drug error (I'm a new nurse too) and losing your license if you are working outside of your scope. You worked very hard to get your license and I think you should do everything you can to protect it. If you employer doesn't agree I would say bye bye. Nothing is worth losing your license over.

DITTO, Well put NurseforPreggers

nursbee04 · Oct 27, 2004

Our LPN's with 3+ years of experience had to take an IVP course and go thru an orientation and be checked off on each med they push, and there are still a number of meds they can't push, and phenergan is one of them. We have a list of meds they can push posted in the med room. You are at a big liablility, especially if you've not had any training or education re/IVP. I'd show them what you found and I WOULD NOT do it any more.

nursbee04 · Oct 27, 2004

Our LPN's with 3+ years of experience had to take an IVP course and go thru an orientation and be checked off on each med they push, and there are still a number of meds they can't push, and phenergan is one of them. We have a list of meds they can push posted in the med room. You are at a big liablility, especially if you've not had any training or education re/IVP. I'd show them what you found and I WOULD NOT do it any more.

southern rn · Oct 28, 2004

i haven't looked at the bon's policy but the last we were told at our hospital was that lpn's couldn't give ip push per bon. it may have been amended since then. prior to this my facility was having all the lpn's give iv push drugs till they were told otherwise. they didn't bother to keep up with the policy. these hospitals will have you do whatever they can just to have enough staff. make sure and cover yourself and don't do this if it is not bon policy. the hospital will not back you if something happened. btw what part of tn are you in?

tracy

southern rn · Oct 28, 2004

i haven't looked at the bon's policy but the last we were told at our hospital was that lpn's couldn't give ip push per bon. it may have been amended since then. prior to this my facility was having all the lpn's give iv push drugs till they were told otherwise. they didn't bother to keep up with the policy. these hospitals will have you do whatever they can just to have enough staff. make sure and cover yourself and don't do this if it is not bon policy. the hospital will not back you if something happened. btw what part of tn are you in?

tracy

laurakoko · Oct 28, 2004

No LPN in Louisiana can push any medications IV. I know because I was an LPN in LA for 2 years before an RN. I practiced what was only in my scope. I know it differs in states, but to know your scope of practice is the law. I agree with the above post. Bring the practice to your supervisor, and tell them you do not feel comfortable, until the time comes that you can administer these meds. They should NOT have a problem with that.

laurakoko · Oct 28, 2004

No LPN in Louisiana can push any medications IV. I know because I was an LPN in LA for 2 years before an RN. I practiced what was only in my scope. I know it differs in states, but to know your scope of practice is the law. I agree with the above post. Bring the practice to your supervisor, and tell them you do not feel comfortable, until the time comes that you can administer these meds. They should NOT have a problem with that.