PA Board refuses to answer skills question

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a debate arose at work regarding the legality of performing of a specific skill. staff nurses and nursing directors were not in agreement. i contacted the pa state board of nursing to get the answer. in one response the respondant provided an opinion but could not cite any part of 49 pa code to support it. i disagreed with the respondant's opinion and cited parts of 49 pa code to support my opinion. the respondant then replied with the following quote; "the board has no authorization to offer you opinions, legal advice or interpretations of the professional nursing law and regulations" and "we suggest that you consult with your own legal counsel..."

this response from the regulatory body of nursing in pa was quite a shock.

has anyone here had problems getting anwers from the pa board of nursing?

jt

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They tend to speak very generally and very generically. I asked them re. a particular practice several moths ago and got a vague read between the lines answer.

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

That's one of those "it is the opinion of the board that......." My BON does the same thing.

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I've been a nurse for only 15 months. This was the first time I had the need to contact the PA BON. I could not believe my eyes when I read the response. The links on their website are links to the law. I believe rules and regulations are common language interpretations of the law. Well, there are no rules and regulations provided by the PA BON even though they are authorized to write them.

This issue really has my boxers in a twist.

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Specializes in ICU, CM, Geriatrics, Management.

Some regulatory boards will give "advisory" opinions on specific, narrowly defined scenarios. Others don't.

Regardless, the opinion presented couldn't / wouldn't bind a court of law in any particular case... as I'm sure we'd all agree.

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Specializes in Trauma ICU, MICU/SICU.

So, what's the skill? I just gotta know.

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So, what's the skill? I just gotta know.

Whether or not an LPN may hang IV meds, flush, and change the dressing on a PICC line. Obviously we cannot touch IV push meds (other than heparin flush), blood products, chemo, or titrated meds.

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They tend to speak very generally and very generically. I asked them re. a particular practice several moths ago and got a vague read between the lines answer.

So how did you get your question definitively answered, or did you?

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Some regulatory boards will give "advisory" opinions on specific, narrowly defined scenarios. Others don't.

Regardless, the opinion presented couldn't / wouldn't bind a court of law in any particular case... as I'm sure we'd all agree.

Then how do you know if you're practicing within the law unless it is specifically spelled out in the law?

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Specializes in Trauma ICU, MICU/SICU.

I'm not sure if this will help. There are rules & regulations on the BON's website: 049 Pa. Code *21.145.*Functions of the LPN. It lists some of the skills an LPN may/may not perform.

Hang and remove IV fluids as long as educated (which is part of orientation at my facility). May not IV push with exception of heparin flush (I would interpret that to mean saline flush as well since heparin flushes are rare now). Since it doesn't mention central vs. peripheral line, but references IV meds, I don't see where the line is relevant. I know at my facility the LPN's hang fluids, but do not titrate drips. They use bard's for IVP or have the covering RN administer. Not sure about PICC dressings, but it certainly doesn't seem to prohibit it.

Excerpts:

(f) The LPN may perform venipuncture and administer and withdraw intravenous fluids only if the following conditions are met:

(1) The LPN has received and satisfactorily completed a Board approved educational program which requires study and supervised clinical practice intended to provide training necessary for the performance of venipuncture and the administration and withdrawal of intravenous fluids as authorized by this section.

(2) A specific written order has been issued by a licensed physician for an individual patient under the care of a licensed physician.

(i) List, identify and describe the intravenous fluids which may be administered by the LPN. The LPN is not authorized to administer the following intravenous fluids:

(A) Antineoplastic agents.

(B) Blood and blood products.

© Total parenteral nutrition.

(D) Titrated medications and intravenous push medications other than heparin flush.

Sorry the board won't give you much more help but I hope my post helps :)

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I posted/ wondered on the same issue. Picc lines. As the PP posted...it isn't very clear? It seems that as long as the facility has trained the LPN to do Picc lines it is okay???

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thanks sue.

i have experience reading and debating other laws and i have read the entire 049 pa code. since the beginning of this debate my contention has been that an lpn may hang meds (except a-d above), flush, and change the dressing of a picc line and i had been doing so until a new don came along who said we may not perform these skills. she provided the same document as your link above, which i had already read. the discussion at work continued so i decided to contact the bon. their initial response was; "the current section 21.145(f) of the lpn regulations stand, which refer to peripheral iv lines only, not picc lines. your new don is correct." i responded by pointing out that nowhere in the pn law are specific vad's mentioned. suddenly they would not opine at all. it seems i backed them into a corner and they are waiving the scripted response flag. meanwhile an inservice was being organized at work which i later attended. i was provided a spreadsheet that is one organization's "interpretation of the state board of nursing iv regulations". wanting confirmation i sent it to the bon. they responded with the quotes in my original post. i'm not sure how this interpretation came about, again, as specific vad's are not mentioned in the pn law.

i still believe i am correct. i simply want the bon to verify this, which they refuse to do. funny thing is, my dialogue was with a "nursing practice advisor". one of them asked for my phone number and best time to call, which is in the evening after work. when i replied she said basically that she works 8-4 and was unwilling to help outside those times. i provided her with several weekdays i have off but no phone call. just what does a nurse practice advisor do if they are "not authorized to advise"?

it must be nice to be a nurse with a lot of letters behind your name and collect a government paycheck for doing nothing.

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