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Hi guys, Needing some guidance. I just recently started a position in the ED. I was just hired on to be the units first LVN which I'm very excited about. I know I can't IV push, but does anyone else know of any hard NOs that LVNs can't do. For example, can LVNS waste meds with an RN? I had an RN ask me if I could waste and I'm not sure. The board is hard to get in touch with so thought I would ask around first. Since I'm their first they aren't exactly sure what I can and can't do either. It's my first time in this setting so I am having to clarify what's acceptable and what's not. Can I draw blood from a pre-existing port? These were situations I was met with today. Any advice is appreciated!

Drs Office 100%, the pay isn't worth it at LTC, and with children you'll want the holidays off. Less Pay but still enough to keep your skills and keep your life balanced.

I Personally worked at an IV infusion clinic when I was an LVN. I was able to hang bags and "superimpose category 1 fluids" (electrolytes,vitamins,and NS pretty much) I could not mix the bags but was able to start an IV and connect it. As an LVN I could not mix so I'm assuming as an RN you would be able to do so. Be careful in this kind of practice because there are often no policies in place or guidelines as of what you can and cannot do. The best advise would be to contact the board for a thorough understanding of your scope, that's what I did. Their wording is often tricking when reading through the scope so contacting them to clarify is suggested.

I've been told that angling the catheter up can help but have not tried this yet. When angling from the side of the vein how far do you insert before you change direction to actually hit the vein?

Thank you so much for responding. I’ve noticed I don’t struggle as much with the elderly, which is bizarre. It seems the common sticks I miss are with the obese population. 22 g is my standard. I’ve found whenever I use a 20 g I have difficulty threading in the catheter.

You should quit! Remember this is your license on the line. I worked in a medical office like that with constant drama and I was miserable. I do things by the book, and they also had a problem with this and at the end of it I was the one in trouble for speaking up. There is no reason to be shamed for doing things the right way. This job won't help your nursing career if that is the environment that the doctor is allowing. I'm sure you would be the first one they would pin something bad on. No reason to stay somewhere that isn't of service to you. Good luck!

I've been a nurse for about two years and just started working as an IV infusion nurse. In the past, I've had experience with blood draws and have started IVs a handful of times. I'm really excited about this position and I've been successful with most of my sticks in the AC/ bicep area and have been successful with placement in the hand a few times. I'm struggling with IV placement in the back of the hand. I usually get flashback and lower my angle but then the catheter won't thread or I go to stick them and the vein completely rolls. I anchor it, but find my hand placement gets in the way of my sticking hand if that makes sense. What angle is recommended? I've started to go more flush to the skin but have even been missing when adjusting my angle. Getting very frustrated with this and I have to admit it psyches me out everytime I know I have to place an IV in the hand. How do you guys keep your cool when you've had a few bad sticks in a row? Also, is there anyway to tell where valves are besides for seeing them? I've hit valves on pretty good veins that made it difficult to thread it in. Any help is appreciated!