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question about scope in TN


I have been an LPN in TN since 1990 but have not practiced in several years. l have just accepted a job in a small office with two physicians. I am the only nurse there. The slots have been filled by two women who aren't even trained MAs. These women were self trained by the docs and are doing everything... Working up pts to be seen, drawing labs, giving injections, calling in scripts, you name it. And are even being called "nurses". They are also giving what the office calls "IV iron infusions". This consists of drawing up iron into a syringe, performing venipuncture with a butterfly set, then injecting the solution into the pt over a series of several minutes. This is my question...

As I understand my LPN scope, I can't do this correct? Isn't doing IV push meds out of the LPN scope of practice? The way I understand it docs can pull folks off the street and train them to.do things under the.doc's own license. But my LPN license prohibits me from certain things such as this.right? I would appreciate advice from an LPN who has more recent experience. Thanks.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Does the TN BoN specify LPN scope online? (Some states do, some don't). Can you call the BoN? Some have hotlines for scope of practice queries?

1000-02-.15 SCOPE OF PRACTICE.

(1) Intravenous (IV) Push Medications - The administration of intravenous push medications refers to medications administered from a syringe directly into an ongoing intravenous infusion or into a saline or heparin lock. Intravenous push does not include saline or heparin flushes.

(a) Licensed Practical Nurses may deliver selected intravenous push medications when prescribed by a licensed health care professional who has legal authority to prescribe such medications, and when under the supervision of a licensed physician, dentist or registered nurse pursuant to T.C.A. 63-7-108, provided:

1. the Licensed Practical Nurse has a minimum of six (6) months experience as a licensed nurse; and

2. the Licensed Practical Nurse has successfully completed a course of study

developed from the Infusion Nurse Society Standards; or

3. has successfully completed a formal (institutional/agency-based) intravenous

therapy training and competency program prior to January 1, 2007; and

4. the Licensed Practical Nurse practices under the supervision (defined as "overseeing with authority") of a licensed physician, dentist, or registered nurse pursuant to T.C.A. 63-7-108. The supervisor shall maintain accountability for the delegation while the Licensed Practical Nurse is accountable for his/her acts; and

5. the Licensed Practical Nurse administers IV push medications in peripheral lines only; and

6. Competency is demonstrated to the chief nursing officer or the chief nursing officer's representative when the Licensed Practical Nurse is employed by a facility required to be licensed pursuant to T.C.A. 68-11-204, or competency is demonstrated to the supervising physician or dentist when the Licensed Practical Nurse is not employed by a facility required to be licensed pursuant to T.C.A. 68-11-204; and

7. Documentation of competence is maintained in the Licensed Practical Nurse's personnel file, signed and attested to by the facility's chief nursing officer; and

8. the Licensed Practical Nurse administers IV push medications only to adults weighing over eighty (80) pounds.

(b) Licensed Practical Nurses shall not administer IV push medications to pediatric or prenatal and ante partum obstetrical patients.

© Licensed Practical Nurses shall not administer the following fluids/medication/agents or drug classifications in the context of intravenous therapy:

1. Chemotherapy; and

2. Serums; and

3. Oxytocics; and

4. Tocolytics; and

5. Thrombolytics; and

6. Blood or blood products; and

7. Titrated medications and dosages calculated and adjusted by the nurse based on patient assessment and/or interpretation of lab values and requiring the nurse's professional judgment; and

8. Moderate sedation; and

9. Anesthetics; and

10. Paralytics; and

11. Investigative or experimental drugs.

You can Google tn lpn scope of practice. There is a pdf version. Specifics start on pg 32