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Really don't understand the mystery of LPNs not able being able to do certain things

Specializes in LTC and School Health.

As a LPN to RN, I don't understand why LPNs are not allowed to push a med or hang first unit of blood. Why is it such a mystery ? As a new grad RN, I'm thinking why could I have not done this as a LPN. Does it really take a 2-4 year degree to know how to push a med. As long as you use the six rights and know basic nursing, a LPN should be able to push a med or hang blood.

pockunit, ADN, RN

Specializes in Emergency; med-surg; mat-child. Has 5 years experience.

As a LPN to RN, I don't understand why LPNs are not allowed to push a med or hang first unit of blood. Why is it such a mystery ? As a new grad RN, I'm thinking why could I have not done this as a LPN. Does it really take a 2-4 year degree to know how to push a med. As long as you use the six rights and know basic nursing, a LPN should be able to push a med or hang blood.

Because it's out of your scope of practice? Because the states say NO? Because LPNs haven't been trained to the same extent in critical thinking?

So there's no point in having RNs, by your logic. LPNs can do everything RNs can, right?

Meriwhen, ASN, BSN, RN

Specializes in Psych ICU, addictions.

Unfortunately the mystery of what a LVN can and can't do is the result of what your state BON has decided. You could always drop your state BON a note and ask them about it.

BrandonLPN, LPN

Has 5 years experience.

For obvious reasons, I agree with you in principal. Of course I have the critical thinking skills to give a med by IV push or to spike a bag of blood. But the different licensing levels of nursing have to have different scopes of practice or else the roles are meaningless. That means there has to be a line and that it has to be drawn *somewhere*. And that line must be sharp and clear. The RN/LPN separation is ambiguous enough already.

Honestly, the same argument you make re: RN vs LPN could be made in some cases for CNA vs LPN. When I was a CNA and I got a febrile temp on a pt, of course I had the critical thinking skills to know how and when to give a couple Tylenol. But I had to go to the LPN because rules are rules and that's just the way it has to be.

Ruas61, BSN, RN

Specializes in MDS/ UR. Has 38 years experience.

For some tasks, a lay person could potentially do te same things. Manual performance alone does not make one a skilled clinician,

OnlybyHisgraceRN, ASN, RN

Specializes in LTC and School Health.

Because it's out of your scope of practice? Because the states say NO? Because LPNs haven't been trained to the same extent in critical thinking?

So there's no point in having RNs, by your logic. LPNs can do everything RNs can, right?

This is not what I meant or said. I just believe pushing IVP and hanging blood should be apart of the scope. Why include it on the nclex and in programs if LPNs are not allowed to practice it. Just that me and a friend was discussing this the other day and started laughing. We were like what is the mystery of if all.

LPNS cannot do everything, never said they could. I just named two examples of what I think the BON should include.

OnlybyHisgraceRN, ASN, RN

Specializes in LTC and School Health.

Unfortunately the mystery of what a LVN can and can't do is the result of what your state BON has decided. You could always drop your state BON a note and ask them about it.

Nope, not that serious. Just wanted to post for discussion.

As a LPN to RN, I don't understand why LPNs are not allowed to push a med or hang first unit of blood. Why is it such a mystery ? As a new grad RN, I'm thinking why could I have not done this as a LPN. Does it really take a 2-4 year degree to know how to push a med. As long as you use the six rights and know basic nursing, a LPN should be able to push a med or hang blood.

Not wishing to stir the pot, nor give offence but here goes my take on *why*.

First it should be mentioned that the RN profession has undergone many changes over the years with quite allot happening from say the 1980's to the present. Many of the functions performed by a staff RN today would have been considered practicing medicine and or reserved for physicans (including post grads) depending upon state and facility practice acts.

During the 1980's worked as an aide in many places where RNs couldn't push anything nor start IVs. Others report where they worked RNs most always had those functions, so there is quite a range there.

Bottom line is that practical/vocational nursing at the time states were beginning to regulate/license professional nurses were graduates of programs that ranged on average twelve months to maybe less than fifteen (depending upon how things were structured) and were mainly concerned with the "practical" aspects of nursing. That is to say (again not wishing to give offence) but a LPN was more task orientated versus a RN

Example:

Here is how NYS defines Registered and Practical Nursing:[h=3]6902. Definition of practice of nursing.[/h]

  1. The practice of the profession of nursing as a registered professional nurse is defined as diagnosing and treating human responses to actual or potential health problems through such services as casefinding, health teaching, health counseling, and provision of care supportive to or restorative of life and well-being, and executing medical regimens prescribed by a licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations. A nursing regimen shall be consistent with and shall not vary any existing medical regimen.
  2. The practice of nursing as a licensed practical nurse is defined as performing tasks and responsibilities within the framework of casefinding, health teaching, health counseling, and provision of supportive and restorative care under the direction of a registered professional nurse or licensed physician, dentist or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations.

    *****
    Being as all this may many states have updated their LPN/LVN practice acts to expand the scope of practice for such nurses to include hanging blood,starting IV's, pushing meds and so forth. Here is an old discussion on your query: Health Care POV - Hanging IV Meds


    As another poster responded the best and first place to start is with your state's BON and nurse practice act. If the state says LPNS can push IV meds but your facility does not allow it, then you have your answer.

canned_bread

Specializes in Cath lab, acute, community. Has 11 years experience.

Have LPN's learnt the role of each blood cell, what they look like, how they interact and blood disorders?

that would be like a surgical tech (who i actually mistakened for a doctor once) wanting to know why the MD had to be there to make the incision?

when i worked as a tech, i wasn't even allowed to hit "stop" on an IV pump that clearly said, "INFUSION COMPLETE" and the IV bag would be empty. the thing could be beeping and driving someone nuts. seriously, how much sense does it take to know that pressing "stop" would simply stop the beep and cause no harm?

different scopes for different folks...that's just the way it is.

I was not allowed to push an IV med during clinical in the BSN program I attended, even under the direct supervision of my preceptor, in my final semester of school. So there are probably plenty of clueless baby RNs when it comes to this typical task. LPN/LVNs don't hold a monopoly on not being able to do things, either by policy or by being properly prepared for the task at hand.

I was not allowed to push an IV med during clinical in the BSN program I attended, even under the direct supervision of my preceptor, in my final semester of school. So there are probably plenty of clueless baby RNs when it comes to this typical task. LPN/LVNs don't hold a monopoly on not being able to do things, either by policy or by being properly prepared for the task at hand.

same here. there were some IV meds i could push, but NO critical care meds...and NO meds to pregnant women period.

Have LPN's learnt the role of each blood cell, what they look like, how they interact and blood disorders?

I certainly have. I learned the former in A@P one and two and the latter in medical surgical nursing.

This is interesting. But like someone else said, I guess you have to draw the line somewhere. It's just interesting to see where the BON draws it in each state. I think there are certainly some "rn only tasks" that an lpn can complete- but I guess legally there has to be a line. Who the freak knows what some hospitals would have lpn's doing if there was no line drawn. Possibly things way out of their scope.

As a LPN to RN, I don't understand why LPNs are not allowed to push a med or hang first unit of blood. Why is it such a mystery ? As a new grad RN, I'm thinking why could I have not done this as a LPN. Does it really take a 2-4 year degree to know how to push a med. As long as you use the six rights and know basic nursing, a LPN should be able to push a med or hang blood.

If u are a registered nurse who have a good sense of anatomy and physiology as part of your assessment, you will think right away why is not given to LVN. It's is more than what it takes on just giving meds. Ex. Simple meds as Lasix IV when you need to check BP, hydration, k level, bun CRT, side effect etc. as an RN covering LVN it would be hard for us to delegate this because of the complexity involved. Remember that we are mandated by the state, so if anything happen you will be the sole responsible to the state where you got your license.

It is not a mystery, you are right, it is a simple as pushing medication and hanging blood it's a skill, but as an RN we are educated to assess, plan, intervene and evaluate all situation. If that's a mystery why do we need doctors who studied 8 - 12 yrs to give you orders when most of the time you probably know what would they order.

vintage_RN, BSN, RN

Specializes in NICU. Has 6 years experience.

I'm not sure, we can do all of that in Ontario.

It's funny that everyone keeps using the "because you didn't learn that in school" reason because most of the things mentioned we did learn. We learned about blood, we learned how to hang blood, how to watch for reactions and what to do should there be a reaction. The question is why in the world did we waste time learning something we can't do? We also had an entire class dedicated to "assessment, diagnosis, planning, intervention, and evaluation" as well as wrote out countless care plans. That doesn't mean I am as qualified as an RN, but i do know a little bit about nursing. With some peoples responses I am curious as to what they think we do in LPN school.

XB9S

Specializes in Advanced Practice, surgery. Has 22 years experience.

We have "enrolled nurses" in the UK which I think are similar and there was a time when they were only able to do certain things and not others, now the only thing they are unable to do is apply for certain jobs due to the criteria for selection.

I have areas where are Enrolled nurses are a higher grade so are in charge of the area and the registered nurses within that area.

We are required to work within our scope of practice so if the experience of that EN allows them to take charge they are able to do so.

I'm not sure, we can do all of that in Ontario.

Yeabut up North Registered "Practical" Nurses are graduates of two year diploma or similar programs, and IIRC are nearly the equalivent of ADN nurses here in the States. Here down South LPN/LVN programs which usually run one year, though there have been newly created two year *Associate in Applied Science" for practical nurses as well.

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