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Discussion

Scope of practice question

I work on a stepdown surgical unit that uses a 70/30 RN/LPN mix. We are trying to work out a policy of what gtts the LPNs can take (or can't and why not) and I'm looking to see what others are doing in their practice. We use a lot of Nipride and Esmolol and the LPNs don't take those patients, but there are some grey areas, such as PGE and titratable insulin drips. Does anyone have any policies and practices based on the following?

PGE

Insulin

Octreotide

Lasix

Dopamine (titrating vs. renal dose)

Fenoldopam (renal dose)

Thymoglobulin (not a drip, med w/ high adverse reaction rate).

To clarify further, our state code is vague and simply states that the LPN provides care under the supervision of the RN, MD, etc.

The hospital policy is just as vague as to LPN and RN scope of practice, so it's up to individual units to devise policies. Thanks in advance for everyone's help. MMB

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The majourity of the LPN's are new to nursing and are dealing with adjusting to caring for stable patients...they still need experience and education to move away from simply "performing tasks" to understanding why they do what they do and be able to analyse the whole situation. This is not limited to the LPNs however, as we have a small senior staff and a great deal of new grads, mainly RNs with the same issues. I am awaiting a response from the BON...but as I've said previously, I don't hold out much hope since this particular state dislikes regulations and the BON in the past shifts the issues to the institution. MMB

I'm sorry MMB, I must have missed your posting on how unhelpful your BON was, as it seems we were both posting at the same time. I sincerely hope you find a solution to your problem, that will give your patients, and your new staff the best outcome.

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