So irritated...

[catladynurse]

so ive been doing home care for my girl for a year and a half, she came off TPN via PICC in june, well now shes in hospital and has a central port and getting TPN again, and now theyre telling mom that i cant manage it, hang, flush, etc because its considered a iv med and only RN;s can do that, um, hello NOOOO

as an lpn in mass i can do everything but iv push meds, i can hang tpn or a bag to be infused. so ill be cut from 40 to 33 hours. thank God i am doing my transition prereq's now

but it is sooooo wrong that these different agencies are doing to LPN's to favor RN's.

so now i am going to lose hours because a hospital is lying to my patients mom. my licensure says what i can do but the are where i live is very anti LPN

i am feeling upset becuase i have gone sooooo far out of my way for this family. but really why do rn's anf agencies hate lpn's so much????

when i get my RN, i will remmeber how i was treated as an LPN

[Asystole RN]

I am sorry you are upset.

If you can utilize a central line to administer TPN according to your SOP then why do you care what the hospital says? More likely their statement is coming from ignorance and not spite. In many states LPNs cannot access central lines, this may be a situation of simple ignorance of your SOP. Educate them.

P.S.

When you state "my girl" I am assuming that you are not referring to the patient in a non-professional romantic way but are simply saying "my girl" in that the patient has been yours for an extended period of time?

[Meriwhen, ASN, BSN, MSN, RN]

It's frustrating when your licensure allows you to do something but the facility will not let you do it.

For example, according to my BON, any nurse can place and read a PPD...but the facility I work at will only let specially trained nurses read them. To be honest, there's very little in that training class that I didn't already know from nursing school...but that's the facility's P&P, so if you're not one of the facility-trained nurses, you have to hunt one down to take care of the PPD for you. Doesn't matter if you've been placing PPDs since dinosaurs walked the earth.

Do I like or agree with this? Not always. But that's how it is sometimes. Perhaps they're concerned about liability, don't want to have LVNs doing IV meds, are trying to ultimately phase out LVNs...who knows?

Sorry you're being hit with this.

[missladyrn]

I worked at a hospital in Massachusetts years ago, and LPNs were nit allowed to access a central line. They could not hang blood, they could not do restraints, and they could not do tpn. I would look up the scope of practice, and get a copy of your agency's policies.

[iluvivt, BSN, RN]

It is your responsibility to know what your licensing board will allow you to perform legally and it sounds like you do already however,just b/c you are able to do certain things does not mean that any agency or hospital you work for will allow you to do certain things. In addition, they may require additional certifications in certain instances and mandatory skill labs as is their right as well. As clinicians we all put up with some of these annoying rules but I can tell you when you become an RN there will be many more to come...not less.

Are you 100 percent certain in your state you are allowed to hang TPN? I can tell you in California you are not able to do that with an LVN license but you can hang blood in California. If you are able and you were doing it then why will your agency not back you up?

Is your agency now listening to the hospital and if so why? Could it be the a heparin flush issue? Something is missing here.

[catladynurse]

i do understand what my licensure allows me to do, which is why this is ******* me off so much, i feel like this is how theyre getting around phasing out lpn's its not state law its just becoming company policies.

sooo irritating, but it motivates me to study my ass of and get RN asap

[jadelpn, LPN, EMT-B]

I am an LPN in MA and the issue is--as I understand our scope to be-- we can not run anything nor take care of a port, or a PICC for that matter. BUT it can differ from facility to facility/agency to agency. So the person mis-spoke when they said that an LPN can't hang any IV meds, but that in Massachusetts, it is my understanding that we can not hang any IV meds/TPN and attach to a port or PICC.

So if they allowed you to do this when the child had a PICC is interesting. Call the BON and ask that within the scope of the LPN in MA what are the limitations of ports. Sometimes it is vauge and it is facility/agency based. If that is the case, I would then go to the agency you work for and ask them what your scope is regarding this in their agency. If they say that you can access, hang and maintain a port after showing compentecy, then have the agency advocate for you. If you are private duty and really have never taken care of or accessed a port before, I would use significant caution, and probably would not want to take this on as a client. TPN as you know can be very complicated. Ports are also not easy. There are specific RN's who are part of an IV team that access ports. As an LPN we can put in IV's after certification. We can hang IV meds and fluids. As you noted, we can't push or hang blood. And in some facilities, can't start the first course of IV antibiotics.

The last thing I would want to do is put my LPN license on the line, or to mess up any chance of getting an RN license over this. I think it has more to do with the fact that RN's can push meds that may be needed if something goes wrong with the port, or the child has some sort of reaction to the TPN, which is perhaps why they don't allow LPN's to do this. Because to monitor is one thing, but not being able to start interventions should something go wrong a whole different thing.