Texas - LVNs not allowed to give blood???

vamedic4, EMT-P · Mar 12, 2008

I looked and didn't find this anywhere. Sounds like someone's pulling your chain.

TexasPediRN · Mar 12, 2008

I dont know where it can be found, but to my knowledge an LPN cannot begin the transfusion, but may monitor the patient during(along with the RN) and DC the transfusion.

Someone feel free to chime in and correct me if im wrong..

RN1989 · Mar 12, 2008

I haven't looked at it in years, since it does not apply to me. But this is true. An LVN can check blood with an RN but an LVN is not allowed to physically hang it on the pole and connect it to the patient. However they are allowed to monitor vs during the transfusion. Years ago LVNs really did not have a nurse practice act. They were allowed to do anything that they were "trained" to do by their employers. This of course is like any training, there is no guarantee that the training was adequate or appropriate. So some of the older LVNS that I worked with were able to hang blood because they had been doing it for 20 years.

TX has been working on a nurse practice act that is more specific for LVNs to prevent some of the tragedies that have ocurred with letting LVNs do "anything they are trained by their employers to do". Thus, more and more LVNs are not allowed to hang blood anymore. This new nurse practice act will also prevent LVNs for being given responsibilities over and above their educational preparation and being used in place of RNs while being paid much less.

Personally, I do not desire an LVN to be put into this responsibility and will not assign an LVN to pt that will likely get blood. Just as I will not simply hang blood for an LVN and allow that LVN to monitor it without me checking the pt during the infusion. This has nothing to do with whether an LVN is smart enough, but as an RN I am liable for anything that an LVN does, per the nurse practice act, I will not put my license on the line hoping that the LVN knows all the ins and outs of transfusions and reactions.

I know that this rankles many LVNs because they do not like being told they can't do something that an RN can do and they feel that they are being told that they are second class citizens. There is a place in nursing for all levels of education. Each person is responsible for allowing someone to make them feel bad because of differences in education. My reply is: if you don't like the constraints of your current education - go back to school to get the degree that will allow you to do what you would like to do.

txspadequeenRN, BSN, RN · Mar 12, 2008

lvn's in texas cannot spike blood . they can verify it and monitor it but not initially start it.

iLOVEbees · Mar 26, 2008

The RN has to spike the blood and monitor for the first 15 minutes. After that, any nurse can take over.

I know a lot of RNs who just sign off that they are the ones hanging the blood and let the LVN actually do it, but that is begging for trouble IMO even though I disagree with the rule.

TheCommuter, BSN, RN · Mar 26, 2008

This might be off-subject, but I personally would not want to administer blood products or monitor the patient during the transfusion process. The RNs are being paid more money for their wider scope of practice and educational attainment, so they might as well be the ones who spike, hang, monitor, and observe the patient who is being transfused.

txspadequeenRN, BSN, RN · Mar 27, 2008

yeah they can have it ..just one less thing i have to do.

this might be off-subject, but i personally would not want to administer blood products or monitor the patient during the transfusion process. the rns are being paid more money for their wider scope of practice and educational attainment, so they might as well be the ones who spike, hang, monitor, and observe the patient who is being transfused.

shannonFNP, BSN, MSN, RN · Oct 9, 2008

I'm in Texas and was told by my employer that I'm allowed to spike the bag and administer blood. I have to double check everything just like everyone else (it takes two to verify blood). The person I have to verify it with just has to be an RN. It can't be LVN to LVN.

?? I couldn't find anything in the NPA to say this is wrong. Don't you just LOVE how vague and gray it all is?

SuesquatchRN, BSN, RN · Oct 9, 2008

I would email them and ask. NY certainly doesn't let the LPN hang blood. We can check and monitor after the initial period.

DeVonna32RN-BSN · Aug 5, 2011

I am sooooo sick and tired of registered nurses that talk down to/about, and disregard LVN/LPNs as nurses. True their scope of practice is limited, focused based vs comprehensive, and primarily technical.........HOWEVER, they are nurses!!! LVNs, can be trained to do whatever their representing hospital deams appropriate or feel can be done within there scope. There has NEVER been anything in the NPA that specifically says LVNs are not to administer blood products. I worked 6 years as a licensed vocational nurse and during those 6 years I worked full-time at 2 different hospitals in different cities. The first hospital I worked at, LVNs could not give medications via PICC/CVC lines, could not administer any IV push medications and only monitored blood administration; but we could drop NGTs. The second hospital I worked at as a LVN was in the Dallas-Fort Worth metroplex and my clinical practice was very diverse and different: I could draw blood specimens, administer IVP medications, discontinue PICC/CVC lines and even SPIKE MY OWN BLOOD!!!! Yet, I could not insert NGTs!!! Prior to being able to complete these task, I had to complete a specialized IV therapy certification class. With all due respect, each nurse is a different nurse with a different practice.......as nurses, we MUST know the guidelines and focus of our NPA in our state. I worked with many RNs (associate and bachelor degree prepared) who were unsafe and did know what they were doing. As a LVN I had a broader knowledge base and understand of nursing than MANY RNs that I worked side by side with!!!!! I learned that in many situations, RNs or those in and educational role, will make certain statements in an indirect way to keep LVNs "in their place." I cannot stress enough the importance of LVN/LPNs KNOWING and READING their NPA for themselves. If you have questions, contact your BON and clarify via them - take legal classes or do continuing education concerning your NPA. Yes, there is a difference in the scope or perspective of nursing practice between LVNs and RNs; however, there are very few technical skills that LVNs cannot perform. TO ALL LVNs: STAND TALL, PROUD, & KNOW YOUR WORTH!!!!!! As nurses we should bond together, not tear each other down because of varying educational or practice levels!!! There has always been a nursing shortage and it only getting worse -- THEREFORE we need ALL nurses (LVNs, RN-ADNs, RN-BSNs)!!!!!!

The Standards of Nursing Practice (217.11) applicable to LVNs (as well as RNs) includes the following standards that specifically relate to medication administration:

The Board's position, therefore, is that LVNs are educationally prepared to administer medications and treatments as ordered by a physician, podiatrist, dentist, or any other practitioner legally authorized to prescribe the ordered medication. LVNs may also administer medications and treatments ordered by PAs and APRNs as established under Position Statements 15.1 and 15.18, relating to nurses accepting orders from Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs), respectively.

As with other practice tasks, the Board cannot provide a list of medications, routes of administration, or other specific information that may be relevant to determining whether or not a task is within the scope of practice for a LVN. What is within the scope of practice for one LVN may not be within the scope of practice for another LVN. The following documents on the Board's web page may be helpful for a LVN concerned about his/her scope of practice for administration of medications or other nursing practices.

15.27 The Licensed Vocational Nurse Scope of Practice

The Texas Board of Nursing (BON) is authorized by the Texas Legislature to regulate the nursing profession to ensure that every licensee is competent to practice safely. The Texas Nursing Practice Act (NPA) and the Board’s Rules and Regulations define the legal scope of practice for licensed vocational nurses (LVN). The LVN scope of practice is a directed scope of practice and requires appropriate supervision. The LVN, with a focus on patient safety, is required to function within the parameters of the legal scope of practice and in accordance with the federal, state, and local laws, rules, regulations, and policies, procedures and guidelines of the employing health care institution or practice setting. The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs.

The purpose of this position statement is to provide direction and recommendations for nurses and their employers regarding the safe and legal scope of practice for licensed vocational nurses and to promote an understanding of the differences between the LVN and RN levels of licensure.

BSN-CCRN, LNC

Ranger College School of Vocational Nursing 2003

University of Texas @ Arlington 2009

Texas Tech SON: ACNP Program 2014

Medical-Surgical/Neuro ICU

Arlington Memorial Hospital

tejas03 · Aug 13, 2011

Do any of you know if there is any hospitals here in the DFW area that will hire a LVN to work as a patient care tech? I've already called the BON and understand they have a position statement regarding this (15.15) but does not say you can't. I'm trying very hard to go back to school to finish my BSN (applying at UTA). I've been an LVN for 11 yrs (have worked various areas outside hospital) but lack any actual hospital experience (which most hospitals aren't hiring LVNs anymore anyway) but I feel very confident working as a tech (and strictly adhering to the role of tech and not crossing that line). I feel this experience would greatly benefit me during school and be a foot in the door for after I graduate. Problem is no hospital is even offering me an interview. Any thoughts on this?!