Texas LVN's giving IVP medications. Whats the problem?

txspadequeenRN, BSN, RN · Apr 20, 2005

I live in Texas and have been doing IVP's for years. However, I am IV certified so, I dont know if that makes the difference. Good Luck

According to the TX BNE, I may have exceed my scope of nursing practice, by mixing and administering IV medications, without proper training, skills and without adq. supervision,as required. I talked with the investigator and he says I'm OK, except that I need to provide proof that I was trained to give IVP medications? I'm kinda lost. I've been nursing for 25 years. Have 16 years of ICU,CCU,CVCU under my belt. Got 2 years ER and was a member of the MICU team for 5 years. I've been pushing medications my whole nursing career. Granted, many states don't allow LVN's to do this, but these states don't allow LVN's to work in ICU's either. I started right out of school into ICU. I took a comprehensive ICU course before I even started, which included giving IVP medications. Back then, they did'nt give out paper showing your training. You took the training, worked with an RN, showed your proficency and either washed out or where accepted into the unit. I have 3 IV certificates for three different employers, have maintained ACLS for the past 16 years. Whats up? Any advice or direction to understanding what the BNE wants would be appreciated.

CHATSDALE · Apr 20, 2005

I think that you are covered from the info you gave in your post...need something in writing about what state requires for the future

mydesygn · Apr 22, 2005

According to the TX BNE, I may have exceed my scope of nursing practice, by mixing and administering IV medications, without proper training, skills and without adq. supervision,as required. I talked with the investigator and he says I'm OK, except that I need to provide proof that I was trained to give IVP medications? I'm kinda lost. I've been nursing for 25 years. Have 16 years of ICU,CCU,CVCU under my belt. Got 2 years ER and was a member of the MICU team for 5 years. I've been pushing medications my whole nursing career. Granted, many states don't allow LVN's to do this, but these states don't allow LVN's to work in ICU's either. I started right out of school into ICU. I took a comprehensive ICU course before I even started, which included giving IVP medications. Back then, they did'nt give out paper showing your training. You took the training, worked with an RN, showed your proficency and either washed out or where accepted into the unit. I have 3 IV certificates for three different employers, have maintained ACLS for the past 16 years. Whats up? Any advice or direction to understanding what the BNE wants would be appreciated.

I live in Texas and am an RN and every hospital I worked at has different guidelines on what LVN's can and cannot do. At one hospital, the LVN's could not do an initial assessment on floor admission and at another they could as long as an assessment was do by an RN at an earlier point (like in the ER). I have worked with LVN's who could give IVP meds (after all I have never had to go give a heparin flush or morphine for a LVN) and others who were told they could administer it if it was on a syringe pump. One place would not allow LVN's to hang blood. There appears to be so much gray area.

Is this just a Texas phenomnon?

GN1974 · Apr 22, 2005

In my state LPNs can't give IVP meds at all. I would not give IVP meds as an LPN because in doing so I think you put yourself at risk. I think this is out of the intended scope of practice and obviously the board must have as well. I have been an LPN for 10 years and have been licensed in 4 different states, none of these states allowed it. Maybe texas needs to define their stance on this in a very clear manner.

Home Health Columnist / Guide · Apr 22, 2005

Texas LVN practice act is very vague and is considered a "permissive act" as long as performing under RN/MD direction with adequate training and supervision given.

Each time your hired by a facility, you should be oriented to its policy and procedures, with most having a checkoff document showing that you were oriented and return demonstration observed along with unit specific policies oriented. You need to get a copy of this from the facility working in.

Also, need a copy of this facilities policy showing that LVN may give IVP meds in Critical care unit. If the unit does not have a policy on this, was your manager aware and willing to place in writing that practice standard in her unit permitted you to give meds?

Those documents + prior IV certification should clear you of working outside scope of practice.