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Worried About I.v.'s

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touche...it all comes down to common-sense . i have worked with rn's as well as lvn's who were excellent and others dangerous. i don't want to hurt anyones feelings. i was an lpn 5 yrs before becoming an rn[ by attending college, not the internet], and was well trained and proficient, but i didn't always understand the limitations of my training and licensure as an lpn. it wasn't until i started rn training and got my ass kicked [so to speak] that i humbled myself, opened my ears, and shut my mouth and learned new perspectives and ways of getting the job done. bye for now. anne

touche...it all comes down to common-sense . i have worked with rn's as well as lvn's who were excellent and others dangerous. i don't want to hurt anyones feelings. i was an lpn 5 yrs before becoming an rn[ by attending college, not the internet], and was well trained and proficient, but i didn't always understand the limitations of my training and licensure as an lpn. it wasn't until i started rn training and got my ass kicked [so to speak] that i humbled myself, opened my ears, and shut my mouth and learned new perspectives and ways of getting the job done. bye for now. anne

dear amk, thank you for hearing my real concern and understanding what i was talking about. if one reads back to my first post, the original post, one will see that my concern is about my having to oversee more lvn's. if CA goes to a 1:4 ratio, then the way that i see the hospitals as achieving this is to hire mostly lvn's, and have one rn to oversee them. now, if i wind up having 26 pt., where does my responsibility end. as it is now i am checking mar's against kardex, checking charts, new orders, labs, progress notes, assessing,,,,,doing the care plan, teaching, and last but not least i.v. meds. there are not enough hours in a shift to do this for 26 pt. i'm probably worried about nothing. i can just move into a specialty area.....

dear amk, thank you for hearing my real concern and understanding what i was talking about. if one reads back to my first post, the original post, one will see that my concern is about my having to oversee more lvn's. if CA goes to a 1:4 ratio, then the way that i see the hospitals as achieving this is to hire mostly lvn's, and have one rn to oversee them. now, if i wind up having 26 pt., where does my responsibility end. as it is now i am checking mar's against kardex, checking charts, new orders, labs, progress notes, assessing,,,,,doing the care plan, teaching, and last but not least i.v. meds. there are not enough hours in a shift to do this for 26 pt. i'm probably worried about nothing. i can just move into a specialty area.....

yes cokie i did understand the original concerns you raised and no one can understand this until they are the rn " in charge". sometimes staff members aren't aware of what is said and directed behind closed doors with managers and administrators. i have found that quietly observing others work habits can speak loads without saying a word; identify your staff and go from there.

yes cokie i did understand the original concerns you raised and no one can understand this until they are the rn " in charge". sometimes staff members aren't aware of what is said and directed behind closed doors with managers and administrators. i have found that quietly observing others work habits can speak loads without saying a word; identify your staff and go from there.

Originally posted by cokie

supervise any number of LVN's while they hang i.v. meds, most without the knowledge base to know proper doses, proper uses (micro),. infiltration, phelbitis, drugs that need to be diluted (K), drugs very hard on the veins....

Ummm, I dont think you get it. Lpns are educated on all the above before actually being able to give IV therapy. The Board of Nursing makes sure of this. If not in the nurses IV therapy class the facility the lpn works for is responsible for this education. As a supervisor you are also responsible for RNs hanging IV meds. They are also educated in all the above. If not in school, the facilty is responsible for this.

Do you honestly think the faciity is going to let ANY nurse give drugs if they are not aware of it's use, side effects, doses. (all the above.) Oh, you forgot compatability.

On the floor, the first time a RN or LPN gives an IV med or does any procedure they have never actually done they must be supervised. This is protocol at every facility I have had the pleasure of working with. Then ya have the good ole drug book, this is actually read by LPNs. I dont know a single nurse who knows off the top of her/his head all the meds they are going to give. We are taught that if you dont know, look it up. We read too!

As I stated in my last post the LPNs education is being extended due to their scopes of practice HAVING to be extended. Notice I did not say overextended. Just as in the last decades the RNs education has had to be exdended due to their scope of practice having to be extended. As I said earlier this is due to longer life spans, the growing population and advancement in medicine.

Do you think when they started teaching RNs to hang blood, insert central lines and do initial assessments on patients the MD said "OMG, they wont know what they are doing." (Years ago the MDs job included all this.) No, they didnt say this. They knew that the RN would be well prepared and educated appropriately.

Just a vivid thought.

Peace and openmindedness to you my fellow nurse

:D :D :D

Originally posted by cokie

supervise any number of LVN's while they hang i.v. meds, most without the knowledge base to know proper doses, proper uses (micro),. infiltration, phelbitis, drugs that need to be diluted (K), drugs very hard on the veins....

Ummm, I dont think you get it. Lpns are educated on all the above before actually being able to give IV therapy. The Board of Nursing makes sure of this. If not in the nurses IV therapy class the facility the lpn works for is responsible for this education. As a supervisor you are also responsible for RNs hanging IV meds. They are also educated in all the above. If not in school, the facilty is responsible for this.

Do you honestly think the faciity is going to let ANY nurse give drugs if they are not aware of it's use, side effects, doses. (all the above.) Oh, you forgot compatability.

On the floor, the first time a RN or LPN gives an IV med or does any procedure they have never actually done they must be supervised. This is protocol at every facility I have had the pleasure of working with. Then ya have the good ole drug book, this is actually read by LPNs. I dont know a single nurse who knows off the top of her/his head all the meds they are going to give. We are taught that if you dont know, look it up. We read too!

As I stated in my last post the LPNs education is being extended due to their scopes of practice HAVING to be extended. Notice I did not say overextended. Just as in the last decades the RNs education has had to be exdended due to their scope of practice having to be extended. As I said earlier this is due to longer life spans, the growing population and advancement in medicine.

Do you think when they started teaching RNs to hang blood, insert central lines and do initial assessments on patients the MD said "OMG, they wont know what they are doing." (Years ago the MDs job included all this.) No, they didnt say this. They knew that the RN would be well prepared and educated appropriately.

Just a vivid thought.

Peace and openmindedness to you my fellow nurse

:D :D :D

we all have to just cover our own asses. no more co-signing for me.

we all have to just cover our own asses. no more co-signing for me.

Originally posted by amk1964

we all have to just cover our own asses. no more co-signing for me.

Why no more co-signing? Just curious.

nowplayingEDRN

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

I have worked where there were 2 RNs and LPN and 1 aide on the night shift for 47 pts....14 of those beds were telley. there were nights when i was the only tellycert. RN on the floor and assigned to work the back half of the unit with the LPN. It all comes down to knowing who is competent and who is not and believe me, I have, shameful to say, worked with RNs that I prayed desperately that I never had to work with them again and would have give my left eye to have one of my LPNs with me. That was back when we were allowed to mix our own KCL into IVs....the LPNs would always ask me to mix up the KCL and if they were not comfy with hanging the bag, they told me and I had no trouble doing it (after all I am the RN and ultimately responsible). I mixed all our meds and the LPN hung the meds on "her half" of the pts and I did my half...then I just went around and checked on all the LPNs pt to make sure everything was kosher, which the LPN never had grief with or felt like I was second guessing......95% of the LPNs I have worked with had better assessment skills than some RNs and I tip my hat to a group of professionals that get treated like glorified CNAs (not knockin ya folks cause we could not do our job with out you aids) rather than having a brain in their head and allowed to use the professional skills that they were trained to use. It is unfortunate that all the legalities have taken the job away from the licensed folks and put it in the hands of the UNlicensed assistive personnel (not counting all the fantastic CNAs I have worked with)

Now....putting the critical job in the hads of those with out a state license of any kind always baffled me :confused: :confused:

nowplayingEDRN

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

PS: And the RN had to open and document the assessment in the LPNs charts too...which was the new policy and an insult to the LPN on shift......I prefered to read what they wrote, ask my questions, eye ball the patient if necessary and co-sign the chart (when I felt comfortable) And there were some that I did everything myself because I was not confident in their skills.....

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