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Authority to initiate intravenous lines
I’m a nurse in the General Class practicing at a wellness clinic where naturopaths offer clients intravenous (IV) chelation therapy. The clinic protocol is for the nurse to start the IV and then the naturopath administers the chelation treatment but there is no order in place for a nurse to insert IVs. As a nurse, am I permitted to initiate an IV for this therapy?
No, you are not permitted to initiate the insertion of an IV in this situation.
Initiation occurs when an RN or RPN independently decides, in the absence of an order, that a specific activity is required and then performing it in compliance with the regulations. The Scope of Practice standard lists the activities that RNs and RPNs can initiate and outlines the key concepts nurses must consider prior to performing the procedure.
RNs and RPNs have the authority to initiate venipuncture to establish peripheral venous access and maintain patency (0.9% NaCl) only when a client requires medical attention and delaying venipuncture is likely to be harmful. Inserting an IV for chelation therapy at the wellness clinic does not fit this description.
The nurse in this situation would require an order from an authorized provider, for example a physician, dentist, chiropodist, midwife or NP to perform the controlled act of starting an IV. Naturopaths are not included in this list.
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