Appendix J: Guidelines around Appropriate Nursing Student Tasks During Clinical

Link for Law/Rules from Maine State Board of Nursing: https://www.maine.gov/boardofnursing/laws-rules/Chapter_10_2-27-2020.pdf 

Student Nurses Cannot Perform the Following Tasks:

  • Insertion of an intravenous device;
  • Insertion of a Dobhoff tube;
  • Insertion of a central line device;
  • Completion of a dressing change on a central line device;
    • Administration of any blood products; ADN students may perform this task
  • Co-signature of any procedures or medications;
  • Transportation of patients from one unit to another without a licensed RN or LPN;
  • Activities outside of the student nurses scope of practice (procedure the student nurse has not been educated on during their nursing education);
  • Titration of any cardiac medications;
  • Removal of any central line, peripherally inserted central catheter (PICC) or midline;
    • ADN students may perform this task
  • Venipuncture of midlines, peripheral inserted central catheters (PICC) and ultrasound-guided peripheral catheters;
  • Blood draw off central lines;
    • ADN students may perform this task
  • Assessment of a patient concerning the appropriateness of specific order for intravenous therapy. May only monitor a stable patient;
  • Administration of blood and blood components, or chemotherapeutic agents;
    • ADN students may administer blood components only
  • Injection of medications into the auxiliary fluid chamber such as volutrol, buretrol, y-site;
  • Injection of medications via direct intravenous routes such as bolus and intravenous push
    • PN students only, ADN may perform IV push on medications not on the Appendix Two list;
  • Preparation of admixtures;
  • Removal of an intravenous cannula from the following: femoral, subclavian, or jugular vein; any venous or arterial site in which a central line is inserted; or any arterial site or cutdown site;
  • Dressing change and intravenous administration set on any arterial site;
  • Draw blood specimens off intravenous line except for the initial insertion of a peripheral intravenous line;
  • Initial intravenous therapy instructions to the patient.
    • ADN students may perform this task

Student Nurses Can Perform the Following Tasks:

  • Perform simple calculation, and adjust flow rates of a peripheral infusion by a mechanical infusion pump, gravity, or other rate controller device
  • Observe, report and document subjective and objective signs of adverse reactions to intravenous administration
  • Inspect insertion site, change the dressing and remove intravenous needle or catheter from peripheral veins only. Cannot remove any central line, peripherical inserted central catheter (PICC), or midline
  • Hang or replace premixed fluid container or tubing.
  • Administer intravenous fluids without added medication and/or administer commercially prepared intravenous solutions via peripheral or central lines
  • Administer intravenous fluids containing medications that have been prepared and labeled by a pharmacist, registered nurse, physician, dentist, or manufacturer via peripheral or central lines
  • Reconstitute and administer unit dose medication for intravenous therapy, e.g., ADDvantage, Mini-Bag Plus such as IV antibiotic bag that has powdered antibiotic vial to attach and mix.
  • Flush peripheral or central intravenous catheter and intermittent device with premixed Heparin solution or saline. Cannot due bolus or intravenous push of any other medications.
    • PN students may only flush peripheral lines
  • Change patient-controlled analgesia (PCA) cassette, program the PCA pump according to a physician order that prescribes a specific dosage and assists the patient with self-bolus when necessary. Medication PCA changes need to be verified with a registered nurse.
  • Administer morphine or other narcotic medications such as Dilaudid by a peripheral and central intravenous line using a continuous infusion pump such as a CADD PCA. Cannot do a bolus or intravenous push of medications.
    • PN students cannot perform this task.
    • Administer solution for total parenteral nutrition.
    • Administer intradermal lidocaine for pain control when inserting an intravenous catheter per established protocols and with the necessary emergency equipment available.
    • Draw blood specimens on the initial insertion of a peripheral intravenous line. Cannot do any blood draws off central line