Does/Can an RN give anesthetics before procedures such as skin biopsy, laser surgery,

[50kn]

Does/Can an RN (working at dermatologist's office, aesthetic clinic etc.) give anesthetics before procedures such as skin biopsy, laser surgery, botox, etc.)?

If so, what anesthetic medications are most frequently used? Is IV inserted just in case at the same time?

[NurseGizmo]

I am a RN supervisor for a very large facility in california. In the state of california it is NOT in the scope of practice for a medical assistant to inject any

type of anastetic (spelling?its late been up since 5am) including lidocaine mixed with Rocephin. I know that there is a big push by physcians to enlarge the scope of practice of medical assistants. For example a lisc. individual is required to verfiy all medications given by an MA against the order prior to giving. That means physcally looking at the medication (ex: dilaudid or immunizations). In a busy practice this can be very time consuming because they don't have nurses on staff. They also can not take a verbal order, and act upon it. We just went through a very large review of what MA's in california can an cannot do. The LVN's now do not see any difference between themselves and an MA.

[ruralgirl08]

Unfortunately, its just another example of: Making More Profits vs. Providing Quality of Care. It frustrates me, as nurses go through extensive education (which is a continuum,) rigorous testing, gain the expereince, to provide specific skills to the public (which we are also held accountable for,) to allow other unlicensed people being able to preform these medical duties by "delegation," in an employment setting. We may not own them, but we earned the right to preform them, this should be respected for many valid reasons.

[lindarn]

And MDs and MAs get away with this because the public is unaware that they have amateurs working on them.

The public also does not respect the education that RNs have, and do not understand what a nurse's scope of practice is, and what an LPN/LVNs scope of practice is. And how that differs from an MA.

It is scary how doctors are continually pushing the envelope with what they will allow MAs to do. Didn't I read on allnurses, how some doctors were allowing MAs to inject rectal polyps with a colonoscope? Unassisted?

Not that doctors go to any great length to educate their patients, do they? And you know that they will be the first to scream for,"TORT REFORM!" And try to prevent the public from collecting damages from them for injuries caused by untrained, minimaly educated MAs. I guess ignorance is bliss.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

[klone, MSN, RN]

Nurses do not perform blocks (injecting local). This is outside of the scope of practice.

Are you sure? If so, I imagine it depends on the state. Where I live, RNs can give a local before IV starts (they don't work worth a darn, IMO, but it's within our scope to do it).

[Rodman]

Nurses should not give local anesthetics. we are not trained in extensive anatomy like an MD anesthesiologist or dentist

[herring_RN, ASN, BSN]

Are you sure? If so, I imagine it depends on the state. Where I live, RNs can give a local before IV starts (they don't work worth a darn, IMO, but it's within our scope to do it).

In my state the only RNs who may administer local anesthesia are Certified Registered Nurse Anesthetists.

Here is a discipline with termination or suspension of a license. One of the accusations is gross negligence/practicing outside the scope of practice for administering local anesthesia.

http://www.rn.ca.gov/public/rn665334.pdf

[akulahawkRN, ADN, RN, EMT-P]

In my state the only RNs who may administer local anesthesia are Certified Registered Nurse Anesthetists.

Here is a discipline with termination or suspension of a license. One of the accusations is gross negligence/practicing outside the scope of practice for administering local anesthesia.

http://www.rn.ca.gov/public/rn665334.pdf

If that's the case, then every PICC nurse that I've ever observed has been exceeding their scope of practice because as part of the SP that they follow, they administer a small amount of lidocaine right at the site where the PICC will be placed, specifically to make the procedure painless. I'm in California.

I read the complaint and it is likely that the RN did exceed his authorized scope of practice. I doubt there were standardized procedures in place to allow him to do what he did.

[sallyrnrrt, ADN, RN]

Hi- After reading your posts, I have a question. I went to see a Dermatologist today. He advised me that I needed a scalp biopsy. To my surprise, he had his Medical Assistant inject my scalp. When I questioned this; I asked her if this was in her scope of practice? She said "yes". I asked for the MD to do it but he said he recommended her to do it since he was "rough with big hands"(aka LAZY). My question is under California state law is this legal? I'm trying to research it but haven't come to a site that can provide me with a clear answer.

medical assistants do not have the type of "scope of practice we do"........they are a task orriented, and work under the physician captain of the ship structure....

[Cindy Glasgow]

Can a medical assistant in a Florida dermatology practice perform the biopsy with local anesthetic injection for a suspicious lesion with the doctor in the office but out of the room (unsupervised)?

[Rodman]

Seems like some on this post are caught up with a little work insecurity. I have a friend who is a dentist and she tells me that nurses are her worst patients. They come in and sign their med histories with with suffixes listing every minute detail of their training and act like they have expertise in every discipline/ This is just her impression and she finds it amusing. Nurses are obviously the most important backbone of medicine (The docs can't do it on their own) but seem to have this axe to grind.