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

  1. 0 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?
  2. Visit  50kn profile page

    About 50kn

    Joined Mar '10; Posts: 43; Likes: 9.

    19 Comments so far...

  3. Visit  mohs rn profile page
    1
    I am an RN in a Mohs surgery clinic. I administer local anesthetic for surgical procedures. We mostly use 1% Lidocaine with epi , buffered of course.
    Mrs. SnowStormRN likes this.
  4. Visit  MrsDeeDubs profile page
    2
    I too am a MOHs nurse and inject local anesthesia (lidocaine and bupivacaine). We do not use IVs.
    sallyrnrrt and Mrs. SnowStormRN like this.
  5. Visit  PetiteOpRN profile page
    1
    Plastics RN here.

    At our practice, RNs can administer topical analgesics (lidocaine) and PO and IV analgesics (percocet, vicodin, valium, fentanyl, versed). Conscious sedation is performed under direct supervision (MD in the room) and with MD order.

    Nurses do not perform blocks (injecting local). This is outside of the scope of practice.
    Mrs. SnowStormRN likes this.
  6. Visit  lblvn profile page
    2
    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.
    sallyrnrrt and lindarn like this.
  7. Visit  MrsDeeDubs profile page
    2
    I am a derm nurse in Michigan but just Googled your question and found this:

    If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.

    The MAs in our practice do not administer the local anesthesia.
    Mrs. SnowStormRN and lindarn like this.
  8. Visit  lblvn profile page
    2
    Thank you for your response. I'm
    Still highly upset about the whole encounter with this office. I'm an LVN here in California & worked ER for 7 years & would never consider doing this. I guess since I have a license it makes it different because I have something to loose; whereas the MA's don't.
    My scalp has a huge lump on it today & I'm not sure if it's from the lidocaine or the biopsy. Either way I'm not returning there as they wanted me to for his MA's to remove my sutures. I'd rather do it mysel(I won't but sure won't pay them my $50 co-pay to do it).

    Thanks again
    sallyrnrrt and lindarn like this.
  9. Visit  Elleveein profile page
    3
    I can't believe what MAs get away with, it blows my mind everytime i read one of these posts.
    sallyrnrrt, icuRNmaggie, and lindarn like this.
  10. Visit  lblvn profile page
    3
    Not to mention what Doctors get away with. The MD handed me the chart & I was literally correcting all the spelling errors. He probably pays them minimum wage.
    Unbelievable!! I'm waiting on a bill. If they dare send me one they will have a grievance coming!
    sallyrnrrt, icuRNmaggie, and lindarn like this.
  11. Visit  ruralgirl08 profile page
    3
    Quote from MrsDeeDubs
    I am a derm nurse in Michigan but just Googled your question and found this:

    If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.

    The MAs in our practice do not administer the local anesthesia.
    OMG, I cannot believe this is allowed?! This undermines the whole point of being a licensed skilled professional with a regulatory body to answer to. We have nurses out there wanting work, and unlicensed workers are allowed to be preforming regulated duties inside our scope of practice. Am I missing something here? IMO that's just wrong....would you want a butcher to do the job of a surgeon, because he is cheaper? I would also boycott that office for the principle.
    sallyrnrrt, icuRNmaggie, and lindarn like this.
  12. Visit  akulahawkRN profile page
    3
    Quote from ruralgirl08
    OMG, I cannot believe this is allowed?! This undermines the whole point of being a licensed skilled professional with a regulatory body to answer to. We have nurses out there wanting work, and unlicensed workers are allowed to be preforming regulated duties inside our scope of practice. Am I missing something here? IMO that's just wrong....would you want a butcher to do the job of a surgeon, because he is cheaper? I would also boycott that office for the principle.
    Just remember, because nurses have something in their scope of practice doesn't mean that nurses own that particular procedure/task/thing. Just because it isn't in a Nurse's scope doesn't mean that it isn't in someone else's either... Different states allow physicians to delegate tasks that nurses aren't allowed to delegate. It's very possible that a state may allow a Physician to delegate to a MA the task of injecting local anesthetics if the Physician knows that the MA is appropriately trained and the Physician is able to supervise the MA in doing that task. I would imagine that if an issue with an MA comes up, the complaint would be lodged to the Medical Board for that state as MA's function directly under the Physician's license...

    On the other hand, if you're not comfortable with the practices of that particular Physician's office, vote with your wallet and go someplace else.
  13. Visit  lblvn profile page
    2
    Oh that's a given. In these tough times MD offices especially speciality office are a dime a dozen. Most are marketing for new PPO PT's. In my case, I'm
    Usually known to be a bit overboard on researching an office prior to being treated. However i was recently diagnosed with a new & scary DX & the rheumatologist recommended a derm to evaluate a skin condition to back up his DX. He recommended a dermatologist & I trusted that his staff would send me to one they frequently use. Instead they looked up my Health Plan & picked an random one... Go figure. Oh well lesson learned. I appreciate all the responses I've received & I'm
    Going to actually call the board to getva final answer. I looked it up on line & it's not clear. For now I still have the sutures in my head & am having a hard time finding a physician willing to remove them. GEEZ!!! guess I'll do it myself.
    sallyrnrrt and lindarn like this.
  14. Visit  NurseGizmo profile page
    2
    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.
    NRSKarenRN and lindarn like this.


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