Need some Help Regarding Practice Issues

  1. I am a nursing supervisor in a small community hospital. We have a fairly new ENT who thinks RNs should be able to insert Storz catheters for epistaxis. I am wondering, are we way behind the times or is this doc just a bit too lazy to come in and wants nurses to do his job? I believe it is the latter, I have real practice issues with this procedure. Any discussion would be greatly appreciated. Thanks terri
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  2. 4 Comments

  3. by   MPHkatie
    I have worked in 3 ER's and in none of them were/are RN's inserting these items. Sometimes the ED doc does it, however, It seems also if a pt is having such a severe bleed that an assessment by an ENT doctor would be in order, rather than just placing a catheter. Also, I don't believe it falls under the practice act for nurses, in either category one or two skills.
  4. by   CraigB-RN
    Check your local practice act and possibly contact your board of nursing. Each state is a little different. In my location, there is no reason why the RN's can't do. We just don't, there is always a MD/PA/NP there to do those things.

    I have worked in places were I did put the packing in.
  5. by   wandernsoul
    I have worked in 7 ER's in 5 different states and have never put these in, nor seen any RN insert one either. Seems to me the appropriate way to deal with it is to have the ER doc talk with the ENT doc and sort it out. ER docs insert these all the time.
  6. by   TerriRN
    Thanks for your replies! I asked for ER nurses thinking you would be allowed to do more skills than the floor nurses would be. This incident actually had to do with floor nurses, so there wouldn't be a doc around. I have done quite a bit of research on these types of precedures in the last couple of days, and it appears to me that first of all the physician needs to be assessing this patient as far as an anterior or posterior bleed, big difference. If the person is bleeding because of low platlets, I don't want to be the person to increase any trauma anywhere. No some things are just better left to the physician, and I am not willing to be responsible for this one. Thanks again Terri

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