Nurses taking patient's off backboards without doctor clearnce?

Find out what the written policy is for taking someone off the backboard. If something bad happens due to this and all you can say is that everyone else is doing it, it wont look good. Follow the policy.

As a rule "NO", at least in my facility. Granted there are times when some of our rural EMS squads have been known to board and collar some patients who may not necessarily need it. Example :little old lady who slid out of recliner onto her bottom on a carpeted floor.

That being said, without the proper x-rays and clearance you can never be sure of what underlying injury may be present. Spinal injuries are generally the sort of thing that can't be "eyeballed" even by the most seasoned nurse. JMO.

Finally, I wouldn't want to be the one responsible for exacerbating an exisiting injury, would you???

And if it's your patient and someone takes them off the board or orders them off document, document, document!

Good luck to you

you are setting yourself of for failure and big trouble if you remove a patient from anytype of spinal package without previous assessment and permission by a doc...this would be nothing but a slam dunk fro a trial lawyer..to all you young er nurses out there, do yourself a favor, don't remove a c-collar spineboard or traction splint without first getting the doc to look at it and getting a order. and be sure to chart and time when you got the order from who and when you removed the device.

I agree with littleRNthatcould and RN1980-you are setting yourself up for disastrous consequences if you remove someone from a backboard before they have been cleared by the MD. Whenever I did, I always charted "per Dr. So-and-So's V.O." We work too hard to get and maintain our licenses to just give them away!

It is my understanding that "clearing a patient" would fall under diagnostic medicine and as a RN, it would be outside my scope of practice.

If I had a nickel for the amount of times I've had to give the "I am the nurse, the doctor has to see you before we get you off of that board" speech...

You should definately check your facility policy - which should be changed to reflect what is allowed within the scope of practice, BTW. It's your license, do all you can to protect it.

Blee

I agree with above posts-- I had a doc recently say "You can take the backboard out" on a pt who was found on his floor, and had been there for an unknown length of time. I know for a fact the doc didn't palpate the spine because the man was incontinent of feces up to his lower back, and still strapped in...... but one cannot remove the backboard to clean between it and the patient until the doctor has cleared the spine.... so, I carefully removed it, wrote "Backboard removed per Dr. Blabla" and was very relieved when the xr's were clear.

DOCUMENT!!

I have to disagree. There is plenty of information out there that shows the majority of patient placed on backboard don't need to be on them. If your taking them off the backboard, you need to have witten policies covering you. You ned to cover things like documentation, distracting injuries, ETOH and such. It can be safe, if your doing it right.

Its routinely done at my hospital, unless they are a major trauma patient going direct to our trauma room. As wait-times are often hours and hours (yes, even if from EMS) it is routine that the nurses roll the patient off the backboard. Collar remains on, and pts are told that they are not to move. Sometimes the doctors will come over to check the spine as we do it, just to save time later on, but not always. It is required that all nurses are TNCC certified.

We don't do it at the hospital I work at because we can pull a resident pretty easily to atleast palpate the spine.

Honestly though,a backboard is used primarily to maintain spinal stabilization in the back of a bumpy ambulance.Think about it? Even when patient's do have spinal injuries (fractures etc.) you don't keep them on a backboard during their entire hospital stay. As long as you keep the cervical collar on and maintain good cervical stabilization then you should be all set.