Why can't nurses intubate? - page 2

Paramedics and Doctors intubate, why can't nurses?... Read More

  1. Visit  KentuckyNurseKim profile page
    11
    I do enough work for the docs. I'd rather not add to that list, thank you.
    PerfectlyNumb, sallyrnrrt, wooh, and 8 others like this.
  2. Visit  KelRN215 profile page
    11
    Quote from natnat122
    Paramedics and Doctors intubate, why can't nurses?
    This is a faulty argument. Paramedics, doctors and nurses are all separate professions. Why not say "Doctors can prescribe medication and perform surgery, so why can't nurses?"
    casi, sallyrnrrt, Jessy_RN, and 8 others like this.
  3. Visit  libran1984 profile page
    3
    Nurses in my ER intubate! I've only ever seen an RN intubate once. She was in charge of the shock rooms, had time (and 28 years experience) and she just straight up did it. My jaw just hit the floor when I found out. The doctor passed by and she nonchalantly told him, "by the way..."

    like wow. Major props to her. Her charting was impeccable and she put in all the order sets in place with the Doctor's permission prior in case of change of condition.

    My ER let's the RN intubate as well as the Medics and PA's. Ta da!
    sweetf, sallyrnrrt, and GrnTea like this.
  4. Visit  azhiker96 profile page
    1
    My last hospital would let a nurse intubate if he/she had been trained and did a certain number each year to maintain proficiency. Nobody that I knew was certified nor did they want to be. We had enough docs wondering around who could do the odd emergency intubation when needed. By the time we got the cart dragged over and opened we'd have someone with an MD badge who could take responsibility for the airway.
    Esme12 likes this.
  5. Visit  portland medic profile page
    13
    Thought I would chime in here. I am in my second quarter of a BSN program, and have been a paramedic for thirteen years. I've probably done about 150-200 intubations in my career. Nurses can intubate. I live in Portland, and our flight nurses who work on the helicopter intubate. It just depends on where they work.

    The thing about intubation is that it is a major skill that has enormous potential to cause adverse events. Perforating a trachea, cracking a tooth and causing an airway obstruction, or causing laryngospasm are just some of the potential scenarios when you intubate. It is a skill where you want clinicians with very recent experience that keep their skills sharp doing it. In the county I work in, we have too many damned paramedics, and not enough tubes to go around, causing us to go to the OR to try and keep our skills up. We compete with residents, and have to convince anesthesiologists who don't like paramedics to let us practice on their patient. It can be a challenge to keep our skills up.

    I think this is the main reason nurses don't routinely intubate. Hospitals would rather keep fewer clinicians performing them so as to keep their skills sharp. It is well documented in the literature that providers who get regular intubations, be they anesthesia providers or paramedics, have greater success rates. It's the same thing with IV's. How good would ED nurses be at starting IV's if techs, phlebotomists, and CNA's did them too?
    PedsED-RN, invisiblewounds, sweetf, and 10 others like this.
  6. Visit  tewdles profile page
    4
    Many nurses work in environments where they intubate all sort of things, including trachea's.
    wooh, GrnTea, HouTx, and 1 other like this.
  7. Visit  subee profile page
    7
    I'm a CRNA and intubate every day. I didn't become good at it by doing a few here and there. The skill set one needs to recognize a difficult intubation and be prepared for it, separates the slick from the bad. Only people who are experienced should be intubating awake patients (not induced with general anesthesia) because when the intubation fails, one is left with a bloody mess for the next attempt. Of course I understand that in some places anesthesia is not around but I don't want to be a patient in those places because I know I am a difficult intubation! And the argument that doctors do it doesn't hold water. With MD behind your name, in some places you can to ANYTHING (liposuction, anyone?). The good docs know what damage they can do attempting to do something they haven't done since internship.
    sallyrnrrt, RNFiona, NurseKitten, and 4 others like this.
  8. Visit  FlyingScot profile page
    2
    Quote from libran1984
    Nurses in my ER intubate! I've only ever seen an RN intubate once. She was in charge of the shock rooms, had time (and 28 years experience) and she just straight up did it. My jaw just hit the floor when I found out. The doctor passed by and she nonchalantly told him, "by the way..."

    like wow. Major props to her. Her charting was impeccable and she put in all the order sets in place with the Doctor's permission prior in case of change of condition.
    Um, while I don't doubt her experience and assessment skills and I'm ALL for autonomy and critical thinking she sounds a bit like a loose cannon.
    AnonRNC and DeLanaHarvickWannabe like this.
  9. Visit  DoeRN profile page
    1
    Quote from All4NursingRN
    Do CRNA's even intubate on a regular basis? pardon me if that's an ignorant question.
    Actually at my old facility yes they do. They were part of the anesthesia team and if they were assigned to be on the code team too then they showed up at codes and intubated the patient.

    Sent from my iPhone using allnurses.com
    natnat122 likes this.
  10. Visit  ♪♫ in my ♥ profile page
    5
    Nurses *can* intubate, if they're trained and they're covered by protocol.

    Flight nurses intubate and one of the local hospitals has specially trained nurses who intubate in the NICU.
    ZippyGBR, tewdles, Altra, and 2 others like this.
  11. Visit  natnat122 profile page
    1
    Quote from KelRN215
    This is a faulty argument. Paramedics, doctors and nurses are all separate professions. Why not say "Doctors can prescribe medication and perform surgery, so why can't nurses?"
    Touche! Good point.
    BrandonLPN likes this.
  12. Visit  BrandonLPN profile page
    3
    I'll never understand the mindset some people have that equates nursing and paramedics. Maybe they watch too many medical shows? They are two very different disciplines, and two very different jobs.


    Being a paramedic is about being a first responder to emergency situations. Being a nurse is about promoting health and alleviating suffering. I'm sorry if that doesn't sound as cool or exciting, but there it is.

    The two roles overlap a bit in the ER for obvious reasons, but they are still separate. A paramedic being able to intubate does *not* make him "higher" than a nurse. Like someone said, that's faulty logic. There are lots of things other members of the healthcare team can do that we cannot. There's even more that we can do that they can't. If everybody could do everything, what point would there be in different titles and licensures?

    There seems to be a fundamental misunderstanding of what a nurse *is* among students and the general public. I cringe a little when I see so many say they want to become nurses because they want to "save lives". Yes, I suppose we do that sometimes, too. But if your main passion is life saving and emergencies, I think you're missing the point of what being a nurse is about.....
    Last edit by BrandonLPN on Feb 21, '13
    ohioSICUrn, sallyrnrrt, and prnqday like this.
  13. Visit  PMFB-RN profile page
    10
    Nurses CAN and DO intubate. All that's needed is a faciliety compenetcy, appropiate training, and a policy in place allowing them to do so. My hospitals requires that I do 30 supervised intubations a year (in 2011 I got all 30 done in one days in out patient surgery) to maintain my competency (spervised by any CRNA or MDA). In addition we (those RNs who hold intubation privalges) sit through a 2-3 hour class each year taught by one of the CRNAs on new equipment / practices in airway managment. For exampe last year we were trained on the glide scope.
    A while back all that training came in handy when I intubated an old farmer with a dead bull laying across his hips/legs in the middle of the night in an unlighted, un heated cattle barn. I had 6 people holding flashlights for me and a terrified sheriff's deputy holding cryc pressure for me while I stood mid-calf deep in cow manure. I love my jobs.
    florence2012, ZippyGBR, ohioSICUrn, and 7 others like this.

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