Why can't nurses intubate? - page 2
by natnat122 20,367 Views | 93 Comments
Paramedics and Doctors intubate, why can't nurses?... Read More
- 7Feb 20, '13 by dah dohNo reason for it at my facility! Some of our experienced respiratory therapists can still intubate. We have medical interns and residents, pulmonologists, some attending doctors, and also have a minimum of 3 anesthesiologists available. My favorite story happened late at night; this one internal medicine attending doctor was walking by a coding patient's room that the medical intern and resident couldn't intubate. This doctor came in to check on us because of the commotion; intubated and placed a central line on this patient who he actually was not even seeing just because help was needed. Then we found out he hadn't intubated or placed a central line in over 20 yrs during his residency! Apparently he's still "got it"!
- 11Feb 20, '13 by KelRN215Quote from natnat122This 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?"Paramedics and Doctors intubate, why can't nurses?
- 3Feb 20, '13 by libran1984Nurses 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!
- 1Feb 20, '13 by azhiker96My 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.
- 12Feb 21, '13 by portland medicThought 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?
- 7Feb 21, '13 by subeeI'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.