[NursefromIowa]

I have a question regarding RN administration of a bolus dose of bupivacaine via peripheral nerve block. Is this within the nursing scope of practice to give a bolus dose as ordered by an anesthesiologist. We have a new anestesiologist with our hospital and he has expressed many times how ridiculous it is that we cannot administer bolus doses. We have expressed that we do not feel comfortable with this and it is outside of our scope and we have not had any inservice. We also do not have specialized pumps to give a bolus dose. I have tried to find out information via Iowa Board of Nursing. Can someone please help? Thank you so much.

[sharann]

A bolus dose in a nerve is a anesthesia scope responsibility. I would not do it unless i was assisting in the initial insertion at the procedure and was instructed to give it so the doctor could hold the catheter in the correct place. This is the only time i would.

[NursefromIowa]

I found out yesterday that according to the Iowa Board of Nursing the RN is able to give a bolus if they are properly trained/educated. We are getting new pumps for this purpose and they are working on P&P.

[sharann]

Originally Posted by NursefromIowa

I found out yesterday that according to the Iowa Board of Nursing the RN is able to give a bolus if they are properly trained/educated. We are getting new pumps for this purpose and they are working on P&P.

As long as the BON in your state(and hospital policy) is followed and training is provided and validated then no problem.
I am speaking from what we do in my facility.I think nurses scopes will be ever increasing over the next few years which is good and bad news. I just wish we could make basic decisions without an "order". Some nurses I know are SO afraid to hang a fluid or start O2 on a patient in serious distress without an order! I swear, I am not saying we should order Morphine 10mg on every patient(but we are more qualified than some docs in pain management), but the very basics, c'mon. It is sad.
Sorry I veered off topic.

[PACUJennifer]

This is outside the scope of nursing practise in our PACU. However,the OR RN assisting the anesthetist in the block room may do it,I don't know -but I doubt it. Our CPNBs are infused on the GemStar. We do not program the pump either.

[soapaddictOH]

I worked in holding and would assist with all kinds of blocks. I gave the boluses with anesthesia standing right there watching. Most of the time it's anesthesia securing the catheter, I have the bupivicaine in hand already from injecting during the procedure. Same with femoral blocks.