[faithrahm]

Anyone out there pulling chest tubes in post-
CABG patient's. Our unit is looking at beginning to do this and we are looking for some help

[jadednurse]

We (staff RNs) pulled mediastinal chest tubes. MDs or NPs pulled pleural chest tubes.

[zambezi]

We (certified staff RNs) also pull mediastinal CT, MD pull pleural...there was a thread on this not too long ago...in CCU board I believe...

[mady]

Follow this link
http://allnurses.com/forums/showthre...threadid=16047
about all chest tube removal.

Any evidence based practice on chest tube removal? as this topic has been discussing for so lon......g

Any lit review!!!

[A/A/OX3]

I have worked hospitals where RNs do pull chest tubes and those that do not. I think that ICU nurses are always ready to gain new skills and beef up their resumes. Some of these tasky things can definitely inflate one's ego, however, what I have learned in the 13 years I've been in critical care is that whatever you are doing better have a piece of paper attached to it or you'll be standing with a chest tube in your hand wondering where all the backup is should something happen.

I work in Houston, Texas Medical Center. During a very short orientation, I was told by more than one seasoned nurse that after demostrating competency on three occasions, in the presence of a certified RN, I was then also certified. Okay... done. I work the night shift. Chest tubes are DC'd generally on days, so whenever the opportunity presents itself, I try to help those without certification complete the process.

One night, a new RN and I completed her third chest tube removal and I sent an email to our manager, complimenting the nurse on her competency and asking the manager to note her file. She emailed back asking me where my signed certification was and what in the heck was I doing.

I emailed back and said, take me off the list and thanks for your support. Policy and procedure is the name of the game. If it isn't in writing you have nobody covering your back. I don't need to pull chest tubes to prove I am a great nurse. And I don't intend on being the dog when the time comes for kicking.

The upside to this is that I was also running their CVVHD machinces without the class or their certification... you know, 'default' care. I suggested she take me off that list as well. As I see it, it's apples and apples. Guess on the nights when she doesn't want the rules to apply, she'll just have to come in and take the patient that requires it. Better watch out what you ask for.... you just might get it.

[tory]

AA&OX3,......all I have to say is YOU GO GIRL!!!