[Annony RN]

As long as it is concious sedation, you are certified competant in CS (take the annual class and test), and you have ACLS you should be OK. Sounds like you are not using propofol which would be just one criterion that would cross the line (and there are enough threads here about that)

Also, you should not also be circulating the case. In most ORs, a second circulator is used. If you are giving sedation then monitoring the pt is your only responsibility.

[oramar]

Isn't it interesting the difference in scope of practice depending on state where you work! Threads like this increase my awareness of the situation, thanks.

[micco]

How long have you been a circulator? I am a circulator too. it is part of my job description to do conscious sedation using versed and fentanyl. Every nurse where I work is able to do conscious sedation cases.

[putmetosleep]

Originally Posted by estherojin

Most hospitals require nurses to have documented competency in moderate/conscious sedation as well as have ACLS if administering sedation will be a part of their job description. Even if the surgeon is present, if he's occupied with the procedure, as the person who administered the medication, it'll be your job to monitor the patient and intervene if necessary. In the cath and EP labs I've worked at, sedating and monitoring patients were a big part of the nruses' responsibility.

I totally agree with this poster. It is in the scope of practice for an RN to administer conscious sedation (usually meaning Versed and Fentanyl), as long as they have proven competency and are ACLS certified. I work in a non-invasive cardiology lab where we (the nurses) are responsible for giving Versed and Fentanyl during TEEs, as well as monitoring the patient and documenting EVERYTHING. Of course it's always a good idea to check with your state's board of nursing.

[racing-mom4]

Wow this post is kind of making me nervous. Last week I had to increase the propofol twice then when that didnt work give 2 bolus propofol of 3mg each. Then when that didnt work give 5mg of versed. It was given of course with Drs orders over the phone. I was not able to talk to the Dr myself as I was holding the ET tube against the patients lips.
The patient was clamped down on the ET tube, no bite bar in place and we couldnt secure it.
Iam a new nurse. Not ACLS certified yet. I did have an ACLS RN in the room assisting me, as well as our house supervisor.
But with 9000 some drugs now available, how do we know which ones we can give and which ones we cant?

[RNKittyKat]

I've pushed propophol for procedures as an ICU RN. Versed, fentanyl and paralytics too. Paralytics and versed were always pushed for procedures in the presence of an attending physician. We took special classes on all these drugs and were certified by the facility as competent in their administration.

I think it all depends on the Nurse Practice Act for your state. Many RNs from our unit went on to become nurse anesthetists.

[Surgerygirl]

Originally Posted by sonnyluv

I think you know very well what the answer to your question is.

1)You are operating outside of your scope of practice, 2)if you hurt anyone you will go to jail 3) You are saving the surgeon A LOT of money which does not make it right.

The job you are doing is called anesthesia, and nurses who perform anesthesia are call ANESTHETISTS. They usaually have a masters degree in anesthesia and certification. But you know this. Be careful okay? Use your noggin- you know the right answer....

I Never administer Propofol.... only Versed and Fentanyl. I have been inserviced and passed the test for Moderate Sedation. I do not believe " jail " is a issue. I am in Texas and I can not find any reference stating that is outside of my scope of practice......... Anyway I would appriciate any link to any information that I am outside my scope of practice. Thank you for your response...

[Surgerygirl]

Total of 12 years.... however I have only been doing moderate sedation for about 6 months. I love it. I am ACLS / PALS certified and did have training and testing.

[jmgrn65]

Originally Posted by estherojin

Most hospitals require nurses to have documented competency in moderate/conscious sedation as well as have ACLS if administering sedation will be a part of their job description. Even if the surgeon is present, if he's occupied with the procedure, as the person who administered the medication, it'll be your job to monitor the patient and intervene if necessary. In the cath and EP labs I've worked at, sedating and monitoring patients were a big part of the nruses' responsibility.

Ditto

[Surgerygirl]

Funny you should mention having a circulator. We had only been using a "Tech" to assist / " circulate " for the surgeon until about a month ago. JACHO...... now there is a circulator in the room with me on all cases!!! I did not like having to do both r/t safety issues.