[shoiy]

This is a very interesting discussion. I practice in a third world country and work in the OR. I have administered Fentanyl and Versed, Propofol only if there is an anaesthetist present. And only because his hands are tied up during intubation.
We do not have a nurse anaesthetist, and even if I do have PALs certification my supervisor would never allow me to intubate.
I do not even give Pethidine 100 mg IV. or Morphine more than a certain dosage. You always have to assess, assess assess.
I have always learnt that if you do not feel comfortable about something you do not do it. You put yourself at risk for error.
Do not do other people's job for them. If you are so good go get certified.

[DutchgirlRN]

I work in medical imaging, CT specials and I do conscious sedation for CT guided biopsies and yes it is allowed by my state and yes it is in my scope of practice.

We have to take a half day class before we orient to do conscious sedation but that's not required by the state, but I'm glad my hospital is consciencous.

[DutchgirlRN]

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....

Not true! It's legal for RN's to perform "conscious sedation" which includes Versed and Fentanyl.

[flightnurse2b]

heres a question for you guys... i work in an outpt endoscopy clinic and work with 2 RN's. neither of them are ACLS certified, and i am (paramedic), so they push the drugs and i monitor the patient and am on standby for any kind of emergency (while snaring polyps in the mean time). i told my boss i didnt think this was a very safe practice, and i wanted them to be ACLS cert too, because i have to bounce back and forth between procedure rooms and monitor the recovery room (there are only the 3 of us and a CNA) and she said it was no big deal because there is a physician in the area at all times.

what do you guys think?

[DutchgirlRN]

Originally Posted by flightnurse2b

heres a question for you guys... i work in an outpt endoscopy clinic and work with 2 RN's. neither of them are ACLS certified, and i am (paramedic), so they push the drugs and i monitor the patient and am on standby for any kind of emergency (while snaring polyps in the mean time). i told my boss i didnt think this was a very safe practice, and i wanted them to be ACLS cert too, because i have to bounce back and forth between procedure rooms and monitor the recovery room (there are only the 3 of us and a CNA) and she said it was no big deal because there is a physician in the area at all times.

what do you guys think?

In our imaging center the nurses all have ACLS. It is mandatory if you work in the dept in any capacity!

[vamedic4]

We use these meds for conscious sedation while putting in chest tubes and central lines on the floor if necessary (ie - immediate intervention needed). The RNs draw up and push the meds while we monitor VS and intervene as needed. As others have stated, if you have questions, check the TX BON website concerning your scope of practice. It is my understanding, however, that you are able to perform conscious sedations - we have a CBT on it every year, and we do it here quite frequently.

[vamedic4]

Originally Posted by flightnurse2b

heres a question for you guys... i work in an outpt endoscopy clinic and work with 2 RN's. neither of them are ACLS certified, and i am (paramedic), so they push the drugs and i monitor the patient and am on standby for any kind of emergency (while snaring polyps in the mean time). i told my boss i didnt think this was a very safe practice, and i wanted them to be ACLS cert too, because i have to bounce back and forth between procedure rooms and monitor the recovery room (there are only the 3 of us and a CNA) and she said it was no big deal because there is a physician in the area at all times.

what do you guys think?

You are correct in your assesment that everyone involved needs to have ACLS. This is a "must have" when dealing with the potential complications. At my facility, everyone is required to have PALS if you work at the bedside.

[putmetosleep]

Originally Posted by flightnurse2b

heres a question for you guys... i work in an outpt endoscopy clinic and work with 2 RN's. neither of them are ACLS certified, and i am (paramedic), so they push the drugs and i monitor the patient and am on standby for any kind of emergency (while snaring polyps in the mean time). i told my boss i didnt think this was a very safe practice, and i wanted them to be ACLS cert too, because i have to bounce back and forth between procedure rooms and monitor the recovery room (there are only the 3 of us and a CNA) and she said it was no big deal because there is a physician in the area at all times.

what do you guys think?

To me, having a ACLS certification should be a job requirement for RNs practicing in an area where they are expected to give conscious sedation. Doesn't make sense to me. Yes, I think you are right, those nurses should get certified.

[Booty Nurse]

I work in GI endo as a circulator. I push Versed & Demerol, monitor the patient, and handle specimen labeling. If Propofol is needed, an anesthesia provider comes in for the duration of the case. ACLS was an absolute requirement for the job; however, my scrub nurse is not ACLS-certified. I've only been in this job for two months and have not had any formal training in conscious sedation, but I'm going to an all-day conscious sedation workshop in May. I've read a lot on my own, but I can't wait for the workshop. I feel like I could definitely use more education on the topic.

Use of Propofol by RNs is a very controversial subject. It's my understanding that it's against the Nurse Practice Acts of most, but not all, states.

[Otessa]

I gave Fentanyl and Versed in ICU, CCU, and Telemetry settings-where they were monitored and there was resuscitation equipment. We would also have respiratory therapy available during conscious sedation as well. We(nurses and physicians) also were required to have yearly consious sedation education and passing test as well as have BLS and ACLS (PALS if we were working with peds patients)