Question about RN's removing Chest Tubes... - page 2

Hello everyone, Just wanting a little feedback on how you guys feel about the removal of chest tubes on a post-CABG/Valve pt via an RN. I previously worked @ a hospital were on the Tele/Stepdown... Read More

  1. by   CV_LVN
    One time we had a pt. pull one of her chest tubes out and the nurse who was an LVN called the doc and he said to pull the other one, so she pulled it. She was the only one on the floor that had done it before, none of the RN's knew how. From what she told me, LVN's and RN's can remove them here in Texas, I never followed up and looked it up so I don't know.
  2. by   ptadvocate81
    I work in SICU (in Texas) so we get all of the hearts and lungs post op, and the nurses pull the chest tubes all the time. I have never thought to look at policy, I just see the nurses doing it all the time. (I am still in school, so naturally I don't touch them). Will definitely investigate before I ever personally pull them...
  3. by   rstewart
    Quote from Larry77
    HUH?....
    Can u translate what u posted...I read it a few times each time scratching my head. Do you write for the BON's because reading your post made me feel like I was reading legal descriptions etc. Hmm...maybe there is a reason I became a nurse and not a lawyer...he he.

    I will look into reading the nurse practice act to find out more.

    Also I hope I did not imply that completing ACLS made me feel like I should be able to intebate, by no means would I try such a high risk procedure until I had a ton of training and a policy stating it was within my scope of practice(which I do not want to).

    Your state has an organization known as the Nursing Care Quality Assurance Commission; Visit their web site.

    There you will find that they list advisory opinions regarding various procedures (conscious sedation, botox injections etc.) Chest tube removal is not among them, therefore you must use the decision tree to determine whether or not you may pull chest tubes; there is also a form with which to request an advisory opinion by the the Commission.

    Finally, if it still appears that you may perform the procedure, make sure that your facility permits same as evidenced by a policy and procedure.

    Clear now?
  4. by   NYNewGrad
    can someone provide me please with a link to where I can see my state's (NY) nurse practice act.

    I tried searching but no luck so far....
  5. by   rstewart
    Quote from NYNewGrad
    can someone provide me please with a link to where I can see my state's (NY) nurse practice act.

    I tried searching but no luck so far....

    The NY State Education Department has an Office of Professions; The laws governing nursing practice (there are several) can be located under their website's Laws, Rules and Regulations listing.
  6. by   Larry77
    Quote from rstewart
    Your state has an organization known as the Nursing Care Quality Assurance Commission; Visit their web site.

    There you will find that they list advisory opinions regarding various procedures (conscious sedation, botox injections etc.) Chest tube removal is not among them, therefore you must use the decision tree to determine whether or not you may pull chest tubes; there is also a form with which to request an advisory opinion by the the Commission.

    Finally, if it still appears that you may perform the procedure, make sure that your facility permits same as evidenced by a policy and procedure.

    Clear now?
    Ok..makes much more sense...I have visited the site before but it seems difficult to navigate and find the info i'm looking for. I appreciate the clarification...
  7. by   kurtzmobile
    Quote from rt2crna
    Reply by Larry77 raises a (maybe silly) question. Can a hospital policy supercede a BON directive? i.e. BON says you can but hospital, or med staff, says you can't or vice versa- hospital says you can, but BON says no. Which would hold up in court? Probably the more restrictive, but what does everyone think?
    Hey there,

    I tend to agree w/ you, regarding this topic holding up in court. I feel that, yes we were trained and had to pass a competency, however, in the event that a negative rx would occur would the fact that it was not w/in a nurses scope of practice cause a malpractice case. The answer is YES. That is what worries me. I will investigate into this issue further.

    Thanks so much for your input. :angel2: -Jen, RN, BSN
  8. by   carmee
    Jen, am trying to find anything referencing CTs or EPW removal by RN in FBON or Nurse Practice Act of Florida. Where did you find it?
    Carmee

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