I would like to hear from anyone regarding unit protocols for removal of chest drains post cardiac surgery. I'm mostly interested in who removes them - RN or MD, particularly in Canada (Ontario), but I am interested in hearing from anyone.
If RNs remove them in your unit, was it always a nursing duty, if not, how long has it been, and was it a difficult process getting the task away from the MD?? What are your protocols? Do you know of any good journal articles that address this issue?
Thanks very much, all responses will be greatly appreciated.
Oct 11, '02
I've worked in units where RN's have removed them, and in units where MD's only have removed them.
In the first, it was always an RN duty. Newcomers had to work 3 months before being allowed to, and then after doing 6 removals under supervision.
In the second, it was always an MD duty. HOWEVER, if they were busy, or not available, guess what. The RN did it!
Nov 3, '02
It is very dependant on the state and hospital in which you are practicing. I have been in ICU's in which the RN's pulled the chest tubes and also places in which we were to do nothing more than change dressings.
As far as Canada, it's been a while since I have worked there, but from what I remember, MD's only pulled the chest tubes (This is in NF, not ON). I'm sure it will still be very much location and hospital dependant. I'm sorry if this didn't really answer your question.
Jan 6, '03
In my cardiothoracic surgery unit the residents, interns, and medical students pull the chest tubes and because my hospital is a teaching facility, a lot of times, it's a learning experience for the one pulling the tube.
Fine with me, one less thing to do on my already full agenda!
oh man, i just realized this is a really old thread!
Mar 8, '03
In our ccu, rns can pull mediastinal C.T. with orders, MD must pull plural...
Mar 9, '03
Hi, here is another thread along the same lines, perhaps a few more answers there.
Aug 31, '03
Nurses, I mean trained CVICU nurses, pull chest tube drains. Like most of us, I was shocked to find out that in my current hospital we, the nurses, have to pull those tubes.
We have protocols and we train nurses both from the ICU and Telemetry floors to pull chest tubes.
By the way, we also pull epicardial pacers.
Dec 8, '03
In my unit, RN's started to remove the tubes only when it became apparent that the fellows could spend more time doing the Attending's chores, if they didn't waste time removing the chest tubes. So, basically it tricked down to nsg. Is good for the pts, though, nurses are much more humane tube pullers!!
Dec 8, '03
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