RT says her scope is wider than mine. Ok?

Longleggedstar · Dec 22, 2016

Hmmm...so she made it a point to tell you her scope of practice is wider, yet if it really came down to it an RN could do her job but she can't do ours! As one poster mentioned already, watch your back, I highly doubt there is reciprocity of that "co-worker brotherly love" you have for her (not right now anyway)... Oh and 1 more thing for kicks .....

attachment.php?attachmentid=23636&stc=1

Libby1987 · Dec 22, 2016

I don't think about scope as all of the stuff RNs have to do. I don't gauge my scope based on covering more real estate on the body.

Colostomy? Would an RT's license be on the line for helping a patient with a leaking colostomy? Is it really against their practice act to not assist with a colostomy change? Or any other basic task?

Anyway, I know the RNs scope is larger, just not OMG it is soooo much larger how can you even compare it larger?!

Now what about PTs? They can diagnose and treat without a physician. How does that compare to an RN who can't even apply a bandaid without an MD order? Who has the widest scope? Us because we insert Foleys and they don't? Or them because they don't need an MD to practice?

klone, MSN, RN · Dec 22, 2016

To those of you suggesting that an RN can perform an RT's job, but that the RT can perform the RN'so job, I don't think you fully grasp what our RT team members are capable of performing, and just exactly how extensive their scooe of practice can be.

What are some things that RTs do that are outside the scope of practice of an RN?

JWG223 · Dec 22, 2016

I work in the ICU and we work very closely with our RTs. I love my RTs and get along and respect all of them. I even respect and love the RT I'm about to mention, her comment just makes me have more sympathy than anything.
Casually discussing nursing and respiratory education she interjects how her scope is greater than mine and can do more yet still gets paid less even as a head RT. I mean maybe she's bitter because she makes less than the Nurse Clinician 3-5? - and her way of justifying everything is by saying "I get paid less but my scope is larger I can do what you do and more".
Okay sure. I'm not even gonna argue that. I'm sure you can. I'm just a lowly ICU nurse. I wipe booty.... das all guyzzzz.
Peace out.

Her position likely comes from meaning she can do everything from pediatrics to adults, or something like that.

Either that, or it's just simple ignorance. I used to think ER didn't do a damn thing. Just stick a half-ass IV in a patient and hit them with some hydralazine, maybe start a cardene gtt, or an insulin gtt, and shuffle them off to the upper part of the hospital and then kick back and chill at the desk until the next poor soul came stumbling in. So, being tired of dealing with the same thing day in and day out, I decided I would go work ER. It's easy, you don't do a lot, and you only deal with the same patient for a few hours max, unless the floor is understaffed and you watch them through the shift on rare occasion. Cake walk.

Well. I was wrong. ER is still one of my favorite, if not my FAVORITE place to work (I work everywhere in the system, from ER to Psych/BHU floors), but I can tell you just how wrong I was.

It was from ignorance. I think the RT is suffering a similar situation.

That said, I don't see how, unless your RT staff is absolutely blind when they visit the ICU,etc.

Of course, I'm just trying to give the benefit of the doubt. Maybe they are stupid/bitter/just wanted to get a rise out of you/who knows? Roll on, nevermind it.

JWG223 · Dec 22, 2016

What are some things that RTs do that are outside the scope of practice of an RN?

Well, for one, other than an ICU nurse, I don't know very many RN's who manage vents effectively, and most systems I work in, even ICU RN's do not mess with the "fine" settings on the vent, which is to say, they do not typically mess too much with tidal volume, etc.

For two, ICU RN's probably would be a bit lost giving breathing treatments to a pediatric. RT's have to be capable of dealing with pediatric airway/pulmonary treatment as well as adult, which does mean they have a broader scope unless the RN is cross-trained.

I am sure there are other things, as well, but I am not an RT, so I'd prefer not to go in-depth describing their profession to them, should one chance across my presumptions, lol!

heinz57 · Dec 22, 2016

What are some things that RTs do that are outside the scope of practice of an RN?

That might be more state dependent. Some states do not allow RN to do intubation, arterial sticks and A-line insertion. Ventilator management may also be defined by statute for proof of additional education and training. Complete PFTs may need an additional certification for nurses. Some labs in a few states restrict full PFT lab to RTs per that state's statute. For others it is more facility specific.

klone, MSN, RN · Dec 22, 2016

Well, for one, other than an ICU nurse, I don't know very many RN's who manage vents effectively, and most systems I work in, even ICU RN's do not mess with the "fine" settings on the vent, which is to say, they do not typically mess too much with tidal volume, etc.!

Right, but that wasn't my question. My question was, what are some things that RTs can do that is OUTSIDE THE SCOPE for an RN?

klone, MSN, RN · Dec 22, 2016

That might be more state dependent. Some states do not allow RN to do intubation, arterial sticks and A-line insertion. Ventilator management may also be defined by statute for proof of additional education and training. Complete PFTs may need an additional certification for nurses. Some labs in a few states restrict full PFT lab to RTs per that state's statute. For others it is more facility specific.

Okay, but the vast majority of those things CAN be done by an RN (with additional training, or dependent upon the state).

Now let's ask the opposite question - what are some things that RNs do that is outside the scope of an RT?

TheCommuter, BSN, RN · Dec 23, 2016

I think your RT coworker is playing a game of one-upmanship due to deep-seated insecurity issues. Secure, confident people do not constantly compare themselves to others.

I work in the ICU and we work very closely with our RTs. I love my RTs and get along and respect all of them. I even respect and love the RT I'm about to mention, her comment just makes me have more sympathy than anything.
Casually discussing nursing and respiratory education she interjects how her scope is greater than mine and can do more yet still gets paid less even as a head RT. I mean maybe she's bitter because she makes less than the Nurse Clinician 3-5? - and her way of justifying everything is by saying "I get paid less but my scope is larger I can do what you do and more".
Okay sure. I'm not even gonna argue that. I'm sure you can. I'm just a lowly ICU nurse. I wipe booty.... das all guyzzzz.
Peace out.

CardiacDork, MSN, RN · Dec 24, 2016

Skills are skills. Skills are learned easily trough training. Skills are different across state lines. Skills are different per facility.

What really makes the RN scope of practice is the amount of information that must be assessed, synthesized, and communicated.

As an ICU Nurse, I may not be a pro at ventilators or pulmonary physiology.

I do however have moderate knowledge in many areas to successfully and effectively care for my patients.

I carefully assess my labs, lines, patients, medications. The moment I receive report my brain is juicing up a storm of pure synthesis. I am thinking proactively and ahead of the game.

Because this is truly so broad and there are thousands of examples, I unfortunately cannot simply explain this in one simple paragraph or even a book.

What we do as nurses is so much more than the physical aspects of our jobs. It is so much more than placing an IV. So much more than dropping a feeding tube. So much more than obtaining an ABG.

What does all this data tell me? that is what nursing is truly about.

Othwrwise hospitals would hire MAs that can legally do anything the MD gives them permission to do.

But hospitals know they can't do this. They need the educated and trained synthesis performed by an RN.

heinz57 · Dec 26, 2016

Okay, but the vast majority of those things CAN be done by an RN (with additional training, or dependent upon the state).
Now let's ask the opposite question - what are some things that RNs do that is outside the scope of an RT?

Having it in your scope of practice doe not always make you the best choice to doing a procedure. We can see evidence of that on this forum as some try to explain basic respiratory care like MDIs, asthma and suctioning. You can say you were "trained" but in reality it might be a 5 minute inservice which gives you just enough knowledge to be dangerous.

I think this all comes down to "How do you define the word 'scope' ?" Yes, some RT's are allowed to do some physical tasks that most nurses are not allowed to do. Some people believe that gives those RT's a broader "scope of practice" than the RT's. Some EMT's think the same way about their scope of practice that allows them to do a lot at the site of an emergency.
I don't see it that way. I see those physical tasks as just tasks -- and I am not as enamored with them as some people are. I think the higher pay that most nurses receive is reflective of the fact that they are expected to know more about more things and make certain types of decisions that integrate a lot of sophisticated information.
And as I said in an earlier post -- and to any RT or EMT who brings up the topic with me. If you want the RN's higher salary, become a nurse and take on the RN's more comprehensive role.

You are comparing an RT to an EMT? Seriously??!! The RT has at minimum an Associates degree and the other has 120 hours of first aid training.

Skills are skills. Skills are learned easily trough training. Skills are different across state lines. Skills are different per facility.
What really makes the RN scope of practice is the amount of information that must be assessed, synthesized, and communicated.
*Snip*
Othwrwise hospitals would hire MAs that can legally do anything the MD gives them permission to do.
But hospitals know they can't do this. They need the educated and trained synthesis performed by an RN.

Are RNs the only ones with education?

Neither of you has any respect for the education an RT has or probably any other professional. RTs' education is in critical care medicine as Associates, Bachelors and Masters degrees Yes, they do have to look at the broader picture in the ICU since advanced ventilation strategies can do great harm including death if mismanaged. RTs usually operate under protocols for ventilator management rather than getting an order for every little thing. I would only hope someday you could get over yourselves to see how useful being a team player can be with other professionals.

If my loved one has an asthma exacerbation, I would hope there are RTs at their side and not just an RN. The same goes for PT. I don't want someone who says they can walk a patient "just like a PT" 3x a day for a check box marked done "per doctor's order". I want someone who can evaluate that walk to speed recovery and prevent future issues.

I hate only reading one side of the story and after reading more of the OP's posts, I have a feeling that RT might have a good reason to vent about a relatively new nurse who has a lot of learning to do. If the OP is going to survive in healthcare working with patients and other health care professionals who are going to annoy you more often than not but it is all part of being a team and learning/working together.

There have been way too many "measuring" discussions like this on here. It seems when we run out of nurses to pick on, other professionals get caught in the cross hairs. ICU vs ER, ICU makes more than Med/Surg. ER doesn't understand Med/Surg. Then there is all the "I hate being a nurse" which means nobody should be happy.

Happy holidays!

Skippingtowork · Dec 27, 2016

PICCS and Art Lines? What states are these?

I haven't seen PICCS but they definitely put in ART lines with their eyes half way closed!