Practicing Out of Scope

Nurses Safety

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I am currently on assignment with a travel company at a facility located in Az. If any Az nurses can chime in here I wold appreciate it.

I want to make a complaint about nurses (more than one) practicing out of their scope. However, I'm not sure how to make a complaint about how the unit is run. Because it is not just one nurse, it is the entire unit. They are doing it knowing that the doctors should be the ones that should be preforming the task and none of them stand up for themselves. When I did, the Doc basically said they were taking me to administration becasue I refused to do the task that is completely their responsibility. I have already spoken to my company about it, but more needs to be done so that it does not occur any longer.

Is there any consulting perosn or group I can speak to first to determine how to best handle this? I have never been in a situation where there was blatant disregard for stand of practice.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
It seems very silly, but the OP appears to be correct:

http://www.azbn.gov/Documents/advisory_opinion/AO Analgesia by Catheter Techniques_ Epidural-Intrathecal-Interpleural-Perineural 0911.pdf

Reading the document, which was very clear......I think the OP needs to print it and go to the manager/director/CNO/her agency and state the she cannot participate in the practice not approved by the BON. I would be prepared to quit over this situation for my license is mine to protect. I would call my malpractice carrier and ask for further advice.

I love clarifications. Thanks for the links, and the OP's path looks clear now. Do let us know what happens (other than the expected grumbling from the nurses who can't do it anymore, and the docs/CRNAs who will have to).

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LOL, I did all of the above the second the Doc literally threw a fit in the room when I asked her to set the pump. It has started a large uproar among everyone.

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Good for you at catching this and not making the mistake and just going with the flow thinking it is ok just because you see the other nurses doing something. Hopefully it will all just blow over and everything will be ok. maybe this could just be a learning moment for the staff and you can all just move on knowing it is the doctors that are suppose to do this task, and not the nurses.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
DorselFin said:
LOL, I did all of the above the second the Doc literally threw a fit in the room when I asked her to set the pump. It has started a large uproar among everyone.

Boo Hoo.....cry me a river snowflake!......... I'd be willing bet she'd be the first one to site the BON practice guideline to throw you under the bus to get her behind out of the sling!

These kind of MD's REALLY grate on my nerves.

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Esme12 said:
Boo Hoo.....cry me a river snowflake!......... I'd be willing bet she'd be the first one to site the BON practice guideline to throw you under the bus to get her behind out of the sling!

These kind of MD's REALLY grate on my nerves.

Thats what I told all of the staff! The first thing they will say when something goes wrong is well I didn't set the pump! I refused to back down and refused to set the thing. I still refuse and the girls on the unit are now starting to follow my lead, not only on this but alot of other unsafe practices in their unit. They are trying to convince me to apply for the open DIrector position because of it.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Good for you.....it amazes me when nursing allow themselves to be bullied into doing things that are against the nurse practice acts....they are putting themselves in a BAD spot.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I used to work in OB in AZ and I can vouch for the OP - the only thing we could do is shut off the epidural pump (after delivery, for example) - could not turn it on, or adjust it in any way. I'm shocked that the nurses at that hospital do that!

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I know!!! I just couldn't believe it!!! And its not that they are being bullied into it, its just that they truly did not know any different. There are so many things that are unsafe here. Beyond the out of scope, how about they use a delee suction to clear Mec when the fluid has mec present at rupture? I just can not understand the lack of common practice knowledge. I had to explain to a nurse who has been at this for 5 years why a delee does nothing for the poo that may or may not be in the airway. Keep in mind they are literally just dropping a delee in, no ET tube blade, just passing it dowm like normal.

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Specializes in Public Health, L&D, NICU.
Esme12 said:
Boo Hoo.....cry me a river snowflake!......... I'd be willing bet she'd be the first one to site the BON practice guideline to throw you under the bus to get her behind out of the sling!

These kind of MD's REALLY grate on my nerves.

I'm sure these same OBs have vetoed having CRNAs around to make sure they can horde more money, but they are now sad that there isn't a CRNA around to do some of the scut work. I've always hated working in L&D units without CRNAs (or with CRNAs who had little scope or authority) because the MDs are NOT going to do things like this if they can bully/manipulate someone else into doing it. In an ideal world (ideal for the L&D RN), CRNAs handle epidurals (placement, boluses, and pumps) and the MDs just sign the paperwork.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Do you mean for a non-vigorous infant, like as part of NRP ?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
monkeybug said:
I'm sure these same OBs have vetoed having CRNAs around to make sure they can horde more money, but they are now sad that there isn't a CRNA around to do some of the scut work. I've always hated working in L&D units without CRNAs (or with CRNAs who had little scope or authority) because the MDs are NOT going to do things like this if they can bully/manipulate someone else into doing it. In an ideal world (ideal for the L&D RN), CRNAs handle epidurals (placement, boluses, and pumps) and the MDs just sign the paperwork.

I would bet that the absence of CRNA's have much more to do with anesthesia putting the halt on having them than the OBGyn. But the nurses are responsible for knowing their nurse practice acts of their states and are responsible for knowing what they can and cannot do...the onus is on them.

My question is where is their manager? Where is the director? Where is their clinical specialist? Where is risk management for not stepping in with proper policy and procedure?

It boggles my mind.

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