RN doing conscious sedation non-intubated patient

  1. I am an RN Circulator. We have a surgeon that does pain injections. I am the anesthesia for the cases. I hook them up to all the monitors at the anesthesia machine and monitor them during the case. I push fentanyl and Versed. So my question is Do you think I should bed doing this? Would you push these drugs? Thanks for any feedback...
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    About Surgerygirl

    Joined: May '07; Posts: 32; Likes: 19
    OR Circulator
    Specialty: 17 year(s) of experience in L&D, Surgery, Case Management


  3. by   TheCommuter
    Moved to the Patient Safety forum.
  4. 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....
  5. by   TelephoneTriage
    When I was an ER nurse I did conscious sedation. I pushed morphine and versed for the ortho docs while they were setting bones and casting. This was at a children's hospital. I was under their direct supervision, but I was the one who drew up the drugs and mixed them with saline to be 1:1. I was a nervous wreck the first time I did it on my own (without another nurse supervising). This was after I had passed my PALS certification. After that, I had no problems with doing it. But, I am happy with my job now and would never go back!
  6. by   perky_nurse:)
    Nurses cannot push propofol. Only a physician or nurse anesthetist can give it. We use mostly propofol in our conscious sedations in the ER. I don't think we even do versed, at least not commonly. Doc, RT and nurse is at bedside. Nurses role is to monitor the patient. Document times of med administration, v/s and patient's response post anesthesia. When hired on at the facility, nurses are trained on proper procedure for monitoring patients, and assisting the doc during conscious sedation.
    Last edit by perky_nurse:) on Mar 11, '08
  7. by   estherojin
    Most hospitals require nurses to have documented competency in moderate/conscious sedation as well as have ACLS if administering sedation will be a part of their job description. Even if the surgeon is present, if he's occupied with the procedure, as the person who administered the medication, it'll be your job to monitor the patient and intervene if necessary. In the cath and EP labs I've worked at, sedating and monitoring patients were a big part of the nruses' responsibility.
    Last edit by estherojin on Mar 11, '08
  8. by   TRAMA1RN
    In PA nurses can push propofol for moderate sedation! You must check with your Board of Nursing for nay questions on your scope of practice. Each and every state has different guidelines. Moderate (previously known as conscious sedation) sedation is NOT the dame as full anethesia.
  9. by   BrnEyedGirl
    I push both of those drugs almost every shift in the ER. I had to take a class, pass the test, and keep my CEU's up to date. All of us are ACLS cert.
    The only time we use Diprivan is if the pt is already tubed,.then we usually just start a drip.
  10. by   angel337
    i push propofol all the time and assist with conscious sedation also. i guess it depends on your BON and the hospital you work for.
  11. by   mianders
    I live in TX and we do moderate sedation in the ER all the time for reductions. Profopol is not used for moderate sedation very much though. We use Versed a lot. I would definately check with your BON and your facilities policy before doing it though.
  12. by   Annony RN
    As long as it is concious sedation, you are certified competant in CS (take the annual class and test), and you have ACLS you should be OK. Sounds like you are not using propofol which would be just one criterion that would cross the line (and there are enough threads here about that)

    Also, you should not also be circulating the case. In most ORs, a second circulator is used. If you are giving sedation then monitoring the pt is your only responsibility.
  13. by   oramar
    Isn't it interesting the difference in scope of practice depending on state where you work! Threads like this increase my awareness of the situation, thanks.
  14. by   micco
    How long have you been a circulator? I am a circulator too. it is part of my job description to do conscious sedation using versed and fentanyl. Every nurse where I work is able to do conscious sedation cases.