I have worked in an interventional radiology department for the last 4 1/2 years. We have 2 rooms, 4 rad techs, and 2 RN's. Our techs do conscious sedations and push IV narcotics. I was told that this is ok, because they are doing it under "direct supervision of the physician". The RN is in another case, or off for the day. But there is always a RN on duty. Never are we off the same day.
We also have a narcotic sign out sheet, and our techs also sign out these narcotics. Is this a practice at other hospitals?
I don't have a nurse manager, and my supervisor is a Rad Tech. She does not know my licensure. Our techs for our state, are not licensed. They are registered with their national registry. But not licensed to practice by our state.
Feb 25, '06
I doubt seriously that this practice is legal, in any state.
Whether you are working 'under supervision of a physician' or not, the job you are doing must still fall within your scope of practice. Unless the rad tech was certified by state examination to deliver narcotics, that is a scope of practice issue limited to docs and nurses.
And if the doc didn't write it as an order, or you don't have a standing protocol (I doubt you do, since it's illegal), then it's going to come down to an issue of RN delegation. And in this case, it's an illegal delegation.
Heads will roll and licenses will be endangered if, God forbid, a patient were mismanaged or a narc was diverted, or even if the DEA audits and asks who all these non-licenses signing off narcs are. . .
And besides, who is doing the IV CONSCIOUS SEDATION forms for these pts? Not to mention the NURSING monitoring that those forms require . . .
I wouldn't sign out a narc for a non-nurse to give (except rarely, I have signed out morphine for RT to give as nebs, under my direct supervision). And if the techs have access to the narcs independent of you, woe be to your hospital if DEA or JCAHO ever finds out.
Last edit by ZASHAGALKA on Feb 26, '06