can nurses intubate?

Nurses intubate in our unit, but they are only the most experienced nurses. They have to be trained (I think under MD supervision) then have so many supervised successful intubations then they must successfully intubate at least once a month. There are very few nurses in our unit that do this, maybe one per shift where we usually staff 18-22 RN's per shift. Resp. Therapists do the majority of our intubations unless an MD is at the bedside. The RT's even have to have specialized training and perform at least one successful intubation per month.

Doesn't it depend on what your state allows? Our lifeflight nurses had to be paramedic certified to intubate...we don't intubate at all, our docs do it.

Girl,

In Alabama not only do we intubate, we "read" x-rays....we never have a doctor in house after they are through making their rounds, we draw our own blood gases, interpret them, and make ventilator and cpap changes based on them!!! I just graduated in May, and I can't believe the stuff we are doing sometimes. I don't intubate and I double-check with more senior nurses before I touch the vent, but still!! We have had some travelers that are working with us now who are in disbelief at all the responsiblity we're given. It's too much. Sometimes we have 2 vents and a cpap...or a HFOV and an isolette..... Then, sometimes you'll have 4 grower-feeders who all eat at the same time, have to be weighed, etc etc. I guess the one thing I should be happy about is if I move to another state (which is a certainty with my Air Force honey!) I will have more reasonable assignments and more physician help.

:)

Wow, that's scarey. What do you do after you "read" a bad xray. Do you just decide for yourself what kind of changes if any need to be made or do you call the doc and they come in and decide. I understand no MD coverage after hours, I've worked a few places like that, but is there no NNP coverage. Do the RT's help you decide what kind of changes to make? What happens when a baby is going bad do the docs come in? Or what happens when you "read" a bad xray and the baby needs surgery? Is everything you're doing within your scope of practice for your state.

Just curious.

Our docs and RTs do it. I wouldn't do it as a staff nurse. They really don't pay me enough to keep giving me their jobs.

We don't intubate here. It's a teaching hospital though, so we have residents there day and night who need the experience. On day shift, there are residents, neonatalogy fellows, attending neonatalogists, and NNPs. On nights, we just have a resident and a fellow.

Some of our RTs know how to intubate, and I really think they should get to do it more often so they're proficient at it. There have been some emergencies at night where both docs were at high risk deliveries and no doc was on the unit to reintubate a sick baby. Luckily, there was an RT that was able to tube even though it's actually not part of their responsibilities at this hospital. I understand that the residents need the experience, but it doesn't hurt to have other qualified personell.

I personally wouldn't want that responsibility, even though I'd love to try it one day just to see if I could do it or not...

Wow, that's scarey. What do you do after you "read" a bad xray. Do you just decide for yourself what kind of changes if any need to be made or do you call the doc and they come in and decide. I understand no MD coverage after hours, I've worked a few places like that, but is there no NNP coverage. Do the RT's help you decide what kind of changes to make? What happens when a baby is going bad do the docs come in? Or what happens when you "read" a bad xray and the baby needs surgery? Is everything you're doing within your scope of practice for your state.

Just curious.

Well, most x-rays are done in the a.m. anyhow and if you saw something really bad, we just call the m.d. We do not have a NNP. I usually ask the RT's their opinions when they bring the blood gas results. Most people take stuff to the charge nurse and then we ask if any other nurse needs to speak to the m.d., then we call. If they're going bad usually the docs will come in.

As an L&D nurse, I learned to intubate in the 1980's. I don't think I did it enough after the first year to keep my skills up. Back then, I did it for emergency C-sections where the ped was not going to make it.

Now we have NNP's who attend every high risk birth. I am so grateful for them! And they don't pay us enough as staff RN's to do that intricate procedure, IMHO>>>

How's it going finding a hosptial in SC to work for?

I am pretty sure that each facility has different protocols on who can and cannot intubate. As a NICU nurse for almost 2 years I am glad that I am at a place that encourages the RN's to become more advanced and skilled at what they do. We do have crazy pt ratios at times but I couldn't imagine only having one vent or two nc's, I would be so bored I would think. I like that we can make vent changes(with or without the RT) usually just the IMV sometimes pressures at our discretion, our MD's are just a phone call away for major changes in a patient when we need them. They really only come in at night for admits and codes, which thankfully we haven't had many of lately. If a kiddo is acting stupid and needs an xray or labs they are normally done first then we call the MD with the results and just let them know what we have done and take any new orders from there. It all works out and we have super smart RN's (some NNP but not praticing as so) here in Bama.

BTW War Eagle KK7724

I work in a teaching hospital where we get the sick babies (ECMO, MAS, etc) The nurses just don't have the time or the expertise to ru the vent along with all the meds, weighings, baths, feedings, etc. Our nurses raw gasses if they are also drawing labs, but otherwise, the RT's handle this. As far as intubations are concerned, if there is a resident redily available, we will let them try twice. If they can't get it, then the RT intubates. We also handle lots of high risk deliveries and intubate there. The neonatologists are dealing with other issues with the baby. We work with the babies as a team. We are lucky to have the staff so that the baby get a specialist for all major facits of care.