who can obtain biopsies?

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I posted this in gastrointersional nursing but got no response. I work extra help at an out patient surgery center that also does upper and lower endoscopies. About two weeks ago there was a rumor that OR/GI technicians were not supposed to be obtaining biopsies. In other words holding the biopsy forcep and "opening and closing" the forceps under the doctors orders to get polyps or biopsies. Has anyone else heard rumors of this.

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This is where you can get sticky about interpretation of the law.

California BPC

2051. The physician's and surgeon's certificate authorizes the

holder to use drugs or devices in or upon human beings and to sever

or penetrate the tissues of human beings and to use any and all other

methods in the treatment of diseases, injuries, deformities, and

other physical and mental conditions.

So anyone else who does anything listed about would be practicing medicine unless they have a license to preform the funtions within the scope of theirt license.

If a GI tech is not licensed to preform the function then it is a not allowed. Same with surgical technologists, they can not function in California as a first assistant and retract tissue or suture due to the wording of the meical practice act.

If a RN were to assist and deply the biopsy there would need to be appropriate standardized procedures to support the action.

Jeremy

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Thanks Jeremy, that is exactly what the rumor was about. What do you think of it. Can't a technician do these things under the license of the physician? As long as the physician is willing to sign some ?? legal?? form that this technician is performing this procedure under my licensure?? I don't know medical/legalese. Following the letter of the law is sometimes crazy!!!! As our GI doctor said not being able to use technicians in GI labs would ruin most free standing GI labs and or make the cost of endoscopies prohibitive!!!!! I don't know enough about OR's to say what damage this would do to them! Who suddenly comes up with these crazy interpretations of the law? Who is going to have the final say so on this issue? Can I write to my representative or some state medical board about it?

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Specializes in Emergency, Trauma, Critical Care.

have you looked at the protocols at your facility? The provisions should be in there to cover you. If they're not than the protocols/procedures should be reviewed and discussed.

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Thanks Jeremy, that is exactly what the rumor was about. What do you think of it. Can't a technician do these things under the license of the physician? As long as the physician is willing to sign some ?? legal?? form that this technician is performing this procedure under my licensure?? I don't know medical/legalese. Following the letter of the law is sometimes crazy!!!! As our GI doctor said not being able to use technicians in GI labs would ruin most free standing GI labs and or make the cost of endoscopies prohibitive!!!!! I don't know enough about OR's to say what damage this would do to them! Who suddenly comes up with these crazy interpretations of the law? Who is going to have the final say so on this issue? Can I write to my representative or some state medical board about it?

If you want clarification on the subject I would contact the board of medicine and ask for a written advisory. To the best of my understanding California is not a medical deligatory state and a physician can not deligate functions to others under their license. But i could be wrong.

In addition the BRN has issued an advisory on scrub functions by non-RNs.

The Board of Registered Nursing interprets any individual not licensed to practice professional nursing

who performs scrub nursing functions may do so only as an assigned technical function under the

direct supervision of a perioperative registered nurse.

So if the BRN considered the GI tech to be preforming scrub function you would be accountable for their actions, which may include aiding the unlicened practice of medicine or nursing. If the BRN feels assisting in a GI lab does not equate scrub functions then the GI techs won't be under your license. You may still be aiding the violation of state laws.

Similar topic to look at is assisting in a ERCP or other scope if the GI tech is injecting contrast or any other medication for that matter there is no legal authority for that action and it would likley be not legal.

Jeremy

If you are workign in an acute care facility you might also want to look at this statement from the BRN

http://rn.ca.gov/pdfs/regulations/npr-b-29.pdf

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Thanks to you both. Yes, protocols, BRN interpretations, are important and wise most of the time. But I have assisted with GI nursing for 10 years now, apparently illegally in some situations, as GI techs have been obtaining biopsies and injection contrast media all along. Just makes me annoyed that something that has been working fine, no problems, everybody is happy, no complaints, then suddenly some one in an ivory tower decides to interpret the policies. It seems to me like the BRN is trying to make what are currently technician functions, be done by RN's only. Seems like they are just trying to make RN's and therefore the BRN more powerful. Seems like, "nah nah to you tech's, only RN' can do that now!"

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Actually just becouse it is the way it has always been done, does not imply that it has always been done correctly or legal. I agree that California does have a lot of regulations in healthcare. But none of the laws or interpretations are new, they have been that way for years. They have just not been followed in many cases.

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