Can an RN licensed in California administer ropivacaine via sciatic popliteal block?

[Nurse Beth, MSN]

I'm afraid I don't have a definitive answer for you, but I can point you to your organization's policies and procedures and the CA BRN.

Here is what I know:

Scope of Practice

In CA, the Nursing Practice Act (from CA Code and Regulations and Title 22) defines the scope of practice for registered nurses (RNs) and outlines the tasks and responsibilities that RNs can legally perform. However, it's not specific to your question.

Administering anesthetic agents, including performing nerve blocks like a sciatic popliteal block, typically falls under the practice of anesthesia.

Administering anesthetics via nerve blocks is generally considered an advanced procedure that is usually within the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) rather than RNs. CRNAs have specialized training and certification in anesthesia care, allowing them to perform these procedures.

For an RN in California, performing a sciatic popliteal block with ropivacaine would likely be outside their scope of practice unless they have additional certification and training as a CRNA or are under the direct supervision of a licensed healthcare provider authorized to perform such procedures.

CA BRN

While it's best to consult the CA Board of Registered Nursing (BRN) directly, getting a straightforward or consistent answer can sometimes be more challenging. 

I've emailed and called the CA BRN and will update you as soon as I have a response.

This could also be considered a Standardized Procedure, allowing CA RNs with specific training to perform highly regulated activities otherwise regarded as medical procedures. 

Policy and Procedure

This is a question for your organization's Risk Management and Staff Development Departments. Your organization's policies and procedures should clearly include who can perform the procedure, what supervision is necessary, and what training and documentation are required. 

I do know of one CA hospital where it was argued that ropivacaine was used as an analgesic, not an anesthetic. Therefore, trained RNs could monitor/maintain a dose but not adjust the dose. 

If an organization requires you to do this, they should protect you with clear policies and procedures.

Best wishes,

Nurse Beth

Update: here is the response from the CA BRN:

Quote

The CA Nursing Practice Act does not address specific medications and their routes of administration but it does address the use of Standardized Procedures.

Standardized Procedures are the legal mechanism for registered nurses and nurse practitioners to perform functions and procedures which would otherwise be considered the practice of medicine.

Standardized procedures are developed collaboratively by nursing, medicine, and administration in the organized health care system where they will be utilized and 11 components are required to be addressed.  Because of the interdisciplinary collaboration for the development and approval, there is accountability on several levels for the activities to be performed by the registered nurse. RNs must be competent (knowledge, skill, and ability) in the procedure and in its requirements for safe implementation along with ongoing evaluation of competency.  Regulations, standards, and best practices of the professional group and/or professional organization are also incorporated. If the professional group requires certification in the procedures, then RNs and NPs are expected to complete successfully the certification. If there are contraindications for/situations in which the procedure should not to be completed by the RN or NP but by a physician, then these contraindications/situations are included in the standardized procedure.  The BRN does not maintain information about certifications.  Organized healthcare systems are encouraged to contact the professional organizations.

Here is the link to the CA Nursing Practice Act regulations (CCR Article 7) regarding Standardized Procedures for your review:  Article 7. Standardized Procedure Guidelines

Here is a link to a BRN Advisory regarding RN Scope of Practice and use of Standardized Procedures for your review AN EXPLANATION OF THE SCOPE OF RN PRACTICE INCLUDING STANDARDIZED PROCEDURES

Nursing Education Consultant

Board of Registered Nursing

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