CNA’s restarting IV pump

[Tofumilk]

I’m a CNA at a hospital. Lately, I’ve had nurses tell me to just press restart on my patients alaris pump when it’s beeping (occluded). Is this okay? The most I’ll do is silence it then go to the nurse to fix the issue. I don’t want to potentially harm the patient by pressing restart.. and the nurse hasn’t seen what’s wrong with the pump and what not. Am I being unreasonable? The other cnas on my unit do it but I don’t really feel comfortable because I don’t know much about IV medications and the pump itself.

[chare]

No, it's not okay to do this.  

[Jedrnurse, BSN, RN]

Wow. So it's been more than one nurse telling you to do this...?

(There's always at least one in every bunch, but to have multiple people give you this VERY WRONG direction is concerning.)

[ThePrincessBride, MSN, RN, NP]

Yeah, no. Don't do it. For various reasons, this is a bad idea. 

[Tofumilk]

44 minutes ago, Jedrnurse said:

Wow. So it's been more than one nurse telling you to do this...?

(There's always at least one in every bunch, but to have multiple people give you this VERY WRONG direction is concerning.)

Yes, multiple nurses. And they get annoyed with me if I refuse. They make it seem like it’s not a big deal but I feel this is outside my scope.

[Jedrnurse, BSN, RN]

19 minutes ago, Tofumilk said:

Yes, multiple nurses. And they get annoyed with me if I refuse. They make it seem like it’s not a big deal but I feel this is outside my scope.

It's not only outside your scope, but it's wrong. (Just resetting a pump without truly determining what the problem is could lead to trouble.)

[chare]

21 minutes ago, Tofumilk said:

Yes, multiple nurses. And they get annoyed with me if I refuse. They make it seem like it’s not a big deal but I feel this is outside my scope.

It isn't a big deal, until there's an infiltrate or extravasation.  And if it happens, and you were the last person to restart the IV pump, which is outside of your scope of practice,  you're going to be the one left holding the bag.

Best wishes.

[Hannahbanana, BSN, MSN]

No, no, and no. You must refuse to do this, and they cannot discipline you for it. Totally outside your scope of practice and an illegal delegation to boot - a nurse cannot delegate an action to someone for whom it is out of scope, so you could both be in trouble for that. 
Suggest you ask your unit inservice person to give a brief refresher on this emphasizing the latter point. Then if there is more of the same, perhaps an anonymous call to the board of nursing would be in order. 

[MunoRN, RN]

We allow our CNA's and techs to be delegated the ability to address pump alarms for which they have been trained (this has survived many years of various accreditation, regulatory, and internal review).  

This is primarily for 'upstream' alarms and downstream alarms where the pump alarms due to a bent arm with an IV in the AC, the CNAs and techs can remind a patient to straighten their arm and restart the pump if the automatic restart has timed out, if the pump still arms with the arm straight then they must notify an RN.

[caliotter3]

A patient died when a nurse fiddle-faddled with their IV.  The nurse was not assigned to that patient.  She was fired, and I don't know what board action came about.  It is secondary that she fiddle-faddled on purpose to get the assigned nurse in trouble.  The words "homicide" and "murder" rushed through the nursing community.  Now that was a licensed nurse.  Do you think a CNA would be left off the hook?  Not likely.  Do not do it!

[JBMmom, MSN, NP]

5 minutes ago, caliotter3 said:

A patient died when a nurse fiddle-faddled with their IV.

That sounds like way more than what could happen by just pressing restart due to an occluded IV.

If I'm in the room providing care with a CCT and a pump starts beeping, I have had the CCT restart the pump, but I can see the IV site being used at that time. I would never ask a tech to restart a pump if I was not present. As others have mentioned, what if it's the one time an occlusion is due to an extravasation event or some other problem and you aren't in a position to assess that or address a problem. The nurses, as inconvenient as it might be at times, need to respond to the alarms appropriately. That unit should have some re-education. 

[MunoRN, RN]

1 hour ago, JBMmom said:

That sounds like way more than what could happen by just pressing restart due to an occluded IV.

If I'm in the room providing care with a CCT and a pump starts beeping, I have had the CCT restart the pump, but I can see the IV site being used at that time. I would never ask a tech to restart a pump if I was not present. As others have mentioned, what if it's the one time an occlusion is due to an extravasation event or some other problem and you aren't in a position to assess that or address a problem. The nurses, as inconvenient as it might be at times, need to respond to the alarms appropriately. That unit should have some re-education. 

And I agree if we're talking about situations where a nursing assessment isn't occurring that would otherwise be occurring if it's a nurse and not a tech or CNA hitting the button.  

In a truly ideal world, the placement of peripheral IVs are continuously monitored using color-flow doppler, of course that isn't what actually happens.

No assessment of the patient's IV is necessary to address an upstream occlusion, and fairly minimal training is necessary to look for and address an upstream occlusion alarm.

Dealing with a downstream occlusion alarm due to a bent arm and an AC IV also isn't going to be dealt with differently by an RN compared to a CNA or tech as it's not common practice to do a complete infiltration / extravasation assessment each time a patient bends their arm causing a downstream alarm.