As an RN, I am having a hard time with this. I came from a hospital that was very by the book, no ambiguous policy's etc. Things were very clear. If you were not atleast an RN, and have ACLS, and a CS class you did not push any form of sedation, narcotic, or any other IV drug for that matter. I have techs giving Benadry, fentanyl, versed, and the list goes on. The unit has recently decided they need to be ACLS certified, but I can think of plenty of nurses who may be ACLS but still have no business pushing sedation.
I have contacted the state boards of nursing, and JCAHO. No one is giving me anything but "qualified persons=ACLS and yearly competency", per each hospitals policy.
Can I get some feed back. I work in IR, and they are very anti RN, i get the feeling the techs think they can do my job! I just feel there is more to giving drugs and monitoring the patient. It goes to the whole system and understanding it as a whole.
I work under a Rad Tech Manager, No nursing manager to speak of. They are very defensive and say that they have taken the test(10 basic questions), and are ACLS certified, and that the hospital policy supports them giving CS under supervisioin of a Dr. THis is an Interventional area, that runs all its RN's off because they are under the impression that they can do pt assessments themselves.
I feel like I am banging my head against a wall with these people, they keep going back to their "Hospital Policy", I go to my NPA, they have suggested I go higher if I am not happy with this plan of care, but that makes me the bad guy of the Unit. I guess I signed on to be Pt advocate first, so wish me luck and thank you so much for all the great information. The support is greatly appreciated!!!
:monkeydance:
No matter what THEY say, it is YOUR LICENSE at risk. The State Board will not take as a valid explanation that non nurses dictated to you how to be a nurse.
Go to the ASA web site American Society of Anesthesiology, they have some very specific guidelines about who gives sedation and the requirements that must be met. If Technologists are pushing any medications other than those they are "certified" as competent to give, you need to talk with your risk management folks.
Also, I agree with the other posting about checking into the practice guidelines for technologists in your state.
I dont know any hospital that allows technologists to give sedation, ACLS or not, they do not have the pharmacological background to give those kinds of drugs.
Here is a good question to ask. Is the person giving sedation competent enough to rescue that patient from the next deep level of sedation? Also, go to your Chief of Anesthesia and see what they have to say. You might be surprised how many people may not realize this is going on.
How connected to nursing are you? Are you working for Radiology or under Nursing, that makes a difference too.
I welcome these comments! I have been anurse for 23 years. I am presently working in a vascular outpatient setting. I TOO came into a practice of RT's administering CS. I feel this is in violation, though since I am surrounded by radiologists and RT's, I am quieted. We have already had to reverse a patient given Versed after I commented in th eprocedure he should NOT be given more sedation! Comments? I would like this stopped! I am looking for documentation to cover me.
I don't work in a hospital setting, but a free-standing clinic owned by radiologists! They say they do not need to be under any mandates! This worries me. I am trained in conscious sedation and not to fight this! Do I have grounds? I think I do. I act under MY license, not the MD's.
Check your state practice act. Check with JCHAO. Check state RT's role. This is just too dangerous to let go. I work in IR. I let the techs run their mouths as they want but they are not going to give my patient anything through mouth or IV! You can't let the haters put your patient in harms way and your license in jeopardy.
Here is some information for you to evaluate the competency level of the technologists you are dealing with.
The old designation was Registered Cardiovascualr Invasive Specialist. (RCIS). There is a new one now. If the technologists are certified or registered by their specialty, they have additional skills that their peers in Radiology would not have. Here is a web site that provides information regarding their skill levels. Very few techs have this certificate. http://www.cci-online.org/apprvs.html
I hope this helps you to weed out the skilled technologists from the others.
I too would be afraid of practicing in a setting where my license is on the line based on my percieved level of delegation to other less skilled staff.
ZASHAGALKA, RN
3,322 Posts
No matter what THEY say, it is YOUR LICENSE at risk. The State Board will not take as a valid explanation that non nurses dictated to you how to be a nurse.
I wouldn't work in such an environment.
~faith,
Timothy.