Did I do the right thing?

[Jackfackmasta, ASN, RN]

I work in an busy Ed as a tech for almost 2 years. I was volunteer for 1.5 years before that. I graduated nursing school last week and have accepted a position at a level 1 STICU.

That being said, I was confronted with a delegated task from an RN who asked me to stabilize a arrow that had gone through this 17 year old boy's forearm with a bulky dressing. It did not hit the bone or any major blood vessels and the patient was stable. He also happened to be the younger brother of one of our admission people who we all know and love.

I told the nurse that I had not done that before and I do not feel comfortable doing it since it was not in my scope of practice and required judgement. The other techs and one of our newer techs were looking at me like whatever let me do it after I refused to do it as he was telling me how to apply the bulky dressing.

Was I right to refuse this delegation? I believe it was the nurses responsibility and not mine. I'm not going to be liable if something happened. I would not have delegated it if I was that nurse.

[northernguy]

I'm curious if you have any training or experience as an EMT. As an RN you have a lot more training than me, but stabilizing a penetrating object like this seems like a pretty simple thing to do and something pretty much every EMT has been trained for and practiced. I understand in the real world things are always more complex and maybe Im missing something, but this seems like it would have been pretty simple and straight forward, which is probably why the other techs were saying hey let me do it.

Still, its always a good thing to not let your ego get in the way of what is in the patients best interest and admit that you arent comfortable doing something, so I wouldnt criticize you for doing that.

[Jackfackmasta, ASN, RN]

I am not an EMT. I have been trained as a ED PCT. We have never been trained on that though before. I have graduated nursing school and am sitting for NCLEX on the 14th. The other tech that did it was a newer and was in nursing school. I just don't know if this is in the scope of a tech's practice or if the nurse should be doing it.

[northernguy]

I would say it is definitely in your scope. Again, EMTs do it all the time, and ER techs are pretty much just EMTs minus the pre hospital stuff like driving an ambulance or extricating a patient from a vehicle.

I wouldnt sweat it though. I work as a PCT on a med/surg unit and there are times when a Nurse has asked me to do something I was never trained to do and I will ask them to please show me. For instance the first time I had a post surgical patient who had orders for a CPM, I asked if the RN or another aide could set it up while I watched so I didnt screw this persons knee up for life. The Nurse was angry and lectured me on how I should already know how to do this, but she got over it, and I learned how to do it right.

In the military we used to say see one, do one, teach one. How can you do it if youve never even seen it.