Epidural bolusing by RN's

Was asked to bolus a new epidural(for post op pain control) and declined to do so as I did not feel qualified and was not sure if it was approved by our Board of Nursing. Is this something(epidural bolusing) that most RN's are doing now?

CaronRN58

[Q.]

I've been asked by a lazy anesthesiologist to bolus an epidural, which I declined. I can, however, titrate the epidural drip and I feel perfectly comfortable doing so as my hospital provided us with the necessary training.

[P_RN, ADN, RN]

Dealing with epidurals and/or intrathecals for pain management should only be done by those RNs with the proper training. Our State Board advised also that we could not remove intrathecals when ordered by the doctor, but we could remove the epidurals.

We were given specific training by a CRNA and an Anesthesiologist in the anatomy and physiology of the areas, the use and management of the pump, and the signs and symptoms that required intervention. We also had specific protocols dealing with the dose, administration, orders for side effects etc.

We had orders for titrating naloxone and Zofran for nausea. I think that first you would need to talk to management, get an opinion from the state board, and consider having the course IF your hospital is amenable to giving one.

The epidurals were fantastic! Folks with a new total knee (usually VERY painful) could do an almost 90degree straight leg raise right after PACU.

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OOOPS I just realized I forgot to say...yes we bolused per protocol epidurals/intrathecals-using the pump, following the written protocol.

[NurseTami]

At my Hospital, the Policy is that the only personnel allowed to bolus is the Anesthesiologist or the CRNA. Periood. We are however, allowed to titrate the drip to their specifications.

[SharonH, RN]

In a couple of facilities where I've worked, we are allowed to bolus pt's on epidurals as long as they are already on the pump. We use similar orders and protocols as when we are using PCA pumps.