Femoral Sticks In Scope Of Practice For Rn????????

NursesRmofun, ASN, RN · Jun 3, 2004

I HAVEN'T BEEN A NURSE FOR VERY LONG AND I NEED HELP WITH A QUESTIONS I HAVE THOUGHT ABOUT FOR AWHILE. IS IT WITHIN THE SCOPE OF PRACTICE FOR A RN TO PERFORM FEMORAL STICKS FOR A HEART CATH OR ANY OTHER PROCEDURE? I HAVE ASKED THIS QUESTION AND GOTTEN CONFLICTING ANSWERS. I NEED TO KNOW IF IT IS WITHIN THE SCOPE OF PRACTICE FOR AN RN IN THE STATE OF MISSISSIPPI. IF I REMEMBER CORRECTLY IN SCHOOL WE WERE TOLD THAT WE COULDN'T PERFORM ANY ARTERY STICKS BUT I MAY HAVE MISUNDERSTOOD. PLEASE HELP ME IF YOU CAN WITH THIS QUESTION WEIGHING HEAVY ON MY MIND!!!
THANKS A BUNCH!!!

To my knowledge, no, it is not within a nurses' scope of practice. However, the best one to answer would probably be a radiology nurse or cardiac cath nurse.

gwenith, BSN, RN · Jun 3, 2004

Check with the board of nursing for your state - Email them so that you have a written answer. Bottom line wherever you are in the world is that if you do not have adequate training to perform a task then it is not in your scope of practice - oh! and here's the needle there is the artery is NOT adequate training!!!

NursesRmofun, ASN, RN · Jun 3, 2004

check with the board of nursing for your state - email them so that you have a written answer. bottom line wherever you are in the world is that if you do not have adequate training to perform a task then it is not in your scope of practice - oh! and here's the needle there is the artery is not adequate training!!!

lol! true! knowing how certainly would help! i am just thinking it is not in our scope of practice here in the usa...i am thinking not in any state. but i could be wrong. i have been before.

gypsyatheart · Jun 4, 2004

Yes, check with the BON of your state. As an FYI, arterial sticks in general are fine. But, again, check with your BON!

Dinith88 · Jun 4, 2004

the answer is NOPE

mattsmom81 · Jun 4, 2004

I have done femoral sticks in a code situation and am comfortable doing arterial sticks for labs and ABG's, have done so for years. Hospital policies and our NPA's dictate our do's and don'ts, but I have found in a code situation things can run a bit different...LOL!

Starting a femoral line venous or arterial line, or an arterial line anywhere is NOT in my scope of practice as a staff nurse in my hospital and state. Some ER nurses DO start external jugular venous lines in dire circumstances (trauma, code, etc). I imagine in a few settings a nurse might be trained to do such things under a physician/s radiologist's supervision, but central line venous placement and lines in arteries are generally a doctor's domain.

Dinith88 · Jun 5, 2004

I have done femoral sticks in a code situation and am comfortable doing arterial sticks for labs and ABG's, have done so for years. Hospital policies and our NPA's dictate our do's and don'ts, but I have found in a code situation things can run a bit different...LOL!
Starting a femoral line venous or arterial line, or an arterial line anywhere is NOT in my scope of practice as a staff nurse in my hospital and state. Some ER nurses DO start external jugular venous lines in dire circumstances (trauma, code, etc). I imagine in a few settings a nurse might be trained to do such things under a physician/s radiologist's supervision, but central line venous placement and lines in arteries are generally a doctor's domain.

Hey mattsmom,...

So, why were you needing to stick a femoral artery in a code? And did the patient have a pulse while you were doing it? If the pt was pulsless, it was a BIG error to go digging blind into someone's groin...And if there WERE a pulse, it would seem other access (for abg's??) might have been gotten. The only time i've seen femoral sticks during a code was to obtain abg's on a pt we werent able to obtain from the radial..(and the fem stick was done by a cardiologist....

And any nurse that goes jammin a needle after someone's jugular is just asking to get in trouble. Nurses doing any central sticks (in a code, trauma, or whatever) are WAY out of nursing scope... If you nick a carotid (especially during a code!) you can kiss the patient good bye...and what were the doc's doing while you were sticking femoral arteries and jugular veins?? Were the doc/doc's just standing around while the nurse was poking a central vessel??? And if a nurse is running a code without a doc present, she would be stupid to go sticking central vessels (imo).

I'm willing to bet that you've never been formally 'trained' to do these sticks (femoral artery, jugular vein, etc)...so why would you be asked or expected to in a code (you said you've done it lots of times??)..?

Also, In controlled situations (in the cath-lab, where cardiologists stick femoral arteries all the time) under the best/oportune environment, people get retro-bleeds ALOT...In an uncontrolled situation/code, where a pt's pulse is thready at best, a fem. stick is SO dangerous and can easily cause retro bleeds or cause limb paralysis (a big nerve (sciatic or vagus??) runs just-lateral to femoral arteries and can be 'run-through' very easily)

I dont disagree that after seeing it done a bazillion times, a nurse could probably do these sticks no problem...but still...

I'm not saying i dont beleive you...I'm just a little taken aback that your hospital allows nurses to do this stuff...code or no code.

Stitchie · Jun 5, 2004

the answer is NOPE

In the two hospitals I've worked at in the Chicago area ABG's are part of our nursing practice. Femoral sticks are more ambiguous: some RN's will do them (one is a flight nurse). Some insist on the resident/doc doing so.

My first job was on a respiratory floor where ABG's were routine for RN's. I did receive training in ABG's, but it did consist of: here's the needle, feel the pulse, don't cause a hematoma. :uhoh21:

My job now is an ER where ABG's -- radial or brachial -- are routine also.

Fem sticks are done by the residents, ABG's are done by the resident if I've tried once and missed. I am not comfortable doing ABG's as a new RN (less than a year of training) and that I am not comfortable with this has caused a bit of controversy for my NM and me.

jnette, ASN, EMT-I · Jun 5, 2004

I do femoral sticks every day.......... but that's 'cuz it's a tunnelled graft.

Guess that doesn't count. It's our one patient's only dialysis access site.

gypsyatheart · Jun 5, 2004

We do arterial sticks for ABG's every day..... Guess it depends on your state, your hospital policy. Again, best thing is to check with your BON.

Dinith88 · Jun 5, 2004

In the two hospitals I've worked at in the Chicago area ABG's are part of our nursing practice. Femoral sticks are more ambiguous:.

The question wasnt about abg's. it was about central vessel sticks (ie Fem artery). What do you mean by ambiguous? And the flight-nurse you spoke of is taking huge risks (unless of course he was 'trained' and 'expected' to (i'm betting neither)...and why in the heck would a flight nurse be drawing areterial blood...or any blood for that matter? abg machine or lab machines on board his chopper??