Can registered nurses supervise stress tests without the "supervising physician"

[cobe]

I've seen forums regarding RN supervised stress tests, but they mostly addressed tests done in an office setting. I would like to know if it can be done in a hospital setting (inpatients and outpatients).

I am currently dealing with a situation at my hospital's Non-Invasive Cardiology Lab, where ordering/"supervising" physicians do not necessarily want to be in the hospital while their patients' tests are being done. Some of the physicians involved have offices in the medical office building next door, and would like to tell us to start and do the test while they continue to see patients in their office (or from home, or just completely off premises). Yet they will continue to bill for supervision and interpretation of the stress test (exercise or pharmacological, and nuclear or echocardiogram).

While it may be true that in an emergency, a code blue may be called in a hospital, can this legally be done? The hospital's policy is being revised to satisfy the request of the off premise supervision. With that in mind, is this still legal for the hospital to agree to this?

If not, please help me with links to reputable articles that will help my cause. I have not had any luck with my research. BTW, I practice in California.

Thank you.

[bluesnurse]

I'm not a legal expert, but if the doc is billing for stress test supervision and is not physically present, that sounds like fraud.

I've been doing stress tests for 16 years, am ACLS certified and very comfortable with 12-lead EKG interpretation. There is still NO way I'd put a patient on the treadmill with the "supervising" physician at home or even across the street. They *have* to be on the premises and available to respond if necessary. Regardless of legal technicalities, it's a liability issue and is beyond the scope of RN practice.

[cobe]

Thank you for your reply Bluesnurse. I'm happy to report that my hospital did not agree with the "off premises" supervision. Our new policy clearly states that they need to not only be on premises, but actually in our dept and readily available before we start any test. Thank goodness logic and ethics came through. :yeah: