epidural catheters

Blue11RN · Dec 2, 1999

The hospital I just left, did not allow nurses to hang epidural bags, but the infusion company I work for now does.

ratchit · Dec 3, 1999

I have done med/surg, per diem, travelling, and critical care. I have always been allowed to hang a new bag if epidural solution and change the tubing; in fact, I can't imagine a residents or attendings face were I to call them to do it.

I have seen policies that prohibit RNs from giving a bolus off the pump, even with the surgeon's or anesthesia pain service's orders. Where I work now (ICU) we open the epidural system and give push fentanyl/ dilaudid/whatever with a preservative-free saline chaser for breakthrough pain. Getting APS onto the floor to program a bolus into the pump is ridiculous but I don't like opening the system for prn's either.

Every hospital/homecare system has it's own "right way" of doing things, but not being able to hang a bag is pretty restrictive. Any idea what is behind those rules? Have they had sterility or air bolus problems?

Ratchit

dinorn · Jan 7, 2000

the hospital where i work all rn's are allowed to change the epidural bags,change the pump settings,and administer bolus doses. we do take a ceu course on epidurals.

Moore · Jan 8, 2000

I have worked in many areas of my hospital including critical care, and all nurses are allowed to give boluses, change tubing, and adjust the rate per orders. Many times the anesthesiologists have us d/c them too. I would like to know the rationale of why you couldn't work with epidurals!