another dumb question

1. i'm just curious. do RNs get to intubate, and do NG tubes and stuff like that?
2. 

   About CNAtoRN2b06

   Joined: Dec '06; Posts: 15

   12 Comments

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3. 
   Dec 4, '06

   Occupation: Registered Nurse - LTC Specialty: 4 year(s) of experience in Developmental Disabilities, LTC ; Joined: Nov '06; Posts: 428; Likes: 84

   I don't know about the intubating...I know it's not a skill included in my 2-year ADN program.
   
   NG tubes? You bettcha! And as I understand it, this is fairly new to our scope of practice...only Drs used to be able to do this.
4. 
   Dec 4, '06

   Occupation: Nurse Educator Specialty: 13 year(s) of experience in NICU ; From: TX, US ; Joined: Nov '05; Posts: 8,750; Likes: 1,692

   In most places, staff RN's do NG tubes, but not ET intubation. Intubation generally falls under the scope of practice for advanced practice nurses (nurse practitioners, nurse anesthetists, etc) or flight nurses (who are often also certified/licensed as paramedics).
5. 
   Dec 4, '06

   Joined: May '06; Posts: 528; Likes: 34

   When I did my rotation at Childrens Hospital, the nurses in the PACU extubate and she said they were one of the only hospitals that do that.
6. 
   Dec 4, '06

   Occupation: Medical Device co. Specialty: 10 year(s) of experience in Critical care, cardiothoracics, VADs ; Joined: Nov '05; Posts: 1,470; Likes: 48

   Nurses always extubate here (Australia) in ICU/PACU - I think it is the same in the US, although you also have respiratory therapists there, so maybe not?
7. 
   Dec 4, '06

   Specialty: med/surg, telemetry, IV therapy, mgmt ; Joined: May '05; Posts: 15,027; Likes: 8,983

   the only nurses i know that actually intubate are the advanced practice nurse anesthetists. nurses who take acls training learn how to intubate, but i've never heard of them actually ever doing it on real patients since most nurse practice acts don't permit it.
   
   as for n/g tubes. . .you bet. i'm guessing i've put hundreds in over my 30-year career because i've worked a lot of med/surg. i've also re-inserted trach tubes, inserted foley catheters in both males and females, inserted rectal tubes, suctioned both orally and nasotracheally, irrigated ears, eyes and noses as well as all kinds of open wounds, and i was trained to inserted p.i.c.c. (peripherally inserted central catheter) lines which is a specialized iv technique and suture them in place. i've assisted doctors as they were inserting endotracheal tubes, chest tubes, tracheostomies, bone marrow biopsies, liver needle biopsies, central line insertions, cutdowns, and female gyn exams. i'm sure there's been more, but these are what come to mind at the moment.
8. 
   Dec 4, '06

   Joined: May '06; Posts: 528; Likes: 34

   Daytonite, when I was in PACU I saw a NP doing a bone marrow aspiration. I thought that seemed strange, what do you think?
9. 
   Dec 4, '06

   Specialty: med/surg, telemetry, IV therapy, mgmt ; Joined: May '05; Posts: 15,027; Likes: 8,983

   Bonny619, an NP, huh? I don't know if the state lets them do that or not. I'd have to look at the nursing law to see if there's anything specifically in the law about it. It may be that if she is working under the direct supervision of a doctor she can do it if the hospital allows it as well. I'm learning that NPs go through a credentialing process and granting of privileges in hospitals just like the doctors do. I know that the PA who works with my last surgeon is the one who stitched my incision up.
10. 
    Dec 4, '06

    Specialty: med/surg, telemetry, IV therapy, mgmt ; Joined: May '05; Posts: 15,027; Likes: 8,983

    bonnie619, as best i can determine from looking at the california laws for nps, they can do procedures within facilities as long as the facility has deemed the procedure one that can be performed by a np and there is a written procedure that states how it is to be done. the facility must verify that the np has been trained in the procedure and is qualified to perform it. this would be done through the credentialing and proctoring activity of the medical staff office.
11. 
    Dec 4, '06

    Joined: May '06; Posts: 528; Likes: 34

    Thank you for the info. The NP was all around the peds hem/onc floor, very involved, then the next day she was doing the aspiration in the PACU and I was able to observe that, it was very interesting.
12. 
    Dec 4, '06

    Joined: Feb '06; Posts: 391; Likes: 9

    Illinois also has a PreHospital RN level. They, of course, would intubate in the field.
13. 
    Dec 4, '06

    Joined: Dec '06; Posts: 15

    Thanks for the info. I'm so dumb when it comes to this and I'm so curious too.
    =]
14. 
    Dec 4, '06

    Occupation: Naval Officer on the Peds Ward at Naval Medical Center San Diego Specialty: ER,ICU and Progressive Care Unit,Peds ; Joined: Oct '06; Posts: 329; Likes: 23

    When I worked at the VA in Tn we had 2 Rn's that were cert. to intubate pts during code situations. Of course these were ACLS trained nurses. But during a code situation there are so many people there that most nurses don't even get a chance at it.
    However, for military nurses we get more chances to intubate esp when deployed.

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