Gtube re-insertion for LVN's

[nursezoey]

an event happened in my facility just last week. I am an LVN; I came on shift to find out that the Gtube of the patient has been dislodged; past practice in my facility is to re-insert it, confirm patency by: 1. instilling air and aucsultate for the rush of air 2. abdominal xray to confirm placement. As soon as it was dislodged; I got a Foley cath (since our facility doesn't have any Gtube in stock), went to the NP and told him what had happened; NP told me if there is any problems in re-inserting to call him. Told my Director of nursing and told the MD that a foley cath would be re-inserted. Md ordered abdominal xray to confirm patency. No feeding and meds were given thru the Gtube. Patency was confirmed by me and the NP for the rush of air. Xray came; xray report is the foley cath cannot be seen thru the xray because it didn't have a radiopaque tip to be visible thru the xray. Informed Md; MD guided me thru some steps to confirm patency. Once the Md was satisfied it was patent; I was instructed to start feeding at a titrated rate. There was no adverse effect on the patient; No abdominal distention, no nausea and vomiting. I was off for 2 days when I got back I was written up for "performing beyond the scope of practice" and the director of nursing and administrator is threatening me with a malpractice suit and is threatening to report me to the boards. Our facility has no policy regarding Gtube re-insertion but as I said earlier it has been past practice at my facility. My question is; am I really going to get dinged for malpractice and performing duties beyond my scope?

[NickiLaughs, ADN, BSN, RN]

Yes they can. What you did is out of scope. I was an lvn and it was common practice as well. You are not covered. The only legal way is for md to reinsert and for them to get xray confirmation. Hopefully they will not report you but take it as a learning experience. If it's not on your scope don't do it!