inserting invasive lines in school

EmeraldNYL, BSN, RN · Feb 24, 2003

Exactly how common is it that hospitals limit scope of practice? I am considering CRNA school because I want more autonomy than a regular RN, but it seems that CRNAs are regulated much more than I thought. How difficult is it to find a hospital that does not limit scope of practice? For those CRNAs out there who are working in restrictive practice settings, are you happy and do these restrictions bother you? Do hospitals just restrict you inserting lines or are other aspects of your practice restricted as well? Thanks for the input!

Pete495 · Mar 8, 2003

How many MDA's do you think know how to insert a Chest tube?

WntrMute2 · Mar 8, 2003

in answer to Emeral'ds question, it is very, very common for hospitals to restrict CRNAs practice. State regulation allows you to do what you've been trained to do (generally) but they don't restrict employers from deciding what they want you to do. it is a long, uphill, politically heated battle in many locations. Who do you think hospital administrators listen to, MDs or nurses?

Tenesma · Mar 8, 2003

every MD should know how to insert a chest tube in case of an emergency (if a surgeon isn't around) - and definitely the first treatment for a pneumothorax isn't a chest tube but rather a needle thoracostomy (a 14 gauge angiocath works great = just gotta make sure to take the needle out after insertion and leave the angiocatheter in place - or else that needle can cause more headaches than good). You don't know how many times those medical folks in the ICU drop lungs with their subclavians or IJ :)

bottom line, i think CRNAs should get more exposure/clinical experience when it comes to invasive monitoring, managing the issues around those lines and also being able to properly interpret the date.

my 2 cents,

tenesma

g8rlimey · Mar 17, 2003

Tenesma:

Off the topic here, just wondering if you noticed your name almost spells anzemet when rearranged? :)

Bored here, late sun. nite, etc. almost anything sounds interesting right now...

Tenesma · Mar 18, 2003

hehe... by the way, tenesma is the plural of tenesmus - which means anal spasms... how is that for freaky!??!!

g8rlimey · Mar 18, 2003

Now that is funny!!! BTW why did you pick that name---gotta know now?!

fence · Mar 18, 2003

Hey guy's that might be a discusion for the adult section....LOL

lml33 · Apr 10, 2003

Maybe CRNAs are limited in their scope of practice because of other's ignorance. I think that other health care professionals do not realize the autonomy that CRNAs posess. Leslie.

Pete495 · Aug 11, 2003

I just wondered whether you thought MDA's were inserting chest tubes a lot? If there was a complication with a SG, do you think the MDA would call a surgeon to insert a chest tube, or would he do it himself?(I'm not saying this happens a lot either) Personally, I doubt that MDA's have a lot of experience with chest tubes(esp. the older docs), or even thorocentesis.

And so we come to the next question. If MDA's don't have as much experience with treating the complications of their actions, why couldn't a CRNA perform the same invasive procedures that the MDA's are performing? It all comes down to politics and ranking, MDA over CRNA, doesn't it? But I refuse to believe that an MDA would put in a chest tube if he caused a pneumothorax. Just like a Cardiologist wouldn't do heart surgery if he ruptured a patient's Left Main.

K38s · Aug 14, 2003

I worked with an NP who put a load of chest tubes in our thorasic patients. I know paramedics are trained to do needle thoracostomies and I believe flight nurses insert chest tubes as well. So, does anyone out there know if CRNA's are trained to manage the possible complications that can arise with line insertion?