Is this in Scope of Practice for RN's?

From what I was taught, go by the facility policy manual, usually on intranet in a bigger facility. If it is NOT in there, it probably is NOT part of your scope of practice. A simialr issue came up while I was still preceptoring in the ED concerning manual disimpaction. All nurses refused the disimpaction order stating it was not in the scope and not in the policy manual. An enema was ordered.

I've never had much luck giving a enema to a pt that is impacted. Have to remove impaction to make much progress with the enema. ! It IS in our hospital policy that RN and LPN can remove impaction with Dr. order.

Find out by asking your charge nurse or unit educator (or whomever is the best resource for education on your unit) if it is common practice for nurses to perform that skill on your unit.

If it ISN'T, page the doctor and let him/her know that you can't do it.

There really should be a policy if the hospital allows you do perform the procedure. It is nursing policy that guides our practice. These policies have been developed from intense nursing research, and by using these policies, we are thereby using evidence-based practice.

What I mean, specifically, is that we are not trained by doctors, but rather by nurses and nursing research. So, just because a doctor shows you how something is done, does not mean you can automatically perform a procedure.

Perhaps find out how you can start the ball rolling on developing a policy for this skill. Take the initiative...nurses don't do it enough :)

Contact your state BON, and ask them directly. I have done this several times, and my BON has always come through. If they don't have a policy yet, then they may publish an advisory opinion based on your question. In the meantime, your BON may have a decision tree published on their website to help you with such decisions until there is a policy.