moderate sedation administered by wound care nurse??

[KMuniz, APRN]

Hi,

I am new in wound care/RN. I am asked to administer moderate sedation when the dr. debrides on wounds. I do not know if this is something that usually RN wound care nurse needs to do. I do not feel comfy by giving it since I've never been asked to do it in my career/10 y nursing experience in diferent settings.

Thank you,

I appreciate your replies.

[PostOpPrincess, BSN, RN]

In my institution, and according to our standards of practice, a nurse who administers moderate sedation has to understand the continuum of anesthesia from light to deep to general anesthesia.

She has to be trained, and monitored and then signed off.

[SummerGarden, BSN, MSN, RN]

what are you not comfortable with, your qualifications or the lack of available equipment to perform it safely? in either care, if you do not feel "comfy", do not do it!

most state bons have a detailed definition of scope of practice as it relates to moderate/conscious sedation and so only particular nurses within particular environments are allowed to assist during the procedure. if your doctor cares anything about patient safety (or a law suit) he/she should be aware of this fact. along with the fact that certain items need to be available just in case the procedure goes wrong... such as a crash cart with an available code team....

[Scarlette Wings]

there are many standards and guidelines that must be followed when administering any kind of "light" sedation. i think using sedation for debridement is a good idea however there should be certain policies and procedures in place to protect both the patient and the nurse. i would ask for specific training in order to administer any sedation and also ask what processes are in place.

you are totally in the right to say that you are not comfortable with doing this. there is special training needed and i would hesitate to do this until i had a little more education. things are not as simple as just pushing "x,y," drug in the iv while the doctor snips away. the vital signs and o2 sat have to be monitored, narcan or equivalent on hand, a crash cart in the event of severe emergency. it is a "procedure" and it is for patient safety.

if there is not a process in place for your facility i would talk to whomever does the light sedation procedures within your facility for guidelines. (endo, colonscopy, where they do picc's, etc) then talk with education or whomever to create a safe process. good luck. you are doing the right thing hesitating to jump in imho.

[PostOpPrincess, BSN, RN]

there are many standards and guidelines that must be followed when administering any kind of "light" sedation. i think using sedation for debridement is a good idea however there should be certain policies and procedures in place to protect both the patient and the nurse. i would ask for specific training in order to administer any sedation and also ask what processes are in place.

you are totally in the right to say that you are not comfortable with doing this. there is special training needed and i would hesitate to do this until i had a little more education. things are not as simple as just pushing "x,y," drug in the iv while the doctor snips away. the vital signs and o2 sat have to be monitored, narcan or equivalent on hand, a crash cart in the event of severe emergency. it is a "procedure" and it is for patient safety.

if there is not a process in place for your facility i would talk to whomever does the light sedation procedures within your facility for guidelines. (endo, colonscopy, where they do picc's, etc) then talk with education or whomever to create a safe process. good luck. you are doing the right thing hesitating to jump in imho.

i also want to add acls, pals, and basic life support are mandated.

[meandragonbrett]

In my facility, the ICU RNs do all sedation on the floor and must be credentialed to do so.

All patients must be on a monitor, NIBP, and Pulse ox. Airway kit and crash cart must be immediately available. The provider prescribing the sedation must be credentialed to prescribe the sedation.

One big key thing in doing sedation is that your job is 100% sedation, airway management, vitals, etc. You shouldn't be leaving the head of that bed to get supplies for them, move things around, etc. Your job is to do sedation and not circulate the procedure.

Should definitely have ACLS too!

[carolmaccas66, BSN, RN]

If u aren't qualified for it u shouldn't be doing it. Only anaesthetic nurses and anaesthetists can give sedation in Australia, which a very highly qualified anaesthetist/surgeon told me during my training 3 years ago. It's illegal to give sedation without training and a qualification. I certainly wouldn't be doing it.

[rn438]

ICU nurses can at my facility, can but you should have ACLS, basic arrythmia training