NGT PROTOCOLS

Not sure what you mean by "nurse doctor", but I'll answer regarding NGT insertions. It is commonplace for an RN (and LPN, depending on facility) to insert these. It is covered in normal nursing school curriculums in the US, and part of a skills 'check-off' in which one is expected to demonstrate competency.

Proficiency comes with practice; if one doesn't do them, one doesn't get good at it, so....one doesn't do them. Still, I don't know any RNs who work in acute-care facilities at the bedside who don't do this pretty routinely.

In the US NGT insertion is within the scope of RNs and in most states, LPN scope also.

If you are in the Philippines perhaps consult with a Filipino nurse, nursing school or the PRC.

It depends on the school. I learned to insert an NG on the job in the emergency dept.

(I also don't know what a "nurse doctor" is. Didn't see anything about it on google search, either.)

Nurse Doctor - I just stated it here to indicate that i am a nurse by profession before i became a doctor. I was a nurse in one of the hospitals in manila before I pursue my medical career. I was in the academe in different nursing schools for almost 10 years here in the Philippines. It is within my knowledge that NGT is within the scope of nursing practice. It is included in the curriculum of nursing school. It just happened that in a hospital in which I am affiliated now nurses almost always pass the responsibility of NGT insertion to doctors claiming that it was not taught during their school days and if ever they will do it, it is considered malpractice. . . . . What is your opinion?

I think it is in nursing scope but critical thinking should be used such as...as a nurse I would never insert any gastric tube into someone with a history of esophageal varices, gatric sleeve, or esophageal or gastric surgeries I would pass this task off to the doctor then.

I agree that not all NGT insertion will be done by the nurses, there would always be an exception to the rule, and doctors will agree with me on this. But NGT insertions to patients without history of upper gi disorders or alike should be done by nurses with confidence..... it is not an excuse that nurse will not do NGT insertion because they are not trained to do it ( it is taught in nursing school during your RLE, CI, clinical instructors should teach the nursing students what are being taught inside the classroom, RLE is a place where theoretical knowledge are applied practically always of course with the supervision of the Clinical Instructors); or will not do NGT insertion because it is a malpractice act ( my point why would it be taught in the nursing curriculum if we are not allowed to do it once we become RN?). . .

Drop tubes all the time. Only time I told a doctor that I was uncomfortable in doing so is when the kid had an already compromised airway and the thought of messing around back there and losing what little airway we had left did not appeal to me. ?

What is the policy of the facility? It should specifically state who can place NGTs. I do not know what the guidelines in the Phillipines are. I have never seen an MD place an NG anywhere I've worked, only nurses did it. We did have a patient once with holoprosencephaly who didn't have a nose and needed an OG tube and the MD placed that...