Hey all, just wondering what everyone thinks of this.
My facility (magnet) does not let nurses perform Intraosseous injections. It is to only be done by a physician, even in a code situation. I cannot speak for our ED, but this is the policy within the hospital. The state nurse practice act says we are allowed to...
I was just told today that the IO drills are being added to our code carts..
I guess you can say im a little jaded that the state says we can do it but the hospital reduces our scope of practice. Im almost certain they review it in ACLS.
This annoys me, especially when Magnet facilities claim to be all about their nurses, communication with their nurses and listening to their nurses.
I often wonder if teaching hospitals places such restrictions on their nurses...
I/Os are ok for emergent situations but they can only stay in around 24 hours and have some complications so IMO a quick EJ is optimal until you can get a CVC.
Any procedure....from foley catheters, to IV's, to IO's, may be taught to in nursing school or on the job.
All of these procedures can cause serious complications if done improperly. Any hospital, teaching, private, etc., has to balance...yes our nurses can be trained, signed off, etc., for this skill, versus, will they be doing it often enough to warrant us allowing it to be done routinely. It costs money to certify that all staff is trained and competent in these skills.
IO's are great for paramedics and ER staff but even then I would bet many paramedics and ER staff may go months without needing to place one.
It does make sense to me, depending on how many traumas your facility handles, to allow only Dr's to do IO's.
I've never had an ACLS class teach me how to place IOs... only PALS did that. We got to play with the Easy IO drill and all I could think about was how terrifying that was - that we literally have a power drill that drills a needle into bone. We have an Easy IO drill on my unit if we really run into an emergency. However, only rapid response nurses are allowed to place IOs at my facility, and I don't work rapid response, so it's somewhat irrelevant to me anyway.
Dranger
1,871 Posts
WHAT?! Everyone in the ICU gets a dobbhoff. We placed all of them and order x-rays to confirm. IR only does it if we can't get it.