need some advice on CS pt safety & legality issues

[chicagobsn]

I posted this once before, but maybe in the wrong section. I work in a day surgery center where CS is being performed by the nurses. In Illinois it is legal for a nurse to administer conscious sedation using propofol. It also states that there must be an anestheiologist onsite for airway.

That being said, the owners have decided that the nurses should just give the ordered dose and deal with it (w/o anesthia in house). I dont want to touch the stuff...I am fine with versed and fent. but no way will I touch the milk! The owner said that was fine, but then did it himself. He pushed versed 2-5mg, fent 50-200 mcg and 100mg iof propofol, and wanted me to stand at the hob monitoring the pt. I kept telling him its not safe, I dont know how to intubate etc etc. He also feels its only necessary to have one nurse per clinic to circulate, do cs and RR! What if something goes wrong?? ITs not safe!

I looked up quite a bit of info and found that some of the things they are doing is illegal (theyre doing it to save $$). I submitted a long letter to DON, CEO and the owners with my concerns and how to perform cs legally and safely. The answer I got is "thanks for the info were on top of it, or "were looking into it". I also stated the things that were illegal and needed to stop, and if it persists, I will be left with no choice but to report them.

Im all about pt safety and having one nurse perform this type of sedation with no back-up is clearly unethical and unsafe practice. Im trying to stand up for the pts safety, (& our license)with that some of the nurses think I am going to far and wont even speak to me and wont support me in this. Im not understanding why they wouldnt want the back-up! Now I am the mouthy-trouble maker.

I gave my notice and am leaving but when I do leave, they will continue since the other nurses wont stand with me. Im the only one who seems to think of the pts safety & the liability. What can I do about this? Who can I report them to so it will be investigated?

Thanks

Any advice?

[CABG patch kid, BSN, RN]

The only thing I can say is that you have to stand up for what you believe in and protect your license. They probably don't want to stand with you for fear of losing their jobs, but that's their choice I suppose. Good luck in your battle, I hope for the sake of the patients, someone steps in.