NRP intubation & UVC care

[10cm]

Help! I think I need a reality check. I realize that nurses can be TRAINED to intubate and to place a UVC line for resuscitation, but my concern relates to ensuring and maintaining competency. We can provide intubation practice on manikins and cats, but when it comes right down to it, I have to question whether that will constitute competency. Thank heavens, the need for extreme resuscitative measures is rare, but then that means that given a relatively "normal low-risk" population, there are few opportunities to practice those high-risk skills. Docs attend our deliveries, but the docs have not universally taken NRP, which is a huge problem by itself. (We deliver 500+ babies a year and have no 24/7-in-house anesthesia or pediatrics support.)

It is wrong to place nurses in a situation of knowing what to do but being unable to do it, yet I am concerned about going down a path that leads to trouble. Without a doubt, I would intubate a baby and/or place a line in a moment of DESPERATE need, but then I have been receiving babies for over 17 years and have been teaching NRP for over eight. New grads or relatively new nurses are at an extreme disadvantage. In your hospital, who is intubating babes and placing UVC lines? How are you ensuring competent care? Do you have 24/7-in-house assistance from anesthesia or a pediatricians?

I realize that legally we are responsible to provide the care that a prudent nurse would provide, given the same circumstances. Even so, my questions go beyond standing in front of a judge; I just want to make sure we are doing the right thing.

[lactationrn]

I dont know about yoru state, but in ours, the nursing practice act doesnt cover thse activities for RN's. I always wondered why they taught this in PALS, as I thought I could never do it anyway, but what they say is they want you to be familiar witht he procedure so you can better assist teh person that iIS coverd to perform these things.