I posted this tonight on the operating room nursing section, and would much appreciate it if the anesthesia providers who post here would visit that section and post your thoughts, so that they can reach those OR nurses who don't ever visit your section.
I know we have discussed this topic here before.
I am getting more and more alarmed at the trend of OR nurses giving conscious sedation, and frankly, I think it is time we simply refuse to do it--too much risk, too much responsibility involved in doing something that OTHER people--those of YOUR group--are experts at doing--and are compensated accordingly for doing.
I would really like to see anesthesia providers lobby to have this practice changed--forever.
Of course, if there are anesthesia providers who DISAGREE--who feel that OR nurses SHOULD welcome this "expanded role as a perioperative nurse--" by all means please respond, as well. I would be very interested in hearing your rationales.
Thank you. My post is below.
Frankly, I have never understood why some operating room nurses feel honored to be able to sit up at the head of the bed and administer conscious sedation, especially during elective cosmetic surgery procedures (in which the patient could afford the services of a CRNA or anesthesiologist.)
I think it is a power trip for them--makes them feel oh-so-important.
OK, here come the flames from those who consider it "an expansion of their role as a perioperative nurse" and apparently aren't concerned about not being trained--or compensated--in the same way a CRNA or anesthesiologist would be for doing the same thing.
I truly believe that this is a classic example of the saying, "A little knowledge can be dangerous."
Yes, I am ACLS certified--I am good at starting IVs--I know the conscious sedation drugs and the drugs to reverse them---and hey, I have even had to do a stab trach or two with a jelco to ensure an adequate airway and prevent imminent death----but that was as a Vietnam era corpsman, when there was no other option.
There was no MD or CRNA to call on--as an independent duty corpsman, I was it. Oh, and the situation was trauma--NOT elective cosmetic surgery.
Today, there are plenty of other options--those include staff CRNAs and anesthesiologists who are PAID for their skills at airway management and conscious sedation (as well as far more complicated anesthesia situations.)
Yes, times have indeed changed.
Personally, I do not feel they pay me enough to take on this role and the extra responsibility it entails--especially when CRNAs or anesthesiologists are sitting around with nothing to do--simply because hospital management, or cosmetic surgery patients who are paying out of pocket, do not want to reimburse those providerd (or bill the insurance) accordingly.
This often happens in elective cosmetic surgery cases where insurance ISN'T picking up the tab. Rather than pay the person who is trained--and welll compensated--to do this job--we are supposed to do it.
Why are we allowing ourselves to be exploited as a source of cheap labor?
I actually worked registry a few times at a hospital where, in my opinion, the "queen bee" RNs who fought for the chance to give conscious sedation were waayyyyyyyy over their heads--they were allowed by certain plastic surgeons to simply give drugs in the increments and fashion they (the nurses) saw fit--usually Fentanyl and Versed--and more than once they got into trouble and had to slip in an oral airway, bag the patient, and reverse the Versed with Romazicon or the Fentanyl with Narcan to end up with (eventually!) a spontaneously breathing patient.
Forget about having anesthesia nearby to come bail them out--they had long since gone home--none covering OB, either, as this small hospital had no OB unit.
I expressed my concern to their supervisor about this--with some trepidation--I knew it would not be well received since I was not staff. Her answer? "We do it all the time--and anyway, if they run into trouble, they can call the ER doctor."
Right. Like he is going to drop whatever he is doing (perhaps handling his own code!) and rush right over to bail someone out of a situation they should not have been doing in the first place.
(When I voiced THIS, I was given a blank and hostile stare--and, not called to work there again, surprise--as if I would have wanted to return to this hotbed of sentinel events in the making.)
What do the rest of you think? Why are nurses taking on this role? If you have no other objection, just consider this one---they just do not pay us enough to do it.
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