Question about Pain Nurses Managing Epidurals in OB

  1. Hello everyone,
    I am a former labor and delivery nurse (16 years) who was recruited by the Anesthesia Dept. in my institution as a pain management nurse in labor and delivery, managing the epidural anesthesia catheters on the unit. The job consisted of the Anesthesiologist placing and confirming the epidural catheter and then turning the job over to me (I am not a CRNA, only an RN) who would chart, bolus the catheter as necessary by hand for extreme pain or breakthrough, and pull the catheter at delivery.
    I was completely trained in house by the director of OB Anesthesia, had standing orders in place for what I could give through the epidural catheter, and had two anesthesiologists in call rooms right on the unit if needed at any time (it is a large unit with 16 LDR's). Protocols were in place within the institution and yearly competencies were given to us (3 nurses in this position) by the Director of OB anesthesia himself.
    After 10 years in this position, the management of the OB unit changed and declared that we were practicing beyond our scope of practice as RN's in NY State (which it appears to be true) and we were all absorbed in other areas of the hospital and now CRNA's are performing this function.
    At the start of this position I did training in a hospital in Rhode Island which utilized RN's for this position, bolusing the patients using a hand pump identical to the one we used for infusion so they could say they were bolusing through the pump, not by hand. The head of anesthesia of that institution told me their program was Joint Commission approved. I know this practice of using RN's for pain control on Labor and Delivery is basically State and then institutionally controlled, and goes on in other states.
    Here is my question: I am exceptionally experienced and am looking to leave the NY area. While knowing the Nursing practice in Rhode Island allows this, I am wondering how I would find out which other states allow RN's to manage epidurals on a Labor and Delivery unit as long as the nurse is also not taking care of the labor patient. I loved this job and continued to work as a labor and delivery nurse in another institution per diem to keep my skills. I would like to move to a warmer climate (South) and with my OB pain management knowledge could be a real asset to someone looking to have or maintain a program like this, so long as the state nursing practice allows (I would be able to set up the whole program for someone as I did in my institution with the Director of OB Anesthesia). Does anyone have any ideas about how I could get a list of, or a good idea of which states allow RN's to perform this task without having to call each State Nursing Board individually?
    Sorry for the long post. Any help will be appreciated.
    Last edit by c1258 on Jul 31, '12
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    About c1258

    Joined: Jul '12; Posts: 1


  3. by   offlabel
    The challenge would be finding another anesthesia department to allow you to do that job again.