4Blessings

My facility has done a few collections and there have been the same problems stated here. I tend to agree with the postee that stated that if a nurse is involved then the hospitol could be implicated if there was an error. We are currently writing a new P&P for this situation that clear defines this issue. Strongly encourage you to bring this up and have one for your facility.

Have worked labor and delivery almost 9 years and have seen many situations like yours....I do have a question though. What made your doctor check your wife at 25 weeks? That seems very odd to me. As to outcomes, every day counts. My best frien had her water break at 18 weeks. Completely broke and every doctor told her she would never make it. They encouraged her to terminate right then. She is the director of our local Pregnancy Help Center, very strong Christian , and pro-life. She stayed on bedrest until she was 33 weeks. As it came time to deliver, lots of scans were done and the neonatologist actually said that her son would have no lungs and he would die. He didn't say could...he said would.....Today my daughter Ellie and her son Joshua torment eachother in the nursury at church. He is three. I tell you all this to say that I believe all anyone can do is trust in whay God says when he promised not to put anything upon us that we could not stand with His help. My advice would be to share your concerns with your doctors, including a good neonatologist, but don't put all your stock in them. Trust the one who created your daughter and is growing her as we speak. I hope this helps. I will put your family on my prayer list. Please keep this thread updated and feel free to continue to ask questions. My colleagues and I can give good nursing care wether on the hospitol floor or on-screen. We are in the buisness of caring.

Have done both.......Really liked having them provided. It felt "cleaner" to me. Now I work were we provide our own. This facility has always had nurses provide their own and my previous facility always provided.....SO..can't really know about infection rates..As to washing, I alway wash me scrubs separatly. I always buy scrubs I can bleach, and I always have an extra set in my locker for contamination issues...

Thanks for that clarification for me....brain clitch...sorry

Please make sure that you and "that nurse along for the ride" aren't practicing outside your scope!!!! My institution was doing "inservices", although I never got one, but my state clarified that this was not acceptable! All I can do as an RN is to monitor the client and the pump and turn it off. That's it! You are doing things that only a CRNA, Anesthesiologist, or Physician should do. We did not go to school to deal with the many complications that could arise SUDDENLY. At that moment, your clints life and the life of that baby can't wait while you call the doc........Be very careful

I appreciate you advise and I like how your facility handles the safety and documentation issues. I must clarify that I am never expected to medicate with a syringe or such to bolus. When my clients start hurting again or get those bothersome "hot spots", our docs tell us to give a bolus of 8-10mls using the pump. My state says that I am not allowed to do that. Arkansas' position statement was very muddy as written so that is why I got verbal explanition from them. They are putting it writting for me so I can present it to my committee members. I am re-writting poilicy and proceedures at my institution. My biggest challenge will be changing the practices of our drs. Many of my co-workers have never felt to comfortable with dosing, but were ignorant in their knowledge of their scope of practice. I came to this facility 7 months ago and was shoked at what I was expected to do. Needless to say, I've been "rocking the boat" quite a bit lately but this may completely capsize the whole ship by the time it is said and done......

mjlrn97 _____ Thank you for your post but I am scared for you. I strongly encourage you to Find out if your state board of nursing supports your hospitol policy. What really concerns me is that you said that there was no formal training for the things that you do to the cath. Remember that it is "your" licence on the line if anything were to go wrong. Make sure you have our governing bodies behind you.......good luck

good to know we're on the samr team........thanks

What training have you aquired to preform such a task?

Not so much to your posting, although I would like your input. I got the word today that the practice is outside of my scope as an RN. Must be a CRNA. What is your states policy, and do you know wether AWON endorses such practices?

Well, I got my defining ansewer today. I got a response from my state board that sealed the deal. Must be a CRNA to dose an epidural. We are being asked to do something that is out of our scope of practice. My advise is to check with your own state boards and find out their stance. Now I'm in for an up hill battle to change policy in my institution.

So sorry about all the misplaced replies. I am grateful for the responses. It appears that I am not alone in this issue. QUESTION?....For those who dose, adjust infusion rates, etc. ....How do you check placement? This is my hold up. My clients with epidurals, often still move around in bed which could displace the catheter. How do I know the medication will go were it was meant to go? Your further input would be appriciated.

Thank you for your response. Your practices seem much more risky than ours though. If I may, how do you check placement and patency of your catheter and do you check level of sensation?

I like your way of doing things. I wish it were that simple were I must practice. Thank you for your response. If I may, is this your states policy or your facility standing?

Thank you for your response, but I am curious. How do you check placement and patency to ensure safe administration of medication?