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Selke: Go to AWHONN.org--I don't know if you have to be a member to access the practice statements, but if you are not maybe someone you are working with can help you. AWHONN is a great resource for all OB/GYN related questions. I know some may consider the guidelines they give merely suggestions, but I feel that if the organization feels strongly enough about an issue that they write the guidelines or practice statements that we should pay heed. And I'm with you--nothing irritates me more than a CRNA or anyone, for that matter, who acts as that CRNA did with you. No excuse for the way she treated the pt, either---she needed to get informed consent--and that means informed about risks, etc. Some of our CRNAs go a bit overboard on that, but they all do it. How would she like to have a procedure done by a stranger who doesn't even deign to introduce him/herself to her? Not good.

AWHONN has a position statement about this. It states that nurses should not bolus (either by injection or through the pump), increase or decrease the rate, restart the pump once it has be stopped, change the PCEA intervals or doses, or obtain informed consent for epidurals. Nurses can stop the pumps, remove the catheters, and replace the syringe or bag of medication with the same medication per protocols. CRNAs or MDAs should be managing the epidurals. They are responsible and have the education, not to mention the fact that they are getting paid quite a large salary---they need to do what they are paid for. Just my 2cents.

Hi, everyone. First time to post on this forum, but I have been reading for a while now. Some background: almost 19 years as a labor nurse, currently working in a Birth Center with 40 LDRPs doing 300-400 deliveries per month. Last week, we had a cord prolapse and got baby out in about 10 min. from prolapse to delivery. One of the docs involved sent us all thank you notes, signed by both MDs involved in the case. When I told him how much I appreciated that, he said that he thought we need more of that--celebrating when we do a really good job and save a life, or help a mom in a special way to make her birth experience perfect for her. So, I thought this would be a good place to do that. Just write in to brag a bit---difficult cases, difficult family or patient, jobs done well--something we all do every day and only get thanked for once in a while. I mean, it's our job, right? So, brag away!!