Putting nurses in a bad spot.

[Telenurse1990]

I'm extremely frustrated at the moment. Without going into much detail, at my facility, the only thing we are allowed to push for intubation is versed. With that being said, half the time it doesn't work. At night, there is no in house doctor unless you call anesthesia (which half the time they're in the OR anyway) where you can have someone who is able to push succs, dip or whatever. I have seen this issue in multiple hospitals, not just where I'm working now. Why is it ok to put nurses in this situation? I'm not legally allowed to push Diprivan so what the hell do we do? . I feel like something needs to change in the policy in order to make it safe for everyone. Either allow us to do what we need to adequately sedate the patient, or make it mandatory that a physician be present on intubation. I'm so sick of stuff like this. What is your policy for intubation? What are you as the RN allowed to push?

[calivianya, BSN, RN]

We absolutely cannot push propofol, even with a MD in the room, but we can push etomidate/succs/fentanyl/versed. Go figure.

[whofan, ADN, BSN, RN]

I can't believe that you don't have and MD there to intubate. The hospital I work for will not allow RTs to intubate, but we are a teaching hospital and we have dedicated ICU docs no matter what.

[essT]

In my old unit, we were limited to RTs to intubate and versed push for sedation prior. No MDs in the unit on night shift. Anesthesia would get called stat if RT couldn't get it; hopefully the patient wouldn't code before they got there.

I'm glad to no longer be working there.

[CrazziiRN913, ADN, BSN]

in the ICU in which I work we can push prop, succs, and etomidate only in the presence of the MD performing intubation. Only MD's perform intubations at my facility. But we can bolus prop off the iv pump if they have a drip running.

[Dranger]

We can push and manage paralytics (Roc/Succ), short-acting anesthetics (Etomidate) and sedatives (Versed etc) but not Propofol.

MDs/NPs intubate. RTs are allowed to intubate in my state but I rarely see it happen. One of our RTs intubated with the doc present once in a non-complicated intubation due to hypercapnic resp failure. We probably didn't need sedatives lol....