RN transporting pt. across state lines

[imenid37]

Recently another RN and I had to go w/ a pt. to a neighbouring state. There was no paramedic available, so as per our policy, we had 2 RN's go w/ a BLS crew from our local fire dept. We are not licensed to practice in the the state to which we travelled. The trip took about 1.5 hours and the pt. was 2nd trimester pg w/ severe PIH and had MGSO4 running. Are we covered if something had happened to this pt. enroute or we had to give meds, etc? I felt uneasy, but pt. really needed to go to the referral facility and it was in the middle of the night. Pt. could not be sent to a closer facility because of insurance issues. How is our license different than a paramedic's? We do not intubate babies which I know some paramedics do. I really don't have a clue re. emergency nursing practice as I work in ob. Due to changes at the facility we usually refer pt's to, this may soon happen again so I want to be prepared.

[CraigB-RN, MSN, RN]

Danger...danger..danger...good rule of thumb...if you have to ask if you are covered to do something...you probably aren't...You are not covered under your basic nursing license in PA to go on a 10 minute road trip if something goes wrong and that pt dies...You can't intubate...which is going to be a big one...and a 1.5 hour trip...at the very least an MD should have been on the tri if there couldn't be a medic...too many things could have gone wrong...If you felt uneasy about it...you should not have done it...because think about the pro's and con's...yes the patient needed to be at the other hospital...however...if they couldn't be transported and something went wrong...at least they are in a hospital where there are far more qualified staff and proper equipment....if something goes wrong enroute, what do you do? The patient needed to be transported to a higher level of care from what your hospital could offer...the transport was a lower level of care for the entire 1.5 hours...a big emtala no-no...There are a million and a half private ambulance transport companies in PA, with both BLS and ALS...You should or could have shopped around til you found one...someone would have done it...hopefully you won't ever have to be put in that situation again...

21.15. Monitoring, defibrillating and resuscitating.

The use of monitoring, defibrillating or resuscitating equipment, or a combination of the three, hereinafter called ''therapy,'' is a proper function of a registered nurse and is a function regulated by this section; the function may not be performed unless all of the following provisions are met:

(1) The employer, through written policy, has agreed that the registered nurse may administer the therapy.

(2) A committee of licensed physicians and nurses within the employing agency has established written criteria prescribing when the therapy shall be administered by a registered nurse either in the presence or absence of the attending physician.

(3) The techniques for administering the therapy have been established by a committee of licensed physicians and registered nurses within the employing agency.

(4) The registered nurse has had instruction and supervised practice in administering the therapy.

(5) The registered nurse has demonstrated competency in administering the therapy to the satisfaction of the employer.

(6) The registered nurse shall have employed the prescribed techniques in administering the therapy in accordance with the established criteria.

right from the PA nurse practice act. It comes down to policy, procedure and documentation of adaquat training.

[mommatrauma, RN]

21.15. Monitoring, defibrillating and resuscitating.

The use of monitoring, defibrillating or resuscitating equipment, or a combination of the three, hereinafter called ''therapy,'' is a proper function of a registered nurse and is a function regulated by this section; the function may not be performed unless all of the following provisions are met:

(1) The employer, through written policy, has agreed that the registered nurse may administer the therapy.

(2) A committee of licensed physicians and nurses within the employing agency has established written criteria prescribing when the therapy shall be administered by a registered nurse either in the presence or absence of the attending physician.

(3) The techniques for administering the therapy have been established by a committee of licensed physicians and registered nurses within the employing agency.

(4) The registered nurse has had instruction and supervised practice in administering the therapy.

(5) The registered nurse has demonstrated competency in administering the therapy to the satisfaction of the employer.

(6) The registered nurse shall have employed the prescribed techniques in administering the therapy in accordance with the established criteria.

right from the PA nurse practice act. It comes down to policy, procedure and documentation of adaquat training.

Exactly, although spelled wrong..you hit the nail right on the head...ADEQUATE TRAINING...just because you are simply an RN...does not mean you automatically are qualified to do transports....thank you for making my point

[CraigB-RN, MSN, RN]

Exactly, although spelled wrong..you hit the nail right on the head...ADEQUATE TRAINING...just because you are simply an RN...does not mean you automatically are qualified to do transports....thank you for making my point

Can't type either. I never argued your point. I was taking exception to some blanked statments that people were making. The back of the ambulance is not different than any other nursing unit. You have to get trained to function there. Now I just wish someone would tell my old boss that. She still thinks that just because I'm an ER/SICU nurse I can handle OB.