scope of nursing practice and intrathecal morphine pump

[mlanern]

Hi, I have looked everywhere I can think of on the internet for information on this topic. I am an RN and I work under a physician to fill intrathecal morphine pumps for chronic pain patients. The doctor orders the medications and tells me how he wants them mixed, based on his calculations ( I can confirm the calculations). I mix the meds, ie; morphine, clonidine, dilaudid, baclofen etc. and I inject them into the pump. I took a class with Medtronic to do this and the doctor has given me further education. However I cant find anything anywhere about this being in the nurses scope of practice and I wonder if I am going outside of it. Also, we only have the patient sign a consent if they are with certain insurances. If you deal with this can you help me to find the answer?

[Jolie, BSN]

You need to direct this question to a live person at your BON, or seek a lawyer with healthcare experience to advise you.

I have no experience with intrathecal injections in a pain management setting, but have worked in hospitals where RNs were responsible for managing epidural catheters and pumps for post-C-section PCA. We had to complete a BON approved course of study (which was 2 days long) and then maintain evidence of continuing education. It was considered a category II procedure, so if we had done these tasks without proper documentation, we would have been practicing outside the scope of an RN.

As for consents, what does insurance coverage have to do with informed consent? Seems to me like you are treading on legal thin ice to get consents only from patients with certain insurance policies. Would you likewise obtain informed consent for surgery only from patients insured by certain companies? I'm sure not.

Please seek reputable legal advice on these issues to protect your license and livelihood.

[mlanern]

thank you, I had looked on the BON site but I went back to it and found an email where you can direct scope of practice questions, so I emailed them. Thanks for your thoughts.