? about scope of practice & BON will not respond

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I am not sure where to post this. the Georgia forum seems to be primarily visited by students and prospective students.

I have a question regarding scope of practice for RN that I have not been able to answer from perusing the Georgia Code sections dealing with RNs or the State Board link. I have called the Georgia State Board of Nursing twice and both times have been promised a call in 24 hrs, it has been a week and no call back.

To make a long story short, a manager at a facility I just started working at PT told us that it is OK for RNs to intubate if trained to do so. He has done it

on one occasion that I know of since I started. He is an RN with extensive trauma, flight nurse, etc background so I know he knows what he is doing....but that does not matter if it is prohibited under Scope of Practice.

Now I work ER and M.S. at this facility,...it is in a rural area so anything really high acuity needs to be sent out. I have current ACLS and there is some brief training on intubation as a part of that but not enough for me to feel comfortable doing so.

At the last ER I worked at, and where I last renewed ACLS, we were told that RNs were prohibited from doing so under state law. That is consistent with what I have been told in the past. I have always thought that CRNAs and paramedics only could intubate besides the MD.

The nurse manager that I spoke of is licensed in more than one state (at least 3) and I know for a fact that Scope of Practice differs between states.

Any advice if I cant even get through to anyone at the BON or if they will not call me back? This is crazy!!! I just want to know what the truth is!

Specializes in Maternal - Child Health.

I can't answer to GA state law or the GA Nurse Practice Act, but I do know that in some states, nurses are allowed to intubate if they have completed a state-authorized education course and have demonstrated on-going competency. It is considered a Category II procedure in these states.

The delay in the reply from the Georgia BON may be because they are

investigating the matter.

The delay in the reply from the Georgia BON may be because they are

investigating the matter.

I would like to think that! However, the person answering the phone is not even a nurse. It is someone who answers phones for the State licensing board, which covers a whole list of professions including RNs.

I gave the person as much info I could about what I was trying to find out and why. She did not even know what intubation was....I had to spell it for her and explain it to her....but she in was to relay the info to a nurse on the BON who in turn was to call me back. I dont know whether an accurate message got relayed or to whom. It is impossible to call and speak to someone directly.

Once before, about three years ago, I had a problem with not getting my license renewal notice in the mail (before it went online) and had trouble getting in touch with anyone. I eventually found email addresses and emailed about 5 different people before one finally emailed me back with a not-so-nice reply telling me how many renewals they had to handle, yada yada.

I suppose if I cant get an answer soon I will have to call the Sec of State office in Atlanta directly or try writing/emailing, but if prior history is any indication that will be an ordeal too.

I just want one question answered!!! It shouldnt be that difficult!

It is not an approved procedure for an RN to do unless you have the additional qualifications to go along with it. Which he does, you do not.

ACLS is not training for intubation, and they tell you so. You have to do so many intubations in a controlled situation, etc. Just like the flight nurse did, and the paramedics do. And you have to do so many per year to stay approved in any facility that I know of. If they need to have someone doing it, where is the physician? And what about the RT? They would be the better one to have do this if needed, but again, they should go thru an adequate training program first.

If a patient needs to be intubated, they can be bagged until the appropriate person gets there.

It is not an approved procedure for an RN to do unless you have the additional qualifications to go along with it. Which he does, you do not.

ACLS is not training for intubation, and they tell you so. You have to do so many intubations in a controlled situation, etc.

I fully acknowledge that I do not have the qualifications. I did not mean to imply that I should be allowed to do it because I should not. And I am not trying to bring any kind of complaint against the nurse manager.

And yes, if it were my patient I would do just that....bag them until the appropriate person got there.

I only want to resolve the discrepancy between what I am now being told and what I have been told in the past. period.

Specializes in ICU, Education.

Is the state practice act available on line?

I just googled. Maybe this will give you a start.

Or try writing or e-mailing the Board of Nursing.

http://www.legis.state.ga.us/cgi-bin/gl_codes_detail.pl?code=43-26-6

Nurse Practice Act - Georgia

43-26-1.

This article shall be known and may be cited as the 'Georgia Registered Professional Nurse Practice Act.'

43-26-3.

6) 'Practice nursing' or 'practice of nursing' means to perform for compensation or the performance for compensation of any act in the care and counsel of the ill, injured, or infirm, and in the promotion and maintenance of health with individuals, groups, or both throughout the life span. It requires substantial specialized knowledge of the humanities, natural sciences, social sciences, and nursing theory as a basis for assessment, nursing diagnosis, planning, intervention, and evaluation. It includes, but is not limited to, provision of nursing care; administration, supervision, evaluation, or any combination thereof, of nursing practice; teaching; counseling; the administration of medications and treatments as prescribed by a physician practicing medicine in accordance with Article 2 of Chapter 34 of this title, or a dentist practicing dentistry in accordance with Chapter 11 of this title, or a podiatrist practicing podiatry in accordance with Chapter 35 of this title.

I fully acknowledge that I do not have the qualifications. I did not mean to imply that I should be allowed to do it because I should not. And I am not trying to bring any kind of complaint against the nurse manager.

And yes, if it were my patient I would do just that....bag them until the appropriate person got there.

I only want to resolve the discrepancy between what I am now being told and what I have been told in the past. period.

I am not saying that. A facility's guidelines cannot exceed what is part of the Scope of Practice of the RN. They can be less, but cannot be more.

Your manager has the training, but that does not mean that you do. It is not meant to be a complaint. First thing to do is to look at the Policies and Procedures of your facility.

I dont think I am wording what I need to know correctly.

I have studied the Appropriate sections of the Georgia Code. Thank you for all of your responses.

maybe a legal nurse consultant familiar with the Georgia regulations could chime in if we have one. I am just a student, but i see what Mtnmom is confused about. What "exactly" legally constitutes that you are qualified as an RN to perform intubation, and where is that in the code, and if it is not there, then how are you supposed to know for sure that you will not be acting outside your scope of practice per the BON? What is the definition "legally" of being trained to do the procedure? Does that just apply to flight nurses or will on the job training under supervision etc.. suffice? There should be a clearly defined course of action or certification to obtain for this proceedure nstead of having nurse managers putting tasks/proceedures such as these into the job description when it may or may not be outside the scope of a staff RN's practice. The first question that popped into my head was "what would my liability be, if i refused to perform this procedure, and it is deemed later that it actually is in my scope of practice because i had ____ class last year?" The ambiguity concerns me. (maybe i am going overboard from our ethics/legal implications lecture etc...)

Intubation and suturing is not in any Scope of Practice for any BON in the US.

Period.

It is restricted to nurses that have appropriate certification, or training to do it, such as advanced practice, or for suturing, the RNFA. For intubation, then a flight nurse with appropriate training. Again, appropriate training is the key word. For nurses that do have the training, you need to do so many in the OR under the experience of an anesthesiologist, and have so many to do per year to keep up the skill. But again, it is not in routine Scope of Practice for the RN.

ACLS does not constitute appropriate training or certification, and they spell that out directly in the program and their guide. Nor wil lyou seen either of these skills taught in any nursing program in the US, unless it is advanced practice.

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