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Discussion

Scope of practice question

Yesterday my patient who had a mostly negative CT of the spine had a flex-ex x-ray ordered to clear the c-spine. Both the charge nurse and the neurosurg resident told me that it was OK for me to take off the collar and hold c-spine during the flexion and extension so I felt really pressured to do it and did it (at least I had EMS experience and knew how). It all went smoothly but I still don't feel right about having done it. Does anyone know if it's in our scope of practice as nurses to do this?

I understand that the risk was pretty low in my patient (Ct and all) BUT I didn't like how the charge nurse was like "oh we do it all the time". She didn't even know how to hold c-spine correctly herself. I am just a traveller so I am going to keep my mouth shut but I was really uncomfortable about the whole situation.

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So... who would have been responsible had a previously undiagnosed Sublux of C1-C2 taken the diaphragm out and paralyzed the patient? I guarantee the resident and charge nurse would have left you holding the bag. Remember- traveler=expendible in most institutions. Protect yourself.

If you don't feel comfortable doing something, don't do it. You're always the one responsible for your actions. They would have hung you out to dry if the need came up.

At one facility I worked at only trauma certified nurse could hold a c-spine patient while out of the collar.

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