E D Nurses and Intubation

[fasttrack]

Are nurses allowed to intubate patients in your State. In Florida Registered Nurses are not allowed to intubate patients according to the BON. Should critical care Nurses be allowed to establish airways by intubation ?

ACLS does not certify the intubation procedure, it simply exposes an individual to the process.

How does your State handle this skill ?

[ladiesman]

in our country,we are not allowed to intubate.but i think it will be better if nurses will be allowed given that they undergo special training

[fasttrack]

The nursing profession is struggling for jobs and pay. If certain well qualified Registered Nurses had the airway managment skills equal to a paramedic, we could eliminate the paramedic from critical care areas such as; E.D. and flight NURSING. Unless Nursing wakes up, more jobs will be lost to ancillary folks. You didn't go to school for 4 years plus to empty bed pans and fetch water. You get paid for your skills and decision making in a global environment ( Hospital, Helicopter, Ambulance etc.) Paramedics, Respiratory Therapists are designed for speicific tasks that ARE or SHOULD BE SUPERVISED BY A R.N. How can you supervise these technicians if you are not familiar with the skill they are providing. IN THE ABSENCE OF A PHYSICIAN, Who is in charge of the patient ? Who says when to stop trying to intubate and bag the patient ? Who ultimately puts the stamp of approval on proper placement of the tube ? Who runs the code ?

In the absence of a physician, Does it not make sense that certain RN's should be well trained in critical care areas to supervise and yes perform if necessary ?

[wanderER]

Where I live, paramedics intubate, as well as flight nurses (helicopter)...however, the flight nurses I know are also paramedics...RNPs...

[MarieAnderson]

The same here with me, nurses are not allowed to intubate but I really suggest that they give special training like this to nurses.

[PEHN]

As an RN, I worked in an ED in a state where RNS were not allowed to intubate. However, my part time job was as a registered Paramedic with the local service. I could entubate when I was working as a Paramedic, but not as an RN. I had to be extremely carefull of where I was and who I was working for at ALL times!

[NURSEDETROIT]

The problems that exist with regard this "skill" is the lack of clear guidelines as dictated by any given state's Nurse Practice Act; or lack thereof. Some states do not even have a Nurse Practice Act that defines exactly what a RN may or may not do. Be sure you know yours. . . Check out the legal ramifications; ACLS does provide the knowledge base for the "need" for such an action/intervention; it does not entitle the bearer to actually perform the act. An administration may make a decision/policy; however, it doesn't mean that you are allowed to do it by law. In lieu of proper training/level of expertise, harm can ensue. . .

Michigan is one state that does not have an actual Nurse Practice Act; rather a few lines vague legal language defining an R.N. Too many shades of grey. . .

[badphish]

As a Paramedic turned RN i take offense at your desire to rid the ER and Air Evac services of Paramedics. Personally I would like to see MORE Paramedics in the ER with expanded scopes of practice. In the field paramedics perform their job using their own judgement. Intubation is a skill, true. I have yet to be at a code in the ER without a MD. It is very seldom that i see a field intubation these days, most patients arrive with a king tube in place and an IO. Intubation is a difficult skill to master and much time is wasted on multiple attempts. Well trained and motivated Paramedics make my job easier as a nurse in our ER. If you feel the need to intubate go to paramedic school and ride the big white taxi for awhile, paramedic school should be a breeze for a motivated ER nurse.
Unfortunately fetching bedpans and water is a nursing job, as i'm reminded every day at work.