Standardized Procedure: A Case Study
According to the California Board of Registered Nurses; An Explanation of the Scope of RN Practice Including Standardized Procedures (2011), if the licensed health facility, BRN and the Medical Board of California considers intubation a “Standardized Procedure” then the RN may be capable of performing the procedure (Example intubation) after all guidelines were completed. The RN must follow these guidelines in accordance to the CA BRN; Specify standard procedure, special requirements, specific training or education specify initiation and evaluation, provide scope of supervision, set forth circumstances to complete the special procedure, state limits, keep patient record of standard procedure and provide a periodic review. If the standard procure is approved and all criteria are met and followed then the RN may perform the special function.
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In the case of Jones RN, she was going against the standard care of a nurse according to the CA nurse practice act and her hospitals intubation policy.
According to the California Nurse practice act, “ The registered nurse who undertakes a procedure without the competence to do so is grossly negligent and subject to discipline by the Board of Registered Nursing” (California Board of Registered Nursing-BRN, 2011). In the case of this patient, other measures could have been done to prevent Jones, RN from not following the nurse practice act or her hospitals policy. In example, to prevent the RN from performing the intubation she could have “ran” the code blue without initiating intubation until a physician arrived. Although this is not the desired route, it is within the standards of care and it is following the hospital policy. In addition to this, Jones, RN could have notified another physician to the code and initiated or continued
CPR.
In my opinion, although Jones has the ICU experience and ACLS training to intubate she should not have intubated the patient. The reasoning for this is because if she did intubate the patient improperly she may not have been properly trained how to handle this complication. In addition to this, although she received some training her hospital may not have been able to test or validate her competency on over a period of time.
Another point is that if the nurse completed the intubation and a severe reaction occurred and the patient had a poor outcome she would not be supported by her employer. The reason for this is since they specifically stated within their policy that RN are excluded from intubation of a patient. Overall, it is understandable that the RN should initiate treatments for the best interest of the patient however if the RN was not formally trained on the procedure, its not within the scope of practice, and the hospital policy does not support the therapy then the RN should utilize other methods to care for the patient.
In the case of Jones RN, she was going against the standard care of a nurse according to the CA nurse practice act and her hospitals intubation policy.
According to the California Nurse practice act, “ The registered nurse who undertakes a procedure without the competence to do so is grossly negligent and subject to discipline by the Board of Registered Nursing” (California Board of Registered Nursing-BRN, 2011). In the case of this patient, other measures could have been done to prevent Jones, RN from not following the nurse practice act or her hospitals policy. In example, to prevent the RN from performing the intubation she could have “ran” the code blue without initiating intubation until a physician arrived. Although this is not the desired route, it is within the standards of care and it is following the hospital policy. In addition to this, Jones, RN could have notified another physician to the code and initiated or continued
CPR.
In my opinion, although Jones has the ICU experience and ACLS training to intubate she should not have intubated the patient. The reasoning for this is because if she did intubate the patient improperly she may not have been properly trained how to handle this complication. In addition to this, although she received some training her hospital may not have been able to test or validate her competency on over a period of time.
Another point is that if the nurse completed the intubation and a severe reaction occurred and the patient had a poor outcome she would not be supported by her employer. The reason for this is since they specifically stated within their policy that RN are excluded from intubation of a patient. Overall, it is understandable that the RN should initiate treatments for the best interest of the patient however if the RN was not formally trained on the procedure, its not within the scope of practice, and the hospital policy does not support the therapy then the RN should utilize other methods to care for the patient.