What Do You Think?

In the June 2002 issue of Cath Lab Digest, there was a table outlining the states and who cross-trains where according to your Email Discussion Group. In Oregon, you stated that only RNs give drugs. Is there a precedence that anyone knows of? I work in a large cath lab (4000 procedures annually) where the RTs give all the IV narcotics and drugs, and the RNs scrub. I’ve been in touch with both respective boards in the state and neither knows if this is right or wrong. I’ve always wondered how RTs could give IV narcotics, but this is how we’ve always done it. Any help you can give would be welcome. Thank you, mbrads9055@aol.com I am the manager of a large cath lab (8000 procedures) that does not employ any RNs in the cath lab. All staff (CVTs & RTs) are trained on a limited pharmacopeia of cardiac drugs, all staff are ACLS trained and all staff give meds under the supervision of a physician. The staff is required to pass a yearly competency exam on moderate sedation and a math test to calculate drug doses. In reality, most of the meds are put on the sterile field and the physician administers the drugs, but some are given off the field by staff. I can find nothing on the state level to support this protocol. On the national level, SICP says that all cath lab personnel should be adept at giving medications. You just have to be able to support your practice with strong documentation about education and competency testing. Hope this helps, Ann Just a little input from the cath labs in the Tampa Bay area. In the Baycare System, which incorporates Morton Plant Mease in Clearwater, all cath lab personnel give narcotics. There is no distinguishing between nurses and techs. We all scrub, circulate, and monitor. In my 10 years of working in the cath lab, this has been the most successful approach. It has also been my experience that the best run cath labs are tech run cath labs. However, the powers that be don’t always share these views. The biggest problems I have come across is, where do they find these screwball managers? Cath labs are a great place to work. Finding the right one is a challenge. David Rey, CCPT We are a small cath lab in Washington State, north of Seattle. Up until recently, RTs, RCVT/RCISs and RNs gave all drugs. In our last Dept. of Health inspection, that fact came to the attention of the inspector, and we were cited for non-RNs giving psycho-active and narcotic drugs. Non-RNs can still give any other drug. We have always had non-RNs give drugs based on the health assistant act, which allows it as being under the auspices of an MD who is present in the room and ordering the med. This is just another example of our tax dollars in action, supporting beauracrats and their beauracratic BS. This has severely inpacted our staffing in that we now have to have a nurse present in the lab at all times in order to give narcotics. Since we are a small lab doing only 7-800 procedures/year, this has meant that we have had to hire 2 new nurses in order to cover call. Jim Miller, RN

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