Too much to do already?
A few months ago, we asked on our Facebook page whether nurses would ever be interested in adding a new “medical” skill, such as lumbar puncture, to their practice.
Common responses to this question were along the lines of “Are you crazy? I have too much to do already!” But what if you used a new set of skills as part of a small team of nurse “proceduralists” in a nurse-led clinic, and received excellent training and ongoing support?
One team’s expertise.
In “Bone Marrow Aspiration and Biopsy Performed by RNs: A Review of Clinical Practice” in the September issue of AJN, Eryn Draganski and colleagues share the details of their hospital’s longtime success in using a team of specially trained nurses to perform bone marrow aspiration and biopsies. In addition to reducing costs and allowing for more timely scheduling, this practice has also provided patients with a team of nurses whose extensive experience in the procedure ensured excellent outcomes and patient support.
“…using a small team of nursing proceduralists… provides a unique opportunity to improve consistency in practice, which may result in better quality control and, ultimately, boost patient safety.”
Nursing scope of practice.
Nurse practice acts in many states don’t specifically address whether or not this task falls within an RN’s scope of practice, and any hospital interested in setting up a protocol in which nurses take on work that is usually performed by MDs needs to work with their state board of nursing to clarify any practice issues. And as with any invasive procedure performed by any clinician, careful training, oversight, and quality control measures are essential.
A way to improve access to care.
The authors summarize their practice review by noting,
“Access to health care continues to be a national issue complicated by many factors, including limited provider availability . . . our program review demonstrates that implementing a nurse-led bone marrow procedural clinic can increase access to . . . care . . . and support the principle of allowing nurses to work to the full extent of their practice.”
The article will be free until October 1.
Let us not forget that giving injections and starting IVs were once considered surgical practices and thus reserved to physicians because they broached the skin, that measuring blood pressure using a sphygmomanometer was considered too complicated for a nurse to perform or even understand, and nurse practice acts never allowed a nurse to practice autonomously.
Times change. We can do this too.