Currently in Louisiana, registered nurses can pull non-tunneled caths. I'm seeking approval for RN's to pull tunneled caths as well, as ordered by their MD's. What is everyone's opinion on this? Should RN's be allowed to pull tunneled caths if properly trained?

Why would you want to add more to your plate, and then add more of the possibility of a law suit when something goes wrong?

My sentiments exactly. A non tunneled cath, no problem. Why change your protocol? Not sure this is would be covered in an RN's scope of practice...

You guys bring up an arguable point. This would add more to my plate and open myself up to more chance of litigation. However, this is a billable procedure, and would therefore increase my value and hopefully my income. The procedure does require a little bit more actual work, but the risks of tunneled verses non-tunneled are approximately the same. Thank you all for your input. Keep it coming; I'm still i deciding whether or not to petition the LA State Board of Nursing for approval.

You are already quite valuable. As far as increasing your income, don't count on it!

I assume from your screen name that you are working in an acute setting. This would mean you have some degree of control over the physical environment (?hospital bed?), and are able to concentrate your attention on the individual in case of complications. I would never consider removing a tunnelled cath in HD outpatient clinic setting. I don't know how things are done in acute setting these days, do the vascular surgeons do it at bedside? Once upon a time, you would not see a central line removed without complete aseptic procedure and the staff to observe for post complications.

Hello AcuteRN,
I applaud your ambition in expanding your role. As with anything you do clearly you would want to be skilled at that procedure. I am assuming that this procedure is done in special procedures under some type of guided imagery? Does your hospital offer this specialized training? or are you looking to introduce a new skill for advanced practice nursing? Your motivation to add this to your job description I believe enhances your role as a professional and doesn't add to the plate of those not interested in added additional skills to their workload. I think we must keep in mind that this would fall under a clinical specialty much like inserting picc lines and I'm assuming that some certification would be required. I would be interested to know the outcome of your pursuit if you decide to move forward with this. Good luck. I say go for it.

I saw let the interventional rediologists handle it and stick to real nursing care!

Well, I never persued the issue any further. Re-imbursement was an issue. It was brought up that if a nurse was doing the procedure, it may not pay as well. I guess I will not be exploring this issue again any time soon.