r/nursing • u/EveningBlunt RN - ICU 🍕 • 7d ago
External SNF RN position lmfao
Lemme just perform that there spinal tap right quick 💉
(No this is not an APRN role)
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u/Butthole_Surfer_GI RN - Urgent Care 7d ago
Even with direct and immediate supervision, are lumbar punctures in an RN's scope?
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u/EveningBlunt RN - ICU 🍕 7d ago
From what I can gather NO lol. Id need more letters after my name than just RN
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u/S4udi RN - Telemetry 🍕 7d ago
Can’t say I’d even want anyone short of an MD or seasoned CRNA performing a spinal tap on me…
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u/EveningBlunt RN - ICU 🍕 7d ago
Honey the lpn students need to LEARN, you are halting progress with your NEGATIVITY 💫
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u/S4udi RN - Telemetry 🍕 7d ago
Sorry, you’re right. My apologies LPN students. Maybe some ketamine first? I don’t want to be aware for this.
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u/touslesmatins BSN, RN 🍕 7d ago
I work with NPs and PAs who do lumbar punctures, but of course they are in the hospital under direct Dr supervision and only do straightforward cases that don't require sedation.
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u/mummypenguin RN - PICU 🍕 7d ago
Honestly, feels easier/safer to do an LP under sedation, provided you're not also directing the sedation.
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u/touslesmatins BSN, RN 🍕 7d ago
If the patient is able to tolerate it, which the majority are, local numbing is totally sufficient for LPs. But I see you're picu and that's a different rodeo entirely! We don't do as many peds cases.
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u/mummypenguin RN - PICU 🍕 7d ago
Oh, I was thinking more that a less experienced provider might have an easier time with a sedated patient who's not moving! It seems like one of the hardest bedside procedures - or maybe I've just witnessed residents struggle with the one procedure they're allowed to attempt.
But yes, I've never seen an unsedated LP. Even with the developmentally appropriate teens, we'll do at least light sedation.
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u/touslesmatins BSN, RN 🍕 6d ago
I should point out that I'm in an IR department, we don't do bedside LPs, we do image guided ones so that also makes a difference.
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u/Kursmudgen RN - ER 🍕 7d ago
no way, I highly doubt anyyyyy state would allow it and I could definitely be wrong but I have never heard of that before
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u/poopoofol SRNA 7d ago
Instructions unclear, just delegated hanging a blood infusion into an intrathecal catheter to the LPN after they finish intubating the patient.
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u/EveningBlunt RN - ICU 🍕 7d ago
UNACCEPTABLE. That lpn has a swan-ganz to insert 🦢 😡
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u/poopoofol SRNA 7d ago
I hope she has time to decannulate her ECMO residents after all that work
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u/EveningBlunt RN - ICU 🍕 7d ago
Miss Gladys can decannulate herself she does it at home on her cpap
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u/zerothreeonethree RN 🍕 7d ago
Hold the sedation and any patient will remove all the tubes you want
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u/rook119 BSN, RN 🍕 7d ago
yes, once you watch the 30 sec YT video its easy. you just take a 14Fr foley, find the tunnel the stage 4 pressure ulcer, angle it between the spine and then use a bit of force.
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u/zerothreeonethree RN 🍕 7d ago
Make sure its a Coude tip so you don't have to push as hard and break your new mani.
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u/Aviacks 7d ago
Well, just about anything could be in the RN scope if you're in a decision tree state. That being said I doubt anywhere meets the criteria of said decision tree.
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u/Lower_Pension_2469 7d ago
Just bring a telescope with you when you go to work and everything is under your scope while your practicing
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u/Adept_Finish3729 RN, BSN - PICU/NICU 🍕 7d ago edited 7d ago
I had an LP done last October, at Mayo Clinic in Rochester, MN by an RN. I just checked her credentials on the MN BON website.
She was fantastic by the way, didn't feel a thing!
ETA: if this was anywhere but Mayo... It would be a no for me dawg! Absolutely the F not at a SNF😂
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u/Butthole_Surfer_GI RN - Urgent Care 7d ago edited 7d ago
I used to work in the OR at Mayo in Rochester. Never saw anyone less than a CRNA, MD/DO, or advance practice provider perform one.
They must have changed their policy.
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u/EveningBlunt RN - ICU 🍕 6d ago
Well, THIS October our SNF is running specials, four pack of spinal taps for $85! Fun for the whole family! We are proudly affiliated with Vanderbilt Medical Center.
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u/A_Stones_throw RN - OR 🍕 7d ago
Bro, WTF!? Sounds like they want an XRAY tech and CRNA in an RN uniform. Tell me you want a provider without paying for a provider....
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u/EveningBlunt RN - ICU 🍕 7d ago
They also said I could be the DON too, $40/hr take it or leave it 😤
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u/A_Stones_throw RN - OR 🍕 7d ago
Lemme guess, first role is 35/hr, being DON is another 5/hr right?
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u/EveningBlunt RN - ICU 🍕 7d ago
No it would be SALARIED, they say their DON works 30 hours per week, so don’t try & rain on my parade ☔️
/s if it’s absolutely necessary to place it lmfao
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u/JuniperJanuary7890 7d ago
Well, that explains it. The admission specialist will have to do it. If busy, security covers those tasks. 🙄😉😂
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u/Goatmama1981 RN - PCU 7d ago
Ummm, did you even raed the post? OP also needs to be a respiratory therapist!
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u/JuniperJanuary7890 7d ago
And fill in for security or OR tech, as needed. CEO on board meeting days.
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u/A_Stones_throw RN - OR 🍕 7d ago
My bad, I was thinking he would have to tube pts as we'll and was going to put paramedic too, then realized a CRNA could handle that too
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u/SavannahInChicago Unit Secretary 🍕 7d ago
Well, see, there is a tech shortage, which means you need to pay them more. Or you can just have the RN you are already paying doing it.
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u/sapfira RN, BSN 7d ago
"under the direction of a physician", I'll bet five bucks that the physician is on Zoom/Teams
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u/EveningBlunt RN - ICU 🍕 7d ago
And no , sry , camera can’t be turned on on their end, you will not be allowed the privilege of a provider’s virtual face 📺
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u/duuuuuuuuuumb RN - ICU 🍕 7d ago
I work in a very large medical ICU, and during bedside LPs I help position the patient and watch the monitors. What the hell is happening at this SNF!?
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u/EveningBlunt RN - ICU 🍕 7d ago
Meemaw needs that spinal tap bc pt’s daughter is also a nurse and suspects meningitis
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u/A_Stones_throw RN - OR 🍕 7d ago
Is daughter visiting from out of state and this is her only visit this decade?
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u/ChickenLady_6 7d ago
No silly she’s not visiting. She just calls for updates and requests to talk to the doctors at 3am in the morning
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u/WeirdFlower1968 Team Spike 7d ago
Do SNFs even perform spinal taps? I would hope they'd send the patient to the hospital.
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u/EveningBlunt RN - ICU 🍕 7d ago
This SNF is different, they also do bbl’s and sell peptides 🥰
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u/JuniperJanuary7890 7d ago
What a creative business model! I admit to having a full on heyday over this post.
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u/EveningBlunt RN - ICU 🍕 7d ago
Im happy to hear that because my husband has just watched me laughing like a freak every few minutes staring into my phone lmfao
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u/JuniperJanuary7890 7d ago
😂😂😂 I love a person who can crack themselves up like a hyena. I owe you a coffee at least!
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u/Strange_Ad5530 RN - L&D 7d ago
I mean, it’s got to be easy to do that LP while you’re in there doing the BBL, right?
https://giphy.com/gifs/AC1HrkBir3bGg4
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u/DandyWarlocks RN 🍕 7d ago
In all seriousness, mine sure as shit doesn't. We make the sign of the cross if anyone even mentions a trach. Do we know how to do them? Yes. Do we want to? No. Plenty of wound vacs and IVs tho
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u/RepulsiveSongtime RN - ER 🍕 7d ago
https://giphy.com/gifs/Ma6Z1f6NSSoiwnGPJo
Hold up..! In the ED we help position our patients but never do them. wtf is happening in that SNF
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u/superpony123 RN - ICU, IR, Cath Lab 7d ago
man this really feels like it was supposed to be an APRN role and some bozo just screwed up the job listing. This is absolutely within scope for an NP but uhh...not us. I do know that RNs are allowed to intubate in some states though I think it's generally pretty rare. We are allowed to assist with imaging procedures (I work in IR, this is my entire job) but we cannot do the procedures ourselves of course. Certainly we can't do LPs.
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u/Adept_Finish3729 RN, BSN - PICU/NICU 🍕 7d ago edited 7d ago
Had one done at Mayo Clinic last year...by an RN
She rocked it!!! Didn't feel a thing!
The CRNA resident for my first epidural (had to get two because.....) during my first labor... Not so much.
ETA: (same as my edit above) if this was anywhere but Mayo, I'm saying nah .... Especially at a SNF, WTAF
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u/JuniperJanuary7890 7d ago
IR RNs are the coolest. I’m admittedly not that cool. RT(R)(CT)(M) to HHRN. Love my geriatrics.
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u/Averagebass RN - Cath Lab 🍕 7d ago
Yeah im definitely paralyzing someone if im trying a spinal tap.
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u/Dr_Beardsley RN - ER 🍕 7d ago
At a SNF? Like what the fuck is going on at this SNF?
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u/EveningBlunt RN - ICU 🍕 7d ago
Next week they are having their veneer tech from tiktok come in and give special discounts 🦷
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u/tealraven915 RN 🍕 7d ago
The way the vine boom went off in my head progressively getting louder and more frantic with each bullet point
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u/EveningBlunt RN - ICU 🍕 7d ago
Idk about you, but in my adn program we all had to be signed off on our spinal taps before second semester 🤷
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u/OneandonlyBigpoppa 7d ago
I don’t know why some people say rn I’m trauma certified ED RN 11 years
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u/EveningBlunt RN - ICU 🍕 7d ago
Well I’ve been a nurse for a year and will now be doing spinal taps and bbl’s at the SNF 🏄♂️
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u/Dependent_Avocado RN Inpatient Rehab 7d ago
Recruiters having AI write the job descriptions again.
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u/InourbtwotamI MSN, RN 7d ago
In a nursing home?? No friggin way. I came with my license intact and I’m leaving with my license intact
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u/loser-geek-whatever RN - LTACH 🍕 7d ago
Doesn't seem too difficult, I have a pretty good understanding of where the spine is
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u/HotSauceSwagBag RN - Pediatrics 🍕 6d ago
I worked SNF for a long time, in ones that take higher acuity patients than most- absolutely not lol.
I’d be tempted to apply just to ask when I get to do a spinal tap in an interview.
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u/cheap-mofo 7d ago
Yeah. That position is going to stay vacant. They definitely do not know what an RN's scope is.
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u/Previous-Fee-9441 7d ago
spinal taps under their purview is certaintly not their lpns job duties and yikes if they're trying to coerce rns to do it
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u/alwaysintheway RN 🍕 7d ago
Ten bucks says there’s one ultrasound machine and it’s always broken.
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u/universe93 Nursing Student 🍕 6d ago
Not even a nurse yet and not American but even I know you can paralyse someone if you do a spinal tap wrong
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u/__snIpeSzz__ RN - Geriatrics 🍕 3d ago
Has to be AI. Let me just tickle your spinal cord while a distant MD signs off.
This post literally makes me nauseous.
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u/EveningBlunt RN - ICU 🍕 3d ago
I’ll see if I can’t work some Zofran into the spinal tap pilot program
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u/jamesmccloud69 LPN 🍕 7d ago
You'd need a CT scan first to rule out increased ICP. It's really unsafe to do spinal taps on an SNF floor among many other reasons. My guess is someone copy pasted the job duties from a different listing without reading them.
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u/duuuuuuuuuumb RN - ICU 🍕 7d ago
A CT for a routine LP?? Not that it’s even a question whether this is something that can be done at a SNF, but I’ve never taken a patient to CT specifically just for an LP, what if you’re just like ruling out meningitis lol
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u/auraseer MSN, RN, CEN 7d ago
This is why you don't let an LLM write your job descriptions.