Nursing Practice

Sedation

Can I as a registered nurse administer fentanyl or propofol to a patient?

The regulation answering this question is found in the Alabama Board of Nursing Administrative Code Chapter 610-X-6-.05(5) which states  “The RN or LPN shall not administer medications for anesthetic purposes or to render an individual unconscious without meeting the requirements of Chapter 610-X-9-.02.” (CRNA)   

For administration of any medication, the nurse is expected to utilize a complex set of knowledge, skills and abilities necessary to assure the safety of the individual receiving the medication.  The components of medication administration are listed below. 

• Knowledge
  • Drug action, classifications
  • Expected therapeutic benefit of medication
  • Expected monitoring
  • Illness or injury processes
  • Developmental stages
  • Possible side effects/adverse reactions & interventions for same
  • Emergency interventions for anaphylactic reactions
  • Seven rights of administration
  • Drug/Drug and Food/Drug Interactions
  • Calculation of drug dosages
  • Federal and state legal requirements related to storage, controlled substances, etc.
• Decision-Making
  • When, how and if medications should be administered
  • Assessment of individual’s complaint prior to administering PRN medications
  • When to contact the prescriber
• Skills
  • Dexterity to open medication packaging
  • Read, write English
  • Read, write, and comprehend Latin phrases relevant to administration of medication
  • Measuring medication dosages
  • Math calculations
  • Routes of administration
• Documentation
  • Administration
  • Therapeutic effect
  • Principles of documentation
  • Seven rights of administration
  • Controlled drug records per federal and state law.