Hello Everyone,
This was the BON response. Happy to forward the email to anyone:
"Thank you for contacting the Maryland Board of Nursing, Practice Department, with your inquiry. The Maryland Board of Nursing staff members were unable to locate a reference specific to the topic of your inquiry in the Nurse Practice Act (NPA) or its accompanying regulations. The Maryland Board of Nursing staff members are able to direct you to the NPA and to the Maryland Board of Nursing, Code of Maryland Regulations, and to resources available on the Maryland Board of Nursing website that may be relevant to the topic of inquiry for your review. We are unable to advise on setting practice or client/patient specific practice questions or to inquiries related to employment. Depending on the practice setting, additional authorities (State, federal, local/jurisdictional, agency, program, facility, institution, licensing and/or accrediting entity, other licensing Boards (
e.g., Physicians, Pharmacy), Commissions, etc.) and regulations may apply. For example, all hospitals, ambulatory care centers, out-patient clinics, and many other health care settings in Maryland are licensed and regulated by the Maryland Department of Health, Office of Health Care Quality (OHCQ) Program and may be accredited by the Joint Commission, or another accreditation organization. Please visit the Maryland Department of Health website at the following link:
Maryland Department of Health Office of the Secretary. Please go to Programs on the menu bar to "Health Care Quality, Office of" to locate the contact information for OHCQ and to Boards on the menu bar to locate all licensing Boards.
We do advise all licensees and certificate holders to be knowledgeable of the statutes and regulations that govern their level of nursing practice in Maryland, the policies and procedures of the practice setting, and to seek guidance, support, education, and supervision, as necessary, from their immediate supervisor, nursing director/administrator, program/facility administrator(s), risk manager, or legal advisor, regarding any identified practice questions or concerns within the specific practice setting.
To locate the NPA and the Maryland Board of Nursing Code of Maryland Regulations online, please go to the Maryland Board of Nursing website at the following link:
Pages - Home (maryland.gov). Please go to "NPA" on the menu bar across the top of the screen. In the second paragraph are links to both documents. It is important to read the information in both documents. The Maryland Board of Nursing staff members are unable to provide legal interpretation of the NPA and its accompanying regulations.
-Click on Annotated Code of Maryland. Please go to Health Occupations, Title 8, Nurses. Please open and read each applicable Subtitle and Section (e.g., Subtitle 1, Sections 8-101(b), 8-101(g), 8-101(i), 8-101(k), 8-101(l), 8-101(o), 8-101(p); Subtitle 2, Section 8-205; Subtitle 3, Sections 8-302.1, 8-310, 8-316; Subtitle 5, Section 8-513; Subtitle 7, Sections 8-701, 8-702, 8-703; Subtitle 7A., Section 8-7A-01, Article III, 8.(a)-(c); etc.).
-Click on Code of Maryland Regulations (COMAR). Select Search Option 3. In the drop down menu, enter Title 10, Department of Health. Please go to Subtitle 27, Board of Nursing. Please open and read each regulation in Chapter 06 "Practice of the Nurse Anesthetist" (10.27.06), noting each regulation in COMAR 10.27.06.05 Scope of Practice., and each regulation in COMAR 10.27.06.05 Standards of Practice. Please open and read each regulation in Chapter 09 "Standards of Practice for Registered Nurses" (10.27.09), noting each regulation in COMAR 10.27.09.02 Standards of Care., each regulation in COMAR 10.27.09.03 Standards of Professional Performance., and each regulation in COMAR 10.27.09.04 Specialty Practice. Please open and read each regulation in Chapter 19 "Code of Ethics" (10.27.19), noting each regulation in COMAR 10.27.19.02 Ethical Responsibilities. Please open and read each regulation in Chapter 20 "Management of Infusion Therapy by the Registered Nurse and the Licensed Practical Nurse" (10.27.20).
-Please go to Nursing Regulation on the top menu bar and to Practice on the left hand menu to locate the reference article "Scope of Practice Decision-Making Framework".
-Please go to Resources on the top manu bar to search for resources by Topic."
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Casey Green BSN, RN, CCRN, CTRN, CFRN, CEN, TCRN, NREMT-P
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Original Message:
Sent: 06-14-2022 09:03 AM
From: Tyra Brown
Subject: RSI and Etomidate
Hi Casey,
Please let us know if they email you back. The form posted at Easton Memorial hospital stated according to MBON, RNs were no longer allowed to push Etomidate, so I would be very curious to know. We've never been allowed to push Propofol, we could only hang it for infusion for those incubated. Thanks for that info.
Original Message:
Sent: 6/13/2022 3:03:00 AM
From: Casey Green
Subject: RE: RSI and Etomidate
Hi Katlyn, Gail, and Tyra,
I saw this thread in my emails and was curious myself. I found the policy from Upper Chesapeake (University of MD hospital system) that says RNs can't administer Propofol or etomidate as RSI medications. However, when I searched MBON board rullings about RSI or etomidate I only could find Propfol listed. So it seems to be more of a hospital policy than MBON ruling/policy. I'm interested to see if anyone can find out more and I also emailed MBON to see if they have any answers. I attached the things I found below.
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Casey Green BSN, RN, CCRN, CTRN, CFRN, CEN, TCRN, NREMT-P
Original Message:
Sent: 05-30-2022 01:43 AM
From: Tyra Brown
Subject: RSI and Etomidate
Hi Katyln,
I wish I could upload the notice that I took a screen shot of in my phone. We use to be able to push Etomidate, however, when I did travel nursing briefly on the Eastern Shore, there was a big sign posted in the employee break room that according to new MBON guidelines, the RN could no longer push Etomidate. So, at my facility, the Doctor's just changed the med that they used, so that the nurse could still push. It's a real thing, but many nurse's do not know about it.
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Tyra Brown
Clinical Nurse
Mercy Medical Center
Bel Air MD
(443)653-2554
Original Message:
Sent: 03-21-2022 11:15 PM
From: Katlyn Bowman
Subject: RSI and Etomidate
Hello!
A question has been brought about RSI and Etomidate and I can not find specific MBON information about scope of practice for the RN.
Are RNs at your facility or in MD specifically allowed to push IV Etomidate for RSI?
I have looked at other states that states the RN can push Etomidate for RSI but not for moderate sedation.
Any insight would be appreciated and if you have a specificity document that you could find from MBON scope of practice would be a bonus!
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Katlyn Bowman
Emergency RN
Carroll Hospital Center
Taneytown MD
(410)456-2121
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