One1, I apologize in advance for the novel below:
Everything being said on here is absolutely correct. IV and blood draws are actually some of my favorite nursing tasks; the more challenging, the more rewarding!
The reason for my original post was to get a sense of how integral IVs and blood draws are in various departments and organizations. I too prefer placing my own IVs and drawing labs, and agree that those tasks hold more importance than many other nursing tasks in the ER. With 3+ years of ER experience under my belt, my IV and phlebotomy skills went from nonexistent to excellent. Truth be told, I could start an IV in the dark....Okay maybe not the dark, but definitely dim lighting
I underwent hand surgery earlier this year for OA in my dominant hand. The expected 4-6 week recovery time was extended thanks to a serious post-surgical complication, CRPS. Prior to treatment and during the acute phase, the condition rendered me incapable of any wrist flexion; my hand was constantly cold and cyanotic; and the excruciating stiffness and burning pain became so intolerable that I sat in my hand surgeon's office while crying like a baby. Needless to say, at its worst, CRPS made any tasks that required manual dexterity an impossible feat.
Pity party over-there's a point fast-coming. Months of painful treatment, multiple steroid regimens, and countless OT appointments eventually lessened the effects of CRPS to a point where I'm "in remission" (CRPS is considered a lifelong diagnosis in which symptom relapses are common but can be controlled with nerve blockades, PT/OT, and medications). Based upon my significant recovery and readiness to return to work, my hand surgeon cleared me for full duty. End of story? Not so much....
As with many neurovascular/orthopedic disorders, residual effects are common. Mine: occasional hand fatigue provoked only after assembling my daughter's desk for more than 3 hours. Use of a CMC hand splint along with ROM exercises quickly alleviate the fatigue.
When I attempted to return to work with strong support from my surgeon, occupational health refused to grant me clearance. Apparently, any chance, whether actual or potential, that an ER nurse's hands may not be 100% 24/7/365 is reason enough to disqualify a nurse from working in the ER. Ironically enough, manual dexterity was not the issue at hand initially; the original reason that I was given was the potential danger posed if I was unable to safely lift a patient.
So I underwent a functional capacity evaluation (FCE) to prove that I am more of performing my job well and efficiently. I was able to demonstrate EVERY physical requirement including successful placement of a 20g IV, blood draw, foley, transfer of a patient from wheelchair to stretcher, and the list goes on.
Still, despite my ability to perform every single nursing task with zero difficulty, I was denied medical clearance required to return to work from occupational health because of a potential chance that at some point I would be unable to perform all of the essential functions of my job. Conveniently, the "essential function" under scrutiny was no longer lifting, but rather functions that require manual dexterity, specifically IV starts and blood draws.
Rather than consider the objective data provided by my hand surgeon and the FCE, I was terminated last month based on mere assumptions about how my hand might fare during a shift.
Apparently if my hand fatigues, I wouldn't be able to start IVs or draw blood, despite past proven competency and proficiency. I was actually informed that in order to work in the ER, a nurse has to be at "100% full capacity without need for any accommodation of any kind."
Call me naive, but that's just beyond unrealistic. Based on their reasoning, a nurse who just documented a 2.5 hour long code should be sent home due to the potential danger that the nurse's fatigued writing hand poses to patients.
That's my point in a nutshell. There are instances during many nurses' shifts when they're not "100%", but that doesn't mean they're not able to perform all of the essential functions of their jobs.
WHEW! Again, many apologies for the length!