[NancyNurse08]

Originally Posted by Soonstudent

In this situation there was hardly any danger to the pt. Think about how long a picc line is. I'm sure it was still patent, and if not. like another poster said, they can replace it.

Actually, that's not quite the case. If this is their only IV access, and it cannot be used because the tip is no longer in the SVC, then it could compromise their safety if they are in need of any kind of life saving infusion. I don't know if you've ever watched a PICC line insertion, but it is no small task, and there are risks involved. This is why patients have to sign a consent for PICC placement. It is an invasive procedure.

[Soonstudent]

You are exactly right on the access issue, there is always some danger, I didn't mean to imply that there was none. The pt is probably a hard stick, or has a chronic condition that warrants a picc. I don't know, however in this situation the pt was not harmed and everything turned out ok. If the picc was pulled back 4 inches that would put it in the subclavian vein, still patent for emergencies. The intent of this is for the new nurse not to beat herself up about this. It happened, everyone is still alive, and I'm sure she learned a lesson.

[NancyNurse08]

I agree the nurse shouldn't beat her/himself up over it. It is important to understand the ramifications of our mistakes though.

[Angie O'Plasty, RN]

Originally Posted by NancyNurse08

Actually, that's not quite the case. If this is their only IV access, and it cannot be used because the tip is no longer in the SVC, then it could compromise their safety if they are in need of any kind of life saving infusion. I don't know if you've ever watched a PICC line insertion, but it is no small task, and there are risks involved. This is why patients have to sign a consent for PICC placement. It is an invasive procedure.

Technically, it might now be a Midline. Of course, you can't draw blood from it or use vesicants in it, but it might be usable, despite being pulled out 4". However, it is no longer a PICC line. Here's what the Infusion Nurses have to say about it:

http://www.mdins.net/sharedresources...s__midline.htm

PICC stands for Peripherally Inserted Central Catheter. In other words, it is a central line that is placed via the peripheral vasculature. Midline is a shorter version of the PICC. It is inserted in the same fashion, but it terminates in the axillary veins rather than in the central circulation.

[GrumpyRN63]

Originally Posted by Angie O'Plasty, RN

Technically, it might now be a Midline. Of course, you can't draw blood from it or use vesicants in it,

A midline can be used for drawing blood we do it routinely, not for tpn/vesicants.

Back to the OP, you did the right thing, mistakes happen, pt's also pull their lines out and yes, the PICC's use to be more secure when they were sutured. I had a pt pull one back once about 4cm, told the doc, she came in the room pushed it back in,checked the CXR, all was fine. Sometimes IV"s ports,anything can be dislodged in the real world. You will be aware every time you change another dsg.

Don't take the "look" too personally. This nurse just may have been projecting her thoughts of how this may inconvenience her day--(now I'll have to call the PICC nurse, reschedule her____whatever/meds,try to get a peripheral line in for now)etc. etc, some people are always like this.. They take a problem and personalize it, instead of just dealing with it. You did not do this on purpose, our days and nites are filled with problems and trouble shooting and fixing them, that's just the way it is

[Angie O'Plasty, RN]

Originally Posted by GrumpyRN63

A midline can be used for drawing blood we do it routinely, not for tpn/vesicants.

Back to the OP, you did the right thing, mistakes happen, pt's also pull their lines out and yes, the PICC's use to be more secure when they were sutured. I had a pt pull one back once about 4cm, told the doc, she came in the room pushed it back in,checked the CXR, all was fine. Sometimes IV"s ports,anything can be dislodged in the real world. You will be aware every time you change another dsg.

Don't take the "look" too personally. This nurse just may have been projecting her thoughts of how this may inconvenience her day--(now I'll have to call the PICC nurse, reschedule her____whatever/meds,try to get a peripheral line in for now)etc. etc, some people are always like this.. They take a problem and personalize it, instead of just dealing with it. You did not do this on purpose, our days and nites are filled with problems and trouble shooting and fixing them, that's just the way it is

Our hospital policy is that midlines are not to be used for blood draws. So of course, you'd want to check the policy before you did anything.

[GrumpyRN63]

Thanks for the reply, our policy does allow blood draws from midlines,guess I should feel lucky! Makes life for me and the pt a lot easier.

[MissMonica]

Originally Posted by suanna

"....even though I was extremely careful"
Apparently not careful enough. I would have most likely given you "the look" when you told me that in report. Sorry but a half an inch is a lot- stop pulling and try something else. To have pulled it out 4 or so inches is careless. Live and learn. No one is perfect and I'm sure it won't happen again soon. You did take the appropriate action which means a lot- some would have just tossed on a dressing and hoped no one would notice. By taking responsibility for your error you did the professional thing but "...it could have happened to anyone, right?" It could have happened to anyone who wasn't as careful as they should have been as I'm sure you will be in the future.

This is exactly why so many nurses leave the profession or get burned out early in their career. I cant stand bullies. This person must have forgotten what its like to be new. I agree with the majority of others. You did better than most by responsibly reporting the incident. You are on your way to becoming an excellent nurse. I have seen more mistakes that have been covered up or lied about to the point now I am terrified to be hospitalized. Thanks for being so honest about what happened to you. You could be my nurse anyday!

[NancyNurse08]

Originally Posted by Angie O'Plasty, RN

Technically, it might now be a Midline. Of course, you can't draw blood from it or use vesicants in it, but it might be usable, despite being pulled out 4". However, it is no longer a PICC line.

True, but in my facility, you'd have to get a doctor's order to use it if the tip is not in the SVC.

[Angie O'Plasty, RN]

Originally Posted by NancyNurse08

True, but in my facility, you'd have to get a doctor's order to use it if the tip is not in the SVC.

That goes without saying, Nancy.