[NewTravie]

The two ICU's I have worked in it is the Docs or midlevels that put art lines in. Its something that would be cool to learn but IMHO nurses have enough to do already in the ICU.

[NurseCutie]

I've never been anywhere where nurses do them....Although I would like to learn. I wouldn't want to be responsible for putting one in a crashing pt I just admitted among other things I needed to do. I would like to put lines in for pts who aren't mine!

[Zookeeper3]

Originally Posted by cardiacRN2006

Can RT's bill?

Ours do, and as a nurse, whenever I pull out supplies and scan them in the BCX.... I've BILLED.

Nurses and RT can insert Alines.. as nurses we reposition swans, yes advancing. It is dependent upon the individual state boards.

As nurses, we do not do any RT treatments because billing is set up through the RT dept and they don't want to give it up... billable hours and billable treatments protect postitions.

Many states vary. To me, the more people able to do clinical proceedures the better. (assuming a good didactic and check off period)

[CraigB-RN]

Originally Posted by Zookeeper3

Ours do, and as a nurse, whenever I pull out supplies and scan them in the BCX.... I've BILLED.

Nurses and RT can insert Alines.. as nurses we reposition swans, yes advancing. It is dependent upon the individual state boards.

As nurses, we do not do any RT treatments because billing is set up through the RT dept and they don't want to give it up... billable hours and billable treatments protect postitions.

Many states vary. To me, the more people able to do clinical proceedures the better. (assuming a good didactic and check off period)

Actually you haven't billed for the service, you've input the information for the hospital to bill for the equipment. As nurses we're included in the room rate, no matter what we do, one of the reasons we're paid at the pay scale we are.

Personally I"ve got to much to do as it is withouth adding one more thing to the list. As long as the people who can do it are there in a timaly maner. I"d rather have dialysis start the CVVDH, (i'll maintain it) and I"d rather have someone else put in the Aline while I"m getting the levo and neo ready.

Now I'f i'm flying, that's another story. The places I pic patients up don't have access to any advanced hemodynamic monitoring. I put in the A-Lines, so I can monitor during the flight. I used to put in Sub-Clavians but I haven't done that in about 10 years. Haven't realy missed it either. (was able to do that not becasue it was included in scope of practice, but because it wasn't prohibitied, not the safest way to do something)

[JohnW]

We don't insert A-lines, although I wish we did, as sometimes it's painful to watch Interns struggles to get one. RNs and RTs can draw AGBs.

We dc Swans, but do not advance them. We maintain CVVH, but do start it. We do not place central lines, IV nurses places PICCs and the MDs place other CLs.

Some of the nurses I work with pull Medialstinal CTs, but I don't and don't really have an desire since I'm not good at reading CXRs.

[CritterLover]

Originally Posted by Zookeeper3

Ours do, and as a nurse, whenever I pull out supplies and scan them in the BCX.... I've BILLED.

As nurses, we do not do any RT treatments because billing is set up through the RT dept and they don't want to give it up... billable hours and billable treatments protect postitions.

Originally Posted by CraigB-RN

Actually you haven't billed for the service, you've input the information for the hospital to bill for the equipment. As nurses we're included in the room rate, no matter what we do, one of the reasons we're paid at the pay scale we are.

And on an inpatient level, the hospital isn't even able to bill for supplies.

Insurance companies pay according to DRGs, not what the patient received. Connecting the supply with the patient via "charging" systems does three main things:

1. Helps to support what the billers code for, DRG-wise
2. Helps with inventory
3. Helps with allocation of the budget throughout the hospital

For outpatients (including the ER), it is a little different and those departments can bill for certain supplies, but not all of them.

[nurseabc123]

Originally Posted by JohnW

We don't insert A-lines, although I wish we did, as sometimes it's painful to watch Interns struggles to get one. RNs and RTs can draw AGBs.

We dc Swans, but do not advance them. We maintain CVVH, but do start it. We do not place central lines, IV nurses places PICCs and the MDs place other CLs.

Some of the nurses I work with pull Medialstinal CTs, but I don't and don't really have an desire since I'm not good at reading CXRs.

Interns/residents insert A-lines. Only RTs/MDs/Midlevels can draw ABGS on our unit (w/out an A-line in place).

We d/c Swans, we don't advance them - although I would say all of us have at one time or another. We start CVVH (pain in the butt!), and maintain it.. PA's place our PICC's, and interns/residents/midlevels place other central lines.

We d/c mediastinal and pleural chest tubes and blakes. Interns/residents/midlevels read the CXRs. Our NP's d/c epicardial pacing wires.

It's interesting to see the differences between all of our units.

[JohnW]

Originally Posted by nurseabc123

Interns/residents insert A-lines. Only RTs/MDs/Midlevels can draw ABGS on our unit (w/out an A-line in place).

We d/c Swans, we don't advance them - although I would say all of us have at one time or another. We start CVVH (pain in the butt!), and maintain it.. PA's place our PICC's, and interns/residents/midlevels place other central lines.

We d/c mediastinal and pleural chest tubes and blakes. Interns/residents/midlevels read the CXRs. Our NP's d/c epicardial pacing wires.

It's interesting to see the differences between all of our units.

Wow, that is a big difference. You guys do a lot, but it seems weird to me that you guys pull pleurals, but they don't let you draw ABGs?

Our NPs or PA pulll epicardial wires as well.

[HazelLPN]

Only the docs start A-lines here, although I've goofed a few times when going for an IV and ended up started an A-line by accident.

[KC531]

Working at 4 different hospitals in 4 years has taught me to QUICKLY learn what is it I can or cannot do.

To those of you who start a-lines, do you only do radial?

A dedicated line team is a night nurse's DREAM!!!!

I think it's funny what my hospital sets as standard....RN's can twiddle with the vents all day long but we can't do arterial sticks (doesn't always stop us from doing it....you do what you have to do...).

I would LOVE to put in my own a-lines!!!!! I Hate begging for lines. (this coming from someone who has( on more than one occasion) titrated levo/neo/dopamine/etc. to a cuff pressure!!!

KC