Agency Nurse doesn't know how to start IVs? - page 4

Yesterday, a new agency nurse showed up in our ICU to fill a hole. He arrived 2 hours early to be oriented because it was his first time at our facility, so I set him to work on a few things while I... Read More

  1. by   SmilingBluEyes
    If his other ICU skills are good, cut him some slack, I say. IF he is "bad" all around, report this to the agency as you can't use him in the ICU.

    But like others said, unpracticed skills become handicaps in new areas/jobs. For example, I know for a fact, I would have a heckuva time dropping an NG tube. I did like TWO during school and went straight to OB where we just don't tend to use NGT (OGT on babies on occasion, but different story, of course). I would be very hard-pressed to do colostomy care---I don't do that either in OB. Some skills are lost as we move into specialized areas. A lot of hospitals indeed do have IV therapy teams and nurses have no choice but to use them---so their IV skills become history. It happens.

    So if he is good all-around, how about doing the nice thing and cutting him slack? Maybe, he can teach YOU a thing or two, you know.
    Last edit by SmilingBluEyes on Mar 2, '07
  2. by   Tiwi
    When you talk about "starting IVs", are you talking simply about connecting an IV med to a cannula, or are you talking about the whole process - ie insertion of the cannula, then administration of medication, and monitoring of medication / fluids...Where I work, whether you have had education in insertion of cannulas at uni, you cannot do it until you have completed the hospital course. Then you have to have it renewed every three years. And at the moment the courses are "out of date" and are being redeveloped, which is really annoying me. If the nursing staff are unable to insert it then it is left to the RMOs - which is most of the time...:trout:
    Last edit by Tiwi on Mar 2, '07 : Reason: It needed to be!
  3. by   joeb1
    It gets pretty bad some nights at our hospital. I used to work peds, and it wasn't very busy, so the house resourcenurse/supervisor would have us running around starting other floors "difficult sticks". I finally began asking the floors if they tried first. Of course they always did, but mybe they thought I never asked the patient where the nurse before me has tried......
  4. by   anc33
    Quote from newnicurn
    No that's not true for RN schools. I went to a well known school that's affliating hospital has an iv team and phlebotmy team. no ivs or blood draws for nurses. My job taught me how to do it. My job had the fake arm with very worn "veins". It still took me a while to get it down. On my busy meg surg unit sometimes you don't have the time to stick a pt, good veins or not. So your expierence can be limited.

    Same here. I also went to a top school where we were not permitted to learn this skill. They told us that MD law prohibits unlicensed personnel from doing these kind of procedures. I also learned on the job, but rarely used the skill as phlebotomy teams were put in place at my facility to cut down on infections, bad sticks, etc.
  5. by   SharonH, RN
    Quote from SmilingBluEyes
    If his other ICU skills are good, cut him some slack, I say. IF he is "bad" all around, report this to the agency as you can't use him in the ICU.

    But like others said, unpracticed skills become handicaps in new areas/jobs. For example, I know for a fact, I would have a heckuva time dropping an NG tube. I did like TWO during school and went straight to OB where we just don't tend to use NGT (OGT on babies on occasion, but different story, of course). I would be very hard-pressed to do colostomy care---I don't do that either in OB. Some skills are lost as we move into specialized areas. A lot of hospitals indeed do have IV therapy teams and nurses have no choice but to use them---so their IV skills become history. It happens.

    So if he is good all-around, how about doing the nice thing and cutting him slack? Maybe, he can teach YOU a thing or two, you know.

    :yeahthat: :yeahthat:
  6. by   GardenDove
    I'm back now, I see there are alot of responses to my opening post. This fellow was 27 and had been a nurse for a few years, and in ICU for 1 year, and his primary job is in a hospital with an IV team. I think otherwise his skill level was adequate. I'm certainly not surprised that an ICU nurse might not be skilled at starting IVs or even not know how to start them at all, but I was more surprised because I thought agency nurses were more versatile. I'm pretty competant starting them, so I would just do it if working with someone less skilled at that task.

    Yes, he said he didn't know how to start them, that he had started on years ago, but never did them where he worked so didn't know how to do it.
  7. by   SmilingBluEyes
    Agency nurses are like any of us. Many of them specialize just like we do. Why not see how things pan out before getting up in arms over lacking one basic skill? Maybe he is skilled in other areas that some lack. You don't know til you get to know him and how well he can do. Agency nurse does not equal "Jack of all Trades".
  8. by   Morning-glory
    I worked on staff at a hospital for a year, then went to agency nursing after doing some outpost nursing in the back of nowhere. I went back as agency at my old place and I still had to take the IV start class over again. I'm working Psych LTC at the moment and I haven't started an IV in 2 years. Even though I rocked at getting the hardest IV's back then, I would still want a refresher before doing it again.

    We did not get the training in school. It was strickly an "on the job" skill and I was one of the very few agency nurses that could start IV's.
  9. by   Gromit
    Quote from lauralassie
    maybe he has worked in an icu where everyone has major lines, if you have plenty of lines you don't have much of a chance to start iv's. lines are usually the first thing that goes in at our unit. but, if i were him i wouldn't have admitted that, i just would have done it and if i had a problem i would have asked for someone else to try.<snip>
    ok, now that is scary. if a nurse is unsure or just does not know a skill, i pray they do admit it, and either ask for assistance or seek instruction -not just 'try' and fail, then ask someone else.
    i have a lot more respect for those who admit their shortcomings than for those who don't, and will just try anyway. this isn't a puzzle you're trying to fit together, its someone who may suffer if its not done correctly.
    Last edit by Gromit on Mar 3, '07
  10. by   GardenDove
    Quote from SmilingBluEyes
    Agency nurses are like any of us. Many of them specialize just like we do. Why not see how things pan out before getting up in arms over lacking one basic skill? Maybe he is skilled in other areas that some lack. You don't know til you get to know him and how well he can do. Agency nurse does not equal "Jack of all Trades".
    Did I appear 'up in arms'? I most certainly was not, and I don't think either of my posts on the thread reflected that in any way. I was just asking a question.
  11. by   GardenDove
    Quote from Gromit
    Ok, now THAT is scary. If a nurse is unsure or just does not KNOW a skill, I pray they DO admit it, and either ask for assistance or seek instruction -not just 'try' and fail, then ask someone else.
    I have a lot more respect for those who admit their shortcomings than for those who don't, and will just try anyway. this isn't a puzzle you're trying to fit together, its someone who may suffer if its not done correctly.
    I totally agree with this post. It's much simpler to be humble and honest about any skills we lack. Much less stressful than trying to fake it.
  12. by   billsilas
    I would have to agree with Floridaguy and nservice. Both comments are very accurate. One cannot judge skills without knowing the facts. The nursing shortage I think has contributed to this as well with what is being taught and what is not. The IV therapy teams created also contibute to this as well. I work in the Emerg and we have had to call the IV team and/or anesthesiology to get a line in someone. I would not criticize my colleagues in this situation as well. I do agree that this agency nurse should have taken some responsibility or at least shown an interest in learning this skill as well. One always has to remember that we are a team and not everyone possesses the same skills where one lacks skill there is another that excels. One has to manage these different skill levels between staff inorder to provide care. This agency nurse is very similar to the experienced nurse that has a hard time adjusting to changes in practice or whatever. It is unfortunate that nurses eat their own instead of sharing knowledge, so that lesser experienced nurses can grow. One would expect an agency nurse to be able to do IV's but there are many circumstances as to why he or she cannot.
  13. by   sayitgirl
    So I guess you really did not need the help to begin with ? Sometimes some help is better than none at all... Kindness to each other please, it goes along way. That same agency nurse may go out and advertise how kind your facility was to other nurses "that have IV skills". Sometimes agencies send the nurses that they have available to facilities. And remember not everyone is a ICU nurse nor wants to be...:kiss

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