Agency Nurse doesn't know how to start IVs?

Nurses General Nursing

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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 was showing him around. When I was going to maybe need another line, and asked him if he'd like to start it.

He told me that he doesn't know how to start IVs because the place where he normally works has IV therapy. I can understand that because I had worked at a hospital with IV therapy and didn't learn to start IVs until I came to my present place of employment. Nevertheless, I was surprised that an agency nurse would lack that commonly used skill.

Sorry but In Florida, Pennsylvania and New York State Nursing Schools, starting IVs is not in the State approved curriculm(approved nursing skills) and hasn't been for a long time(if it ever was) nor is not on one of the Prqactical critical skills mandated by the state nursing boards either. I went to a 120 hour state(3 month long) sponsored IV Therphy course where I learned to do starts and am now state certified. If the Industry wants Nurses to be proficient in this skill, they should pressure the Nursing Boards in their states to instruct on it in the schools witin their jurisdiction. Criticism is misplaced on the posts where some posters state "Nursing schools teach IV Starts"--not true,,, IMHO,,,

Specializes in ER/Nuero/PHN/LTC/Skilled/Alzheimer's.

Sorry gotta stick my two cents in.

As a former agency nurse, yes I did have to fill out a competency list. I was right out of RN school, but had one year's experience as an LPN before getting hired on. I'm n ot sure about other agencies but I went to mostly LTC and res care facilities where IVs were not common. A few SNF/rehab facilities had people on IV vanco or ancef after a joint replacement but they either had centrals, PICCs, or something equivalent.

They did try to assign me to a couple of the hospitals in the area but when the hospitals asked if I had med-surg experience or had worked in hospitals before they would turn me down. The hospitals ended up usually not taking someone from our agency or from any of the other agencies. It was not required for hiring and I had actually worked in ER during my independent and was very good at IVs. Only a few times did I have to start IVs during my agency days and I never had any trouble. In fact I started a couple for the regular shift at the facilities I went to. So by refusing me on one technicality, the hospitals lost on help for that day. These are also the hospitals that had want ads all over the newspapers but wouldn't hire new grads because they "couldn't afford" to orient a new grad. Guess they really didn't want the help after all.

Specializes in ICU, L&D, Home Health.

We weren't taught IV starts in nursing school (a diploma program). We were told there was no point in training us because each hospital has its own way of training and we would learn there. I thought this was ridiculous! There were a few clinical instructors who "borrowed" some supplies and allowed us to practice on each other, but only if we didn't spread it around that we were doing so.

When I graduated and did a critical care internship in the ICU I was sent to Same Day Surgery to practice sticks, and then rarely used that skill again. We didn't have as many peripheral IVs as the floors and many of the ICU nurses were a little rusty when it came to those. Yes, I know, pathetic, but it's one of those use it or lose it skills.

I really wonder if those Nurses who claimed they were taught this in Nursing School(ADN, BSN, Diploma) could actually Document where in their Course(exactly what course)it was taught and how many hours was devoted to this area? As far as I know, the its is not requiried in any US based NLN accredited Nursing program. No more then Ventilator compentency, EKGs and various cardiac rythmn interpretation are requiried to be taught in any US Based Nursing school. For some odd reason many out of the Nursing field and some within, assume(and incorrectly I will add)that these skills are included in a Nursing Curriculum but you know what they say about the word "Ass-u-me" ,,,LOL

RedSoxRN-Are YOU kidding me? Why did you bother posting to the message board? Lots of people post things that sound irrelevant or dumb to another person. Doesn't anything more important happen in your life than writing a complaint about 'this trivial thing' on the internet? :uhoh3:

Vent over

The OP had thought agency nurses were required to have certain skills in order to work agency. Then she met an agency nurse who didn't have a certain skill. So she asked if this were common. The response was that yes, it's quite common. I don't think it's ridiculous to assume that agency nurses would know how to start an IV, especially if every agency nurse you'd met before could start IVs. At least the OP made the effort to get more information instead of just assuming that the nurse was incompetent. :idea:

Precisely. I just wanted to ask a question as I was surprised. I really didn't have a big problem about it, but I had always thought of agency nurses as being hotshots and thought that were more versatile in their skills.

LOL, if someone wants to take the time to lay into me for posting the question, so be it. :rolleyes: Not a very positive contribution, but I've posted on the internet long enough to know it comes with the territory. It did start an interesting discussion.:lol2:

I am sort of surprised that this turned out to be a little bit controversial, starting this thread. I thought it was a rather bland subject, actually, and I had zero emotion about the subject. It's going on almost as long as the circumcision thread!

Specializes in ER, ICU, Infusion, peds, informatics.

okay, kind of late into this thread, but here is my take, for what it is worth :)

if he filled out his skills checklist honestly, and the agency was honest with your facility about his skills checklist, then it isn't a big deal.

if either of them lied, though, then it should be dealt with . are iv skills a requirement to work on your unit? did your staffing coordinator (or whomever....) excuse this lack of skill b/c you were so short-staffed and really needed help?

i, too, would have been surprised, since i was expected to be able to start ivs as an icu nurse. however, none of the hospitals in this area have iv teams, so most icu nurses, even those from other facilities, have this skill. (this is especially true for nurses that come from non-teaching hospitals, since [in this area] getting a physician who is no longer a resident to place a central line just might cost you your first born child. )

for the record, gardendove, i understand you confusion, and agree with jjoy that it was open-minded of you to ask the question here rather than assume the agency nurse was substandard for not knowing how to start the iv. if one thing this website has taught me, it is how different things can be in different parts of the country.

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 was showing him around. When I was going to maybe need another line, and asked him if he'd like to start it.

He told me that he doesn't know how to start IVs because the place where he normally works has IV therapy. I can understand that because I had worked at a hospital with IV therapy and didn't learn to start IVs until I came to my present place of employment. Nevertheless, I was surprised that an agency nurse would lack that commonly used skill.

Well, that is certainly...different. Agency nurses shouldn't be that limited. They move around alot, right? Why not train them to do basic things like that before they hit the floor? Then again...In CNA school, they didn't teach us how to do the ADL flow books, soooo...:uhoh21: Maybe the classes are going downward.

When I went to nursing school they didn't teach starting IVs. That was considered a technical skill that one learned on the job. They told us not to worry about that, that we needed to learn other things in nursing school. They were entirely correct about that.

I really wonder if those Nurses who claimed they were taught this in Nursing School(ADN, BSN, Diploma) could actually Document where in their Course(exactly what course)it was taught and how many hours was devoted to this area? As far as I know, the its is not requiried in any US based NLN accredited Nursing program. No more then Ventilator compentency, EKGs and various cardiac rythmn interpretation are requiried to be taught in any US Based Nursing school. For some odd reason many out of the Nursing field and some within, assume(and incorrectly I will add)that these skills are included in a Nursing Curriculum but you know what they say about the word "Ass-u-me" ,,,LOL

Hate to say how many years ago that I trained, but all that you mentioned above were in my program. All but vent competency. And when the first ACLS courses were offered, the nurse was also required to be checked off on intubation as well as central line insertion. Intubation was on the dummy, and for the lines, you had to demonstrate what you would do exactly but not stick the person. Things do change.

And when I first started, nurses were only permitted to start the butterfly. Physicians only could insert the angiocath. And very few of the docs were proficient at that. And if you could not start an IV you were supposed to call the physician to insert a line, only they rarely did.

Skill requirements have changed thru the years. We never had ant models or dummies for learning to do procedures, all were on living and breathing patients. We did not use other students as out guinea pigs for anything. Not even the bath.

And I went to a hospital-based Diploma program.

I have yet to see a Nursing School where IV Starts were even part of the Official Curriculm; as far as I know, its not included on the list of Critical Compentencies(for legal liability concerns?) that Nursing schools are bound by state law to include in their instruction. After I graduated from Nursing School, I went to another school for this(iv), EKG Certification, Venipuncture and Ventilator Competency. Maybe they should include some Basic instruction on IV Piggy Backs as I actually observed a Nurse (who was the Valedictorian of her Class BTW) and she inserted two Needles(I'm really dating myself here) into the SAME Heplock Device. Anyone ever see this done before? Instead of inserting it at the Y in the mainline, she utilized a seperate needle and plugged it into the same heplock as the Main IV line Needle. The law of Physics does not allow this as it does allow a good seal,,, This of course started a major flood in the patient's bed not to mention loss of Medication. Valedictorian she was but of Common sense she had none,,,LOL

Specializes in ER, Cardiology, and GYN long ago.
Maybe they should include some Basic instruction on IV Piggy Backs as I actually observed a Nurse (who was the Valedictorian of her Class BTW) and she inserted two Needles(I'm really dating myself here) into the SAME Heplock Device. Anyone ever see this done before?

I nursed back when we used needles in the locks as well and I don't think I 've ever seen that done ...

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