Agency Nurse doesn't know how to start IVs? - page 8

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   Wavedancer
    I say its crap! I would report it to his AGENCY! Tell em to send someone quailified for the job next time... agree its too big of bucks not to get the skills you need.
  2. by   suzanne4
    Quote from Wavedancer
    I say its crap! I would report it to his AGENCY! Tell em to send someone quailified for the job next time... agree its too big of bucks not to get the skills you need.
    Sorry, but I do not agree with that at all. Now in the ICUs most patients have central lines, and those are not started by nurses. Different areas have different skill sets. Pre-op holding, out-patient GI lab, ER; units like that and the nurse gets plenty of experience. In the ICU, the patients are sicker than the used to be by far, and they require different lines, than peripheral in many cases.

    When I was in nursing school, I worked as an IV tech at a 600 bed hospital and never lost those skills. This is back when nurses did not even start IVs. I have been a critical care nurse for years and years, among other speciality areas. And over the past year, I may have started a dozen IVs total on my patients. More often on patients that are not mine. Some nurses are also better at starting IVs. Same as with lab techs, even though they draw blood day in and day out, some are better than the others.

    But to say that someone has to be removed from a job because of their IV skills is crazy. And what if they have superb IABP skills over even ECMO skills, but never get a chance to start a peripheral line as those patients usually have central lines that were placed.

    What about the nurses that have problems with foleys? Should they be denied a position because of that? Each person has a different skill set that they bring to the table, and some are better at certain things than others.
  3. by   Mulan
    people are always spouting off about the big bucks that agency nurses make, not necessarily, some areas of the country they make big bucks, some places they make little more or less than a prn hospital position, I speak from experience
  4. by   suzanne4
    Quote from Mulan
    people are always spouting off about the big bucks that agency nurses make, not necessarily, some areas of the country they make big bucks, some places they make little more or less than a prn hospital position, I speak from experience
    And that is very true. The agency makes the big bucks, not always the nurse. And they are usually the same or quite similar to the Per Diem rates.
  5. by   AishaRN
    I just graduated from nursing school December 2006. I started a residency program for L&D/special care nursery in January and starting IVs is a skill that is needed fairly regularly. We were not given much instruction in school beyond practicing on a rubber arm and the rare opportunity to start a real IV on a real patient during clinicals. Sadly, I have a variety of preceptors and one of the preceptors was stunned that I had not come out of nursing school will a solid knowledge of this skill and made me feel absolutely ignorant . While I have had good success with other preceptors starting IVs and drawing blood, every time I attempt a start with this particular preceptor, I miss ... probably from her initial negativity.

    Please keep this in mind if you ever have to precept :spin:
  6. by   caroladybelle
    Quote from jamato8
    Interesting that you can start IV's on coworkers. An IV normally has to be ordered or part of the standing orders and to start one otherwise is practicing medicine without a license, in a normal situation. At least this is what I know to be fact where I worked.
    Prior to entering nursing school, I learned to start my first IVs. At that time (mid - late 1980s), people with AIDs often had difficulty finding HH nurses that would come out in off hours to restart IVs. And missing a few doses of ABX meant a death sentence. So some MDs/nurses taught friends of PWAs how to start IVs.

    In nursing school, my classmates and I practiced NS injections and IV starts on each other.

    For a while, some medical personnel got taught this skill for use in the battlefield - I don't know if they still teach this.
  7. by   moh_sir
    :spin:
    Quote from bluesky
    This is a touchy subject for me because I am an ICU nurse who always worked very high acuity ICUs where 95% or more of my patients had central lines or arterial lines that I could draw from, not to mention an IV therapy backup. I was always a bit of a wus about starting IV's because I didn't want to hurt my patients, and I always knew another nurse who was better at it and would start one for me. Mind you I have excellent assessment skills, I am great at many other tasks including difficult NG tubes and foleys and I have personally trained myself to almost a physician's level of knowledge in clinical. Yet this fear turned into a phobia and for 2 1/2 years I avoided IVs like the plague.

    Well, just one month ago I accepted a contract agency position in a cathlab. Little did I know I would be starting IV's all day long. At first, I was completely scared and reassured that they would fire me. Yet, the lord blessed me with some really supportive co-nurses who told me the same thing, each and every one of them (2 were ER nurses and one is a previous IV therapy nurse)... practice, practice, practice! It's been a month now and I'm not a certified expert yet but I definitely have improved a million percent! Fortunately they didn't second guess my other skills just because that one was lacking. In fact, I received a midterm evaluation with all "excellents".

    I am so happy and relieved that I was surrounded by people who believed in me and helped me gain the skill instead of tearing me down.
  8. by   moh_sir
    :spin: Every nurse has something they're very good at, and something they should know but are not so good at. I would rather a nurse tell me "I don't know how to do that" than say nothing and attempt a procedure with a sharp object:spin:
  9. by   chuck1234
    Not only the agency nurses...some of the senior nurses working in the ICU do not know how to do it either....
    As least that nurse is honest about it....
    As Moh_Sir just stated, he would rather hearing a nurse says that "I don't know how to do it" than pretending he knows what he is doing. Have you ever been sticked by a needle(gauge #20 or #18)? It is painful!!!!
  10. by   Maternity Girl
    Quote from TazziRN
    Yes, schools teach IV starts......but if you never use that skill because of IV teams, you're not gonna become proficient.

    He may have been able to complete the checklist when he was hired at the agency but that doesn't mean he's comfortable with his proficiency.

    No they don't. I went to nursing school in NJ and we were not allowed to start IVs or do IV push meds. We didn't even practice on fake arms. Whatever hospital you start at puts you through an IV certification class.
  11. by   SmilingBluEyes
    It obviously varies. My school not only taught IV skills, we practiced on each other and were required to take any and all opportunties in our clinical experiences to start them. I graduated in 1997.

    Like I said, it does vary by program and state.
  12. by   teeituptom
    IV starting is a skill
    all should know how
    but some at best will never be more than so and so at it
    some will become competent at it
    some will excel at it
    some like me become the Masters at it, sought after and admired by one and all.
  13. by   Nurse Beth
    I think being an agency nurse implies that you have some basic skills

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