Agency Nurse doesn't know how to start IVs?

[GardenDove]

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.

[caroladybelle, BSN, RN]

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.

[moh_sir]

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.

[moh_sir]

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

[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!!!!

[Maternity Girl]

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.

[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.

[teeituptom, BSN, RN]

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.

[Nurse Beth, MSN]

I think being an agency nurse implies that you have some basic skills

[btwabookandapillow]

"Each one Teach One"

[GardenDove]

Double post

[GardenDove]

I'm amazed that this thread is still going. Are IV skills, or the lack thereof, a controversial subject for nurses? I really never knew that.

[csiln]

I was taught how to start an IV - in school, on jobs, etc. BUT I have a 2 out of 21 failure record. I keep trying, but it just seems like a skill I can't master. If there's someone that can start an IV, why in the world would I stick a patient twice and then get someone else who could do it the first time? I don't get the hangup about everybody being able to do everything. Its about patient care and putting an already traumatized person through more pain when its so unnecessary.