Could Be Fired for IV skills.

[Caffeine_IV]

SHORT VERSION

I feel like my job is on the line because I'm not at 100% success rate for IVs. This is an outpatient rad center and part of a large hospital system. Would you transfer to another specialty or is there something I can do to be at or near 100% success?

LONG VERSION

It has been brought to my attention (via email) in my outpatient job that I am missing too many IV starts. I made a post back in September when I had a bad IV day but I haven't had a day like that since. Usually, I will need someone to start 1-3 IVs that I could not get after 2 tries.

I do not know what I can do to have a 100% success rate. I've been asked what will help me improve. I've read many tips on here and put them into practice but still can't get to 100%.

I get lots of practice and I have improved since starting from my view but it is not to their satisfaction. I'm thinking of asking to be transferred to a different area where this is not a factor because I don't think I will be at 100% start rate anytime soon. The other nurse that works here (has been a nurse over 20 years) and usually doesn't miss any.

I'm not a new nurse (6yrs) but I've started more IVs in this facility than I have in the past couple of years combined. At my bedside job, I rarely start them.

Overrall I would say I'm at around 75-80% success rate most days better than that. I am starting IVs on anywhere from 10-20 patients per day. I don't know what I can do.

[APRN., DNP, RN, APRN, NP]

You can purchase a little hand held machine ~ a "vein finder". Very useful, and your success rate will go up tremendously :)

[caliotter3]

When someone sends an email instead of speaking to you in person, they either don't have the gumption or time to speak to you or they want to start a paper trail or both. While I would try to improve to 80 to 85 or 90% success rate and decrease the stress of worrying, I also think that it would be a good idea to look into a transfer out of this department. I think the email complaint method would irritate and alienate me more than what they were complaining about, and I do not believe they are justified in criticizing you at this point. If you had been able to work on an IV team for a certain amount of time, I don't think any of this would be an issue. Good luck.

[Caffeine_IV]

When someone sends an email instead of speaking to you in person, they either don't have the gumption or time to speak to you or they want to start a paper trail or both. While I would try to improve to 80 to 85 or 90% success rate and decrease the stress of worrying, I also think that it would be a good idea to look into a transfer out of this department. I think the email complaint method would irritate and alienate me more than what they were complaining about, and I do not believe they are justified in criticizing you at this point. If you had been able to work on an IV team for a certain amount of time, I don't think any of this would be an issue. Good luck.

Thanks, I definitely want to improve. This is the first time my IV skills have been at the forefront of a nursing job.

I'm also frustrated because I also think that criticism should be given in person not via email. I don't know the tone in which this intended. Is it a warning? How many can I miss and still keep my job? Now I feel like staff hate when I'm the nurse there (I'm PRN) because of this.

If the manager had talked to me about it, I would have asked about even working in the ED just starting IVs and having someone observe my technique.

[Caffeine_IV]

As far as I know the only thing that improves IV skills is practice. There are days when even the most experienced nurse cannot get an IV. Most of the patients come to the hospital being NPO and are therefore dehydrated and thus makes it impossible to get an IV. It may not always be you or your skills!!! You can suggest an IV inservice from the IV team, or do some volunteer time in the lab so you can get practice sticking. I agree with the above posts that hardly anyone is ever 100% with IV sticks.

IVs may just not be my strong suit. I really don't think I'm that bad but if I'm not up to par for them, that is fair enough. I want to get better but I don't want my job to be dependent on me improving my IV skills to 99-100%

[JenERally]

I agree with previous posters; IV success percentage is relative. While there are basic IV skills to master, a large part of your success is going to depend on the patient's clinical status. The only way for your unit to hold you accountable to a certain "percentage" of successful IV starts is to develop an IV competency that everyone has to demonstrate a certain numbers of times to be signed off.

[TheCommuter, BSN, RN]

You can purchase a little hand held machine ~ a "vein finder". Very useful, and your success rate will go up tremendously :)

My workplace has a 'vein finder' machine, but my technique is still subpar. My IV start rate is only about 50 percent. I am simply not a hands-on person.

[imintrouble, BSN, RN]

I've never heard of measuring a nurse's performance on one skill.

I don't know a single nurse who's 100% on IV sticks.

I've never seen a nurse be fired for being "bad" at IVs.

Of all the things a nurse can and can't be fired for, missing a vein wouldn't make it to my top 50 list.

If I can't get an IV started I ask another nurse for help.

None of us are perfect alone, but together we're 100%:)

[jadelpn, LPN, EMT-B]

Go to your local fire department, and/or the local ambulance company, and see if you can sign up to take some courses/ audit some classes from Medics on IV starts. They often require large bore IV's inserted in the least awesome conditions (a moving vehicle) and they can perhaps give you some of their pointers.

In the most ideal circumstances, an 18 or 20 gauge in the right hand only is really NOT IV skills that will take your anywhere but a surgical center. Most of the time there's a lot more of a choice on the best site as opposed to one site only common in pre-op.

[JenERally]

I've never heard of measuring a nurse's performance on one skill.

My unit actually started doing this recently. A few "expert" people

with the most experience put a competency outline together, and everyone has to be observed by one of the observers placing 3 successful IVs using the competency skill set. Once you place 3 IVs successfully, you're considered competent and don't have management focused on your success percentage.

[Here.I.Stand, BSN, RN]

Ask the ones sending you the emails if you can practice IV starts on them. Then they can critique as you poke:cheeky:

Brilliant!

[Caffeine_IV]

I've never heard of measuring a nurse's performance on one skill.

I don't know a single nurse who's 100% on IV sticks.

I've never seen a nurse be fired for being "bad" at IVs.

Of all the things a nurse can and can't be fired for, missing a vein wouldn't make it to my top 50 list.

If I can't get an IV started I ask another nurse for help.

None of us are perfect alone, but together we're 100%:)

I agree, but in this case I have to ask CT staff to start the IV. From the email, this is posing a problem as we are getting more patients. They will be too busy with there things so I NEED to ask them as less as possible. That's the impression I got from the email.

So I'm there to start IVs and because they need an ACLS nurse in the building. My manager is not a nurse.

I've not heard of being fired for this specifically either but I have been terminated before and I know how it starts.

[Caffeine_IV]

Go to your local fire department, and/or the local ambulance company, and see if you can sign up to take some courses/ audit some classes from Medics on IV starts. They often require large bore IV's inserted in the least awesome conditions (a moving vehicle) and they can perhaps give you some of their pointers.

In the most ideal circumstances, an 18 or 20 gauge in the right hand only is really NOT IV skills that will take your anywhere but a surgical center. Most of the time there's a lot more of a choice on the best site as opposed to one site only common in pre-op.

Thanks those are good options but above and beyond what I will do for this PRN job. I can't guarantee that I won't miss more than 2 IV starts on a particular day.

I'm in a RN-BSN program that is consuming a lot of free time as well as my other PRN job. It won't guarantee my position and if I'm expected to be 100% after taking a class or two, I won't last anyway.