Never placed an IV!!!!!

Esme12, ASN, BSN, RN · Jun 17, 2012

Thank you......Nursing school and hospitalizations back then was a world apart from how it is now. (except for the stress level)
I don't get any exposure to recent grads in my current path, so that is why I was quite shocked to see nurses graduate now with so much less practical experience.

Sadly......They get very little. It started dropping dramatically in the early to mid 90's. Many graduate without ever putting in a foley or dropping an NGT. This is what has lead to the hospitals right now not wanting to hire new grads as they require so much training and guidance for at least a year. Then they leave after they get that "year under their belt" for bigger and better things.

Many facilities now require participation in new grad residencies....and some facilities are charging the nurses for them! with no guarantee of a job when you are done. They get a RN to pay them for orientation with no promise of a job. The problem? There are so few residencies they fill and had extensive 2 year or more waiting lists. Shameful really.

The minute you mentioned diploma graduation for you I realized what you were referring to.....that animal thankfully doesn't exist anymore.

Hang out.....check out the forums. Much has changed. Peace

:paw:

PrimaFacie · Jun 18, 2012

Sadly......They get very little.
The minute you mentioned diploma graduation for you I realized what you were referring to.....that animal thankfully doesn't exist anymore.
Hang out.....check out the forums. Much has changed. Peace
:paw:

-Yes, it is very sad that they get very little hands on experience.

-I'm not sure why you say what you do about Diploma grads. The only drawback was the additional length of time to complete the program, but the hands on clinical experience was unmatchable. Diploma grads came out as competent, skilled professionals.

-I haven't been out of nursing, just not in a position where I see new grads.

Esme12, ASN, BSN, RN · Jun 18, 2012

-Yes, it is very sad that they get very little hands on experience.
-I'm not sure why you say what you do about Diploma grads. The only drawback was the additional length of time to complete the program, but the hands on clinical experience was unmatchable. Diploma grads came out as competent, skilled professionals.
-I haven't been out of nursing, just not in a position where I see new grads.

My only excuse is age related Brain flatus............ :bugeyes:

That little voice inside my head typed..... :lol2:

"The minute you mentioned diploma graduation for you...... I realized what generation you were referring to and the hospitals as they were then with the separate wards.....that animal thankfully doesn't exist anymore." My bad...

I agree....Diploma grads were the best skilled graduates skill wise and that type of grad does not exist anymore in any program but the isolated diploma program. I was an early ASN grad myself, from a program that was literally moved from the hospital and had it's offices placed on the college campus.....Poof! college course college degree. My sister was a diploma grad. Compared to the all programs today........ The amount of time outside the lab time I had to spend was tremendous.

I remember having to show up at clinical at 4 am to help the night nurses prep all the patients pre op or having to have to go to the OR early to put in all the Foley's and NGT's. Still have clinical and go to the campus for the evening nursing lectures....4 days a week. We even had to "work weekends" for school clinical...much like the diploma grads.

I didn't mean to imply you were out of nursing........I meant look at all the new grad chatter and nursing school chatter to find out how much school and taking their boards have changed. I know I was suprised about many of the aspects especially they can take the boards multiple times.

A vast difference from "our day" :loveya:

PrimaFacie · Jun 18, 2012

My only excuse is age related Brain flatus............
A vast difference from "our day" :loveya:

Sorry, didn't mean to put you on the spot, but thanks for the clarification.

I'm a little sorry for the new grads of today because they get less experience, yet twice the hassles from admin, and at least 5x the worry of litigation and/or co-workers throwing them under the bus. Nursing is difficult enough without all the new worries.

Horseshoe, BSN, RN · Jun 18, 2012

hmm...i've not seen an IV placed above the elbow.
I recall as a student that i stuck a patient and didn't get flashback and my preceptor took over and didn't get flashback either....and then someone spoke up and said "try his hand."
i said, "no, i'll let you do that." Hand = nerve damage = lawsuits.
Not something I was willing to do as a student.

From the way you've been posting, I'm surprised that you've never seen an IV placed above the elbow. Yes, they are placed above the elbow, in the breast, often on the scalp of infants.

You can start an IV on the hand with no problems. The areas most vulnerable to nerve damage are the radial and median nerve. At my facility, they start IVs in the hands all the time. The center has never once received a complaint of nerve damage nor a lawsuit ever.

From "Caution: Nerve Injuries During Venipuncture" by Sue Masoorli, RN:

The two nerves most often injured during a venipuncture procedure are the radial and median nerves. The radial nerve passes along the thumb side of the arm, from the shoulder down into the wrist area, and is in close proximity to the cephalic vein. In a venipuncture procedure, the cephalic vein is often the vein of choice for many clinicians. The distal three inches of the radial nerve, just above the thumb, is the area most often injured during the insertion of peripheral IV devices.
The median nerve is the largest nerve in the arm. It runs inside the antecubital fossa and passes through the forearm into the palm of the hand. When nurses are drawing blood from the antecubital fossa or inserting peripheral IV devices, they could contact and injure this nerve. Insertion of IV catheters into the superficial veins of the inner aspect of the wrist above the palm of the hand can result in serious injury to the median nerve and carpal tunnel syndrome.

BuckyBadgerRN, ASN, RN · Jun 18, 2012

I prefer to do my IV starts in hands, that way if you blow it, you can move up! I've done plenty above the a/c---great veins up there on many people.

As a pt, I prefer the hand as well =)

minnymi · Jun 18, 2012

From the way you've been posting, I'm surprised that you've never seen an IV placed above the elbow. Yes, they are placed above the elbow, in the breast, often on the scalp of infants.
You can start an IV on the hand with no problems. The areas most vulnerable to nerve damage are the radial and median nerve. At my facility, they start IVs in the hands all the time. The center has never once received a complaint of nerve damage nor a lawsuit ever.
From "Caution: Nerve Injuries During Venipuncture" by Sue Masoorli, RN:

i've seen IVs in the scalp. when a poster mentioned "above the elbow" i assumed they meant on the ARM.

i didn't feel the need to mention PICC lines that are "above the elbow" either since that is different than an IV. i *thought* it was implied that we were talking about simple IVs on the arm.

Horseshoe, BSN, RN · Jun 18, 2012

I've seen many IV's started in the arm above the elbow. It's certainly not the first place you start; it's probably where you go when you can't find anything in the hand/forearm. But not all that uncommon in my experience.

Esme12, ASN, BSN, RN · Jun 18, 2012

Sorry, didn't mean to put you on the spot, but thanks for the clarification.
I'm a little sorry for the new grads of today because they get less experience, yet twice the hassles from admin, and at least 5x the worry of litigation and/or co-workers throwing them under the bus. Nursing is difficult enough without all the new worries.

No spot.....It's all good.....I would rather someone ask than think I meant something else and have hurt feelings. I've been a nurse for 34 years ALL at the bedside in the Acute care arena....I've got a pretty thick skin.

I feel bad for them as well and the school not preparing them makes the transition from student to nurse so very hard.

RNsRWe, ASN, RN · Jun 21, 2012

.....
ATTENTION EVERYONE!!!!!
Just for the record......I remember "indigent wards" and every facility had them. Those patients were treated differently. The units were staffed differently. They looked different....almost barren. They had no families to protect them. They were homeless, from the "Poor farms", or orphanages.

It was the ONE thing I HATED about nursing when I started.

I stand corrected........those things did happen.
They were wrong then and they are wrong now. I remember my 1st year nursing instructor persuading me to stay because I told her if this was nursing I wanted out! The "wards" were separated by Insurance, "Private Pay", government pay with separation of medicare and medicaid....and the indigent....no pay.
For all you who don't remember these times.....THIS REALLY HAPPENED. It was horrible.

Ah, but you are willing to state that it WAS wrong then and IS wrong now, which puts you a considerable step ahead of those who not only don't recognize that is was wrong, but continue to defend the practice as not being unacceptable even today.

Sadly, some don't realize what some of us would call a deficiency in human decency. But I am glad that you obviously do!

PrimaFacie · Jun 22, 2012

Ah, but you are willing to state that it WAS wrong then and IS wrong now, which puts you a considerable step ahead of those who not only don't recognize that is was wrong, but continue to defend the practice as not being unacceptable even today.
Sadly, some don't realize what some of us would call a deficiency in human decency. But I am glad that you obviously do!

A deficiency in human decency?? Because someone has different ethics than you about something that does no harm, does not make them a lesser human being.

For people who are so up in arms about something that still exists today in medical schools, let me ask you; do you ask a physician before letting him treat you or a family member, if he learned procedures on corpses? And were any of those corpses unclaimed bodies? Would you refuse to use that physician if so?

Who is harmed by this process of using dead, unclaimed bodies to train medical professionals?

I remember one fabulous doctor who was also training on such bodies to perfect a skill in reconstructive mouth surgery, and now is one of the foremost cleft palette surgeons in the world, doing hundreds of free procedures a year for children who's parents can't afford to repair that defect. Does he have a "deficiency in human decency "? Did you miss the part about the bodies being dead?

I take issue with the testing/experimention on live bodies. For example, in todays news, these victims of forced sterilization: North Carolina Sterilization Compensation Plan Blocked | TPMMuckraker

or the victims of syphilis testing: Tuskegee syphilis experiment - Wikipedia, the free encyclopedia

In those two examples, people were harmed.

The learning on dead, unclaimed bodies is also used for crime scene training. They are allowed to decompose on "body farms" to teach CSI workers about stages of decomposition. This leads to better investigation and solving murders, which can help to remove dangerous people from general society where they can cause harm.

Is it not more humanly decent to strive to protect and help the living?

I truly believe that any of those unclaimed bodies, (in their spirit sense), would have been thrilled if they were able to contribute to helping society through the use of their body, which they no longer needed, and were no longer using. (similar to transplants)

I take extreme offence to your scandalous statement about "a deficiency in human decency" and hope the guides remove your comment as it is beyond insulting and is extremely hostile.

julianp · Jun 22, 2012

My school taught IV placement and I put a few in during clinicals. However, that was two years ago and I haven't done any since. I'm thinking it's a perishable skill because I remember the basics but I'm not sure I could put one in now.