Starting IV's or Insertion in Nursing Homes

Specialties Geriatric

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Hi i have been accepted in a nursing home/snf as a new grad or re-entry RN since i am a foreign nurse with not much of an experience and graduated a long time ago and this is my first job here in the US. I have a question with starting IV's, do nurses often start IV's in nursing homes? i am a bit worried coz, i know the steps on how to start a regular IV insertion but in my entire nursing career i have done it only a couple of times, the first one wasnt even successful, and they might expect me that i know how, can i ask for an inservice training from a nurse educator in our facility?, is that okay? the same with foley cath insertion, is it common in nursing homes, i am also not adept with this skill, coz with my very limited nursing experience i didnt really get to do it when i was in the philippines. I am a bit scared!!! The facility that ill be working in do IV's, some patients with G-tubes, but that's about it, they dont have a sub-acute area, who has residents with vents or the like. They will give an 8 wk orientation, hopefully that would include IV training, Foleys etc.

Specializes in ER CCU MICU SICU LTC/SNF.

Since you are hired as a new graduate, you will be trained as such. An 8-week orientation program is sufficient provided the employer sticks to the plan. If you have a written statement stating so, keep it in a very safe place. It is not unusual to cut short the orientation program in many nursing home facilities. Skills for all the procedures you have mentioned will be learned. You willl not be compelled to perform any procedure you have not been supervised.

I had colleagues who worked as Med Reps for several years without any nursing experience at all; came to the U.S. and had their first exposure in ER, OR, and Critical Care units. With adequate orientation, adapted so well in just a short period. Be proud of your nursing training. It will kick in spontaneously.

You can check the facility background you'll be working for...

http://www.medicare.gov/NHCompare/Home.asp?version=alternate&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True

Since you are hired as a new graduate, you will be trained as such. An 8-week orientation program is sufficient provided the employer sticks to the plan. If you have a written statement stating so, keep it in a very safe place. It is not unusual to cut short the orientation program in many nursing home facilities. Skills for all the procedures you have mentioned will be learned. You willl not be compelled to perform any procedure you have not been supervised.

I had colleagues who worked as Med Reps for several years without any nursing experience at all; came to the U.S. and had their first exposure in ER, OR, and Critical Care units. With adequate orientation, adapted so well in just a short period. Be proud of your nursing training. It will kick in spontaneously.

You can check the facility background you'll be working for...

http://www.medicare.gov/NHCompare/Home.asp?version=alternate&browser=IE%7C6%7CWinXP&language=English&defaultstatus=0&pagelist=Home&CookiesEnabledStatus=True

Thanks talino for your words of encouragement, its deeply appreciated. It helped lessen my fears. When i spoke to the DON during my interview, i think they really follow the length of the orientation program coz she said they will do a monthly assessment or consultation on me to check on how i am progressing in the training, what are my concerns, things like that, and that is up to 3 months, then after that i could be totally on my own so i could feel that they really care about their new staff and follow the very purpose of the newgrad/re-entry program.

Patients that require IV medications are not usually in nursing homes in normal situations, they are at least in a Skilled Nursing Facility (SNF).

Specializes in med/surg, telemetry, IV therapy, mgmt.

I've worked in nursing homes for many years. Since I was also an IV therapist for many years as well I took every opportunity I could to start or keep any IVs in the nursing home(s) going and to draw blood to keep my skills. My recent experience has been that any patients coming into nursing homes needing IV medications are usually coming in with PICC lines now. Also, any patients who we needed to start an IV on were pretty sick and almost always ended up being transferred to the hospital. Our pharmacy service had IV therapist RNs on call. If any of the nursing home nurses ever had a problem getting an IV started we only had to call the pharmacy service and they had one of their RNs come out to start the IV. When you go through your orientation program I would ask what the facility does if the nurses are unable to get an IV started on one of the residents. Having been an IV therapist for many years, I can tell you that an elderly dehydrated patient, which is usually when the doctor decides to order an IV, :uhoh3: is not the easiest to find a vein in!

I've been a nurse in LTC for about 10 years. Most of those years I've only worked prn or part time due to having kids. When it comes to IVs, I will have to admit, I stink at starting them. As a PP said,most res will come with a PICC or midline or a central line or port, so chances that I will have to start one are slim. I try every time I can and sometimes I can, sometimes I can't. Most LTCs will have an IV team thru the pharmacy that will be able to come out and start them.

An 8 week orientation sounds great (often unheard of in LTC) good luck and dont' worrry.

thanks everyone for your supportive replies and for giving info on IVs in LTC, i havent started yet, tomorrow i still have to do pre-employment physical then ill know when ill start, its a skilled nursing facility so they do have residents with IV.

I work in a SNF and when I started as the RN, we had to have several sticks with a RN before we were allowed (or expected) to do it on our own. With being trained for eight weeks, you will get practice starting IV's and putting in foleys. One of the things that I always did was if I was not sure or had not done it I was not too proud to ask someone to go with me. I remember the first time I had to change a G-tube I was a nervous wreck. I called my friend who was working another floor and was a LPN and asked her to come up and watch me/talk me through it. She laughed and asked, "Aren't you MY supervisor?" but was completely willing to come up with my while I did it. But she never let me forget about it!:lol2: I decided when I first took my position that I would rather ask for help than do something wrong. Good luck with your new job! You will do great!

Specializes in nursing home care.

In UK we don't fo IV in nursing homes. Can do sub cutaneous fluids but in 5 years, I have never seen it being used. Starting to get training in using syringe pump drivers (eg for morphine) but in my home it is still done my District Nurses coming in on call. I think the biggest problem over here is we can access training but rarely have the opportunity to get supervised practice.

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