Respiratory Therapists Inserting PICC Lines

Specialties Infusion

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Here in Arizona several of the hospitals have started an experiment, they are actively replacing PICC nurses with RTs and calling them "Vascular Access Specialists." These RTs will place PICC lines, midlines, and US guided PIVs. My local INS chapter has not issued an official statement about this and my local AVA chapter is fully supporting this with about half of the members being RTs.

Any thoughts on this? Has anyone seen this in any other State?

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

As an RN who has started art line it depends on facility policy. I have worked at facilities that allow the RRT to have broad rage of responsibilities and at some that restrict their scope of practice. It all boils down to the facility and the medical director.

As a nurse in a critical care area for 35 years.......I have worked with RRTs that I could not be without them as a member of the team. My issue with resp therapy inserting PICC lines is that they have other focus to their practice and IV therapy should not have to be one of them....they have enough to do.

As a nurse in a critical care area for 35 years.......I have worked with RRTs that I could not be without them as a member of the team. My issue with resp therapy inserting PICC lines is that they have other focus to their practice and IV therapy should not have to be one of them....they have enough to do.

I certainly agree that most RRTs have more than enough to do without having IV therapy added to their list of responsibilities; however, if it makes sense for a particular facility to train and credential an RRT to do PICC lines, I don't think it's inherently unsafe for an RRT to do that.

My point in responding to Lindarn's post was chiefly that I disagreed with her caricature of the RRT skillset and educational process and that scope of practice varies from facility to facility for all of us.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I certainly agree that most RRTs have more than enough to do without having IV therapy added to their list of responsibilities; however, if it makes sense for a particular facility to train and credential an RRT to do PICC lines, I don't think it's inherently unsafe for an RRT to do that.

My point in responding to Lindarn's post was chiefly that I disagreed with her caricature of the RRT skillset and educational process and that scope of practice varies from facility to facility for all of us.

I don't think it unsafe either....I would think it helpful as an adjunct......but should never precede their responsibility of intubation, Rapid Response, vents...etc
I don't think it unsafe either....I would think it helpful as an adjunct......but should never precede their responsibility of intubation, Rapid Response, vents...etc

Oh, goodness, no! I didn't become a respiratory therapist because I wanted to insert PICC lines. I wouldn't want PICCs to be the only thing I did, but if a manager made it clear that being credential to work as part of the PICC team meant I got more shifts or wasn't furloughed as often, I would certainly give it some though.

Our RRTs not only give treatments but ...do ekgs, do ABGs, run codes, etc...as they are all ACLS certed.

Do RRTs, who place PICC lines, charge for this? If so, there is a good reason that a hospital would pick RRTs to place PICC lines over nurses. I will bet, that if floor nurses were to start placing PICC lines, they would not be charging for this.

One of the main tenets of hospital administration, is that they DO NOT WANT NURSES TO BE ABLE TO PROVE THAT THEY BRING INCOME TO THE HOSPITAL!!

They prefer a nurses' profesional practice to ALWAYS BE ON THE NEGATIVE SIDE OF THE HOSPITAL BALANCE SHEET!! Rolled in with the room rate, houskeeping, and the complimentary roll of toilet paper.

By allowing RRTs, and/or, other departments to take over nursings professional practice, it keeps nurses, "barefoot and pregnant", so to speak. No worth at all, the only thing that they do is drive up the hospitals costs for salary and benefits.

Think about it. Just another way to down grade nurses, and continue to disempower us.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN(ret)

Somewhere in the PACNW

Nurses do PICCs at my hospital

I guess I don't understand why you'd pick respiratory to do a vascular procedure. It's not so much that they can't do it, but anyone can learn a skill.

It's more about keeping the skill sets within the professions that deal with them the most. In that keeping, RNs would be the most logical choice to train on PICC insertion and the most experienced with IVs and vascular access in patients and the unique problems that presents.

It's also about the fact that while PICC insertion is a skill, inserting a central line is not a low-risk procedure. While an RT has a lot of understanding with regards to respiratory, I would think an RN would have a much bigger picture of the anatomy/physiology involved and a more holistic approach to the procedure on the average.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

ABG's are a vascular procedure....I have worked where RRT's do a-lines for the units....it's all in the medical director.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Do RRTs, who place PICC lines, charge for this? If so, there is a good reason that a hospital would pick RRTs to place PICC lines over nurses. I will bet, that if floor nurses were to start placing PICC lines, they would not be charging for this.

One of the main tenets of hospital administration, is that they DO NOT WANT NURSES TO BE ABLE TO PROVE THAT THEY BRING INCOME TO THE HOSPITAL!!

They prefer a nurses' professional practice to ALWAYS BE ON THE NEGATIVE SIDE OF THE HOSPITAL BALANCE SHEET!! Rolled in with the room rate, housekeeping, and the complimentary roll of toilet paper.

By allowing RRTs, and/or, other departments to take over nursing's professional practice, it keeps nurses, "barefoot and pregnant", so to speak. No worth at all, the only thing that they do is drive up the hospitals costs for salary and benefits.

Think about it. Just another way to down grade nurses, and continue to disempower us.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN(ret)

Somewhere in the PACNW

Now I do agree with that....:yes:

Why would an RRT run codes? Doctors run codes. If no doctor, then RNs run codes. EKG techs do EKGs.

Why do you feel the need to embelish your skill set on a nursing website? We know better.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN(ret)

Somewhere in the PACNW

Why would an RRT run codes? Doctors run codes. If no doctor, then RNs run codes. EKG techs do EKGs.

Why do you feel the need to embelish your skill set on a nursing website? We know better.

Why wouldn't an RRT run a code?

What unique skill sets does nursing possess that, in the absence of a physician, only they are qualified to run a code?

Did you read any of the declaratory statements at the link I provided in an earlier post?

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