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 Oncology, Vascular Access.

Not where I work, thank goodness for our patients.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I do agree that Nursing could have made more of an effort to hold on to this source of hours for Nurses. But I've long since learned that at least ANA unions will gladly sacrifice what's best for patients, what's best for all Nurses, and what's best for Nursing as a profession in order to make a relatively small group of Veteran Nurses happy.

*** Man you NAILED it! SOoooooo true.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Double post.

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Yes, I agree, RNs are allowing themselves to be driven right out of business. We need stronger cohesion...somehow, some way, or why even spend the extra time, money, and agony to become one.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

I am shocked at the variability of practice out there when it comes to PICC lines. In my hospital only trained RN place PICCs. They can place PICCs without a physicians order. When a physician do "order" a PICC it is entered as a PICC consult. The PICC RN assess the patient's need for access and their suitability as a PICC candidate and decide of the patient would benefit from a PICC vs a mid line or simply using the ultrasound to place a couple of IVs. They a order lab tests like coags o CBC to determine a patient's suitability for a PICC.

We have 24/7 PICC coverage (PICCs are collateral duties). I am shocked that any management would allow their PICC RN jobs to become a 8 hour day shift gig.

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Specializes in critcal care, CRNA.
I am shocked at the variability of practice out there when it comes to PICC lines. In my hospital only trained RN place PICCs. They can place PICCs without a physicians order. When a physician do "order" a PICC it is entered as a PICC consult. The PICC RN assess the patient's need for access and their suitability as a PICC candidate and decide of the patient would benefit from a PICC vs a mid line or simply using the ultrasound to place a couple of IVs. They a order lab tests like coags o CBC to determine a patient's suitability for a PICC.

We have 24/7 PICC coverage (PICCs are collateral duties). I am shocked that any management would allow their PICC RN jobs to become a 8 hour day shift gig.

Our PICC team would get annoyed if you called around 530 because they didnt want to get off late. Didn't matter what the pt needed. I have seen similar attitudes from IV team nurses. Never been impressed with the IV teams I encountered. Some, in my experience, were just nurses who didnt want to want the floor and be nurses anymore. I'm sure it I different everywhere.

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Morificeko, That is a shame. Our team is more like PMFB-RN's, except we also check GFR. Just because a PICC is ordered does not mean they are a good candidate.

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Specializes in Oncology, Vascular Access.

The fact that Lynn and others so readily make it the vascular access nurses fault that all hours aren't covered is generalizing, stereotypical, horse pucky. As I have stated much more than once, many of us have begged to have night coverage, even work night coverage, only to be told "no" by our administrations.

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Specializes in Oncology, Vascular Access.

PMFB-RN: This is us too. Except that our Admin won't give us enough staff for nights.

I am shocked at the variability of practice out there when it comes to PICC lines. In my hospital only trained RN place PICCs. They can place PICCs without a physicians order. When a physician do "order" a PICC it is entered as a PICC consult. The PICC RN assess the patient's need for access and their suitability as a PICC candidate and decide of the patient would benefit from a PICC vs a mid line or simply using the ultrasound to place a couple of IVs. They a order lab tests like coags o CBC to determine a patient's suitability for a PICC.

We have 24/7 PICC coverage (PICCs are collateral duties). I am shocked that any management would allow their PICC RN jobs to become a 8 hour day shift gig.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Does not mean they are not out there. I never knew of any either until last year either. It is very nice to know someone can actually cite Indiana practice. It has been a huge uphill battle to convince governing bodies that LPNs can do so much more than they allow, given the chance.

PS- I absolutely love LOVE your doggy pictures. They have filled me with so much joy over the last year or two!

I love my baby..she is such a ham...William Wegman isn't a genius .....he just loves weimarners....LOL

I went to school in Indiana....Purdue grad here....lived there for a long time. Indiana has one of the more liberal nurse practice acts for LPN's that I have seen. I was stunned when I moved to New England and found out that they were essentially removed from acute care all together and had an extremely limited practice.

I think there is selfish motive in the nurse practice acts. They are set by RN's and advanced degree RN's. LPN's really do not have real representation. This is that push for higher education at the bedside...that club of exclusivity.... which will ultimately be our doom.

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Specializes in Critical Care.

Whether the order is written as 'place PICC' or 'PICC consult really makes no difference, it will get carried out the same way.

Just like everything else we do (and everything RT does) the appropriateness of all potential interventions will be evaluated based on their appropriateness related to the indication, and contraindications will be ruled out. It would be one thing if this basic premise was not already a basic component of RT practice just as it is in Nursing practice.

If the indication is "difficult IV start", it really makes no difference if the practitioner is an RN or RT, unless you think that trying an US guided peripheral IV first is out of the comprehension abilities of an RT.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Whether the order is written as 'place PICC' or 'PICC consult really makes no difference, it will get carried out the same way.

*** We changed it from order to consult because some of the doctors thought that since they ordered it we had to place it

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