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?
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.
We could have chosen to adapt to the changing needs of our patients, and in the process not only kept the FTE's we already have but actually add to them, although the way things are set up the best option for our PICC Nurses is to just surrender the role to another discipline. As it stands, when the PICC RN team is dissolved, this will require a restructure, which according to our union rules will have to include multiple other departments with M-F 8-5 shifts. Our PICC Nurses have enough seniority that they'll have no problem picking up other M-F 8-5 shifts on other departments (booting less senior RN's out of those departments in the process), so they really have no incentive to agree to working off hours as PICC RN's or even to argue that the PICC team should remain RN's, since their best option (as they see it) is to allow the position of PICC "RN" to go extinct, thereby forcing a restructure. They could have just applied for openings on other units as they became available if they didn't want to part of PICC team once it went to off-hours coverage, but they would then have to accept the openings as they were posted, rather than a restructure where they have far more choices of FTE's and schedules.
In my area at least, CV tech salaries are very similar to that of RN. While I don't doubt that my hospital in mainly interested in who can do the same job for the least amount of money, they've been more than willing to keep the PICC team primarily RN's, in the end they just need somebody to do it and the PICC team and the union made it clear that it wasn't going to be Nurses, so I can't really blame the Hospital for looking elsewhere.
In the end, PICC placement is a task, one that hardly encompasses the wide breadth of skills and knowledge that defines Nursing, so I don't see it as a huge blow to Nursing to lose something that really best falls under the role of a "Tech". I do however think that the profession of Nursing needs to be more progressive; we need to be more assertive in filling demands, but unfortunately Nursing too often seems more interested in avoiding more complicated tasks and roles, rather than moving into areas where we could increase our value.
Last edit by MunoRN on May 17, '12
great transcript of your discussion. i'm glad i ran across it. both of you bring up some very good points.
i have had the opportunity to work with some very good techs in an i.r. setting. they were/are very strong professionally, however, techs are not trained to deal with a lot of the intricacies that surround really sick people getting piccs.
to be fair, nurses that are placing piccs have usually worked in the trenches so to speak and are intimately familiar with seeing patients as a whole. what i mean by that is you can see a patient's info (age, diagnosis, medical history, medications, labs, current overall condition, body habitus, etc.) and you immediately know how all of these things are going to interplay with a line placement.
on one occasion, i was going to help with staffing in an i.r. and with placing piccs in a hospital that was affiliated with the hospital i work at. the tech placed the piccs at this hospital.
we grabbed the cart and ultrasound, etc and went to the icu to place a picc. i was just helping out opening things on the sterile field, etc. and tech placed the picc. super nice guy, but after watching that picc placement, i was like, no way.
the short story is that it's more than just a procedure or act. i walked away from that assignment.
i understand that hospitals need coverage etc. all things being equal, i'll take the nurse.
"in the end, picc placement is a task, one that hardly encompasses the wide breadth of skills and knowledge that defines nursing, so i don't see it as a huge blow to nursing to lose something that really best falls under the role of a "tech"."
like i said, great discussion, but this particular point made by munrorn above is completely contrary to my experience assessing for and placing piccs.
i have noticed similar trends in working in/around unionized hospitals and could not agree with you more.
Last edit by mandomania on Aug 7, '12
: Reason: clarify point.