Why does a hospital need RNs which are unable to do anything else but starting IV's?? - page 2
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Feb 12, '02I got to be very good at starting IV's. In neuro, you get to practice on the old, dried-up population. Another thing is to use a BP cuff instead of a tourniquet, and sometimes nothing at all in the elderly. If you have it too tight, those older veins just blow.
I worked in a hospital with an IV team from 6a to 6p. They are the BEST. Never, never sitting in the caffeteria waiting on a call - they get in the office early, set up their supplies and that's often their ONLY break during the day. We were supposed to get all the IV's in that we possibly could, and only call them if we'd tried and couldn't, if we were afraid that our trying would ruin the only site available, or if the patient specifically asked. But you know a lot of people just got soooo busy and called for IV team so she could carry on with everything else.
Incredible bunch of nurses. Once I was in the cafeteria on my lunchbreak and heard a code called at the main elevator. I ran there, and an IV nurse had been closer and that IV was IN there before more than a couple of other people even were close.
Another time, one of my patients was going bad, and I only had a 20 gauge IV in him. IV nurse came in and asked if I wanted a bigger site - "I saw people running and I thought you might need me."
Why in the world would you want people like that putting people on bedpans??? And I don't think the IV nurses should hook people up to setups at the bedside - It would take too much of their time to look for THAT order and check the tubing, etc., etc., etc... Let them do what they are incredibly good at.
Feb 14, '02Well, it's now February and I must say that I have greatly improved my IV skills. I had an experienced RN watch me and she then told me what I ws doing wrong. Since then I have gotten most of my IV starts! What a relief! It's just something that takes time, practice and patience! Thanks to everyone for thier helpful hints!
Feb 24, '02I have worked as a travling nurse with and without Iv nurses. Are they a god send NO. Yes while everyone is not mr/ms supernurse with i.v.'s it takes practice and confidence to do it. I was taught in the Navy and was told one rule of thumb. After doing 100 your an expert. Its a degration of nursing as a whole as new nurses will not get a chance to try I.V.'s they will let the iv team do it for them and allow them to limit thier abilities as a nurse.
Are they helpful? depends. The few who i have met were nurses who help 10 to 15 years of senoirity at the hospital and let me tell you they wouldnt lift a finger to do ANYTHING outside of thier job discription... I had one tell me they wouldnt start a Iv on a patient with chest pain until they had a written order by the md ont he chart....
are they useful.... well they reasons for Iv team were to decrease med reactions from infiltrated Iv's, perpheral infections and complications from iv thearpy. But instead of challanging the floor nurses with training and encouragin better performance or giving them the staffing they need to do te job properly they created the Iv nurse who removed the iv from the scope of practice of the nurse. Its common everywhere in the US to remove skills from the scope of practice in order to increase the care given to the patient .....and its a bad practice
Feb 24, '02Ok...here is a something I haven't seen mention yet. I showed another newbie IV starter this trick, which I'm sure most of the experienced IV starters had used or know of.
Just as someone has already pointed out...have someone with poor viens...warm the area. If starting in the arm start at the hand and work up. If you do a AC put it on a arm board, or prepare to run in the room frequently for a beeping pump. In an emergency....yeah go for the AC. Another site can be started when there is more time, and that one capped off until time to change sites. Ok ...here's the trick that has rarely ever failed for me. Hook up a syringe of NS...when you get a flash..push NS and push the cath forward slowly. It's called "floating" it in. The nurse I showed this to...listen to someone else...and started trying to start without "floating" it in, and would miss everytime. When she would "float"...she never missed. I rarely use "floating", anymore...except when I have someone who is dehydrated. The b/p cuff is an excellent way to try also...and remember to lower the arm. I have worked in many different areas where I had to be quick starting IVs, and I rarely had to stick more than once.
But even so...I LOVE having the IV teams where ever I go. In places where they weren't I noticed a lot more pts. with outdated sites, infiltrations, and outdated tubing. They also help in hospitals where the RN is the only one who can change CL sites.
I think every nurse should be able to start a line...and I believe it should be part of the orientaion process. In some hospitals it is. Like it has been said...being good at it takes practice...and some people will always be better than others at it...as in any skill. But don't let that frighten you away from increasing your skills. I don't mind starting an IV for anyone who asks....but what I don't like is the ones who ALWAYS ask, and haven't tried for themselves yet!Last edit by Brownms46 on Feb 24, '02
Apr 27, '02I know that this is an old thread, but I just thought of another IV technique I learned on my own.
You know those people with very large, engorged veins that seem to pop as soon as you get the IV in. I found that using no tournaquet at all works really well with these people (as long as the vein is not sclerotis). The IV slides right in and you don't have the back pressure of blood leak around the site of insertion.
If the patient insists that you must uses a tounaquet, then put it on very loose. Works like a dream.
Jun 4, '02We dont have an IV team. But to be honnest I would be sad to loose the chance to do them since it is a challenge that I like. And when I really have to do blood work I am confortable doing it because I have a lot of practice and proper technique. I guess you can save time with such a team but....no, I prefer going without!!!
Jun 4, '02Since our hospital switched to the retractable-needle IV cannula, we've all had to re-learn technique. The rep (HAHAHAHAHA - almost wrote REPTILE!) assured us these needles were sharper, "much sharper than those you've been using." While I wholeheartedly appreciate the protection value of our retractable, the rep's statements translated to: "You won't feel the POP anymore when you hit the vein." As Radiology Nurses, we start 20+ IVs a day in CT, most "first time, every time"- EXCEPT after we switched IV needles! We found ourselves doing in two and three tries what we'd previously done in one. FRUSTRATING for us AND our pts. It was SO HARD to start the IVs without feeling that POP! We even had the rep come out to critique our technique (and we certainly verbalized our dissatisfaction w/product -- too late, contract already signed, etc.) and offer suggestions: What are we doing wrong???? We did improve but it took 2 - 3 months till I noticed improvement for myself. Anyone else have any stories about same??
Jun 5, '02DianaH,
I know exactly what you're talking about. They switched on us and all the nurses hate them. Luckily for the patients the OR and Anesthesia Department still have a rather LARGE stash of caths. hidden and they won't tell where they are and it just eats management up!
Jun 5, '02We do are own IV's but we do have an IV team for PICC's and midlines. Plus the get the ones with no veins. They have a nice little ultrasound machine. I work in a county hospital so needless to say we get all the drug addicts with no veins but the IV nurses seem to find them.
Jun 5, '02My hospital has a very small IV team -- have downsized over the years. All units place their own IVs -- IV therapy is called for the most difficult sticks. I'm a vascular nurse & get most of my sticks. If I can't feel a vein, I'll have a co-worker check. Only as a last resort do I use the IV team. They place PICCS & do PICC dressings. I'm certain it's a matter of time before each unit has a designated "PICC person" on the unit -- I'm quite sure I'll be elected since I seem to have good luck (actually good technique and practice practice practice.) I do like placing my IV sites -- can start an IV site & have the labs drawn when admitting a patient before the IV therapist can get to the floor. But in a difficult "stick" I've found their contribution invaluable. Less sticks/better patient satisfaction.
Jun 5, '02Originally posted by dianah
Since our hospital switched to the retractable-needle IV cannula, we've all had to re-learn technique. The rep (HAHAHAHAHA - almost wrote REPTILE!) assured us these needles were sharper, "much sharper than those you've been using." While I wholeheartedly appreciate the protection value of our retractable, the rep's statements translated to: "You won't feel the POP anymore when you hit the vein." As Radiology Nurses, we start 20+ IVs a day in CT, most "first time, every time"- EXCEPT after we switched IV needles! We found ourselves doing in two and three tries what we'd previously done in one. FRUSTRATING for us AND our pts. It was SO HARD to start the IVs without feeling that POP! We even had the rep come out to critique our technique (and we certainly verbalized our dissatisfaction w/product -- too late, contract already signed, etc.) and offer suggestions: What are we doing wrong???? We did improve but it took 2 - 3 months till I noticed improvement for myself. Anyone else have any stories about same??
Jun 5, '02Do any of you use local anesthesia before starting IVs in tender spots (underside of wrist, thumb, finger, etc) - when no other site is available --or for pts who are allergic to needles? I don't use it for every IV I start but it has REALLY helped me when I'm starting IV on sites/persons mentioned above. I feel it does increase success rate, as pt isn't squirming and tensing up. Most of the time they react as the vein is accessed, and by the time they react, the cannula is already threaded.
Re: the new retractable IVs: yeah, we were mandated to switch (OSHA) and as I said, I am all for safety changes with US in mind (!!) but wow, the transition was rough! I'm pretty much back up to snuff with success rate, tho', and glad of it.
Jun 5, '02Originally posted by Chuckie
We had an IV team years ago we really didn't need them.