Why does a hospital need RNs which are unable to do anything else but starting IV's??

Specialties Infusion

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Do 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.

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Specializes in Community Health Nurse.
Originally posted by Chuckie

We had an IV team years ago we really didn't need them.

I would love being an IV nurse because I love to stick people! :chuckle I know....a sickness I guess. :chair: It's just that I'm so darn good at it, so why shouldn't I be the one doing the sticking! :D

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Originally posted by PhantomRN

I personally love the IV team. It frees me up to do other things while they find a vein and stick em. At our hospital most, not all, of the IV team will hook up a patients antibiotic or IV line if it is all set up in the room for them. Which is nice.

I don't expent them to do patient care for me. I figure they did their time on bedside nursing and are now IV team and they dont have to help me. It is nice of them if they want to do it, but it is not in their job description, at least at my hospital.

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Girl, I would have loved to have had an IV team anywhere in the 18 years I did hospital nursing. Even in the last two years I spent on the floor(disabled) we were trained to put in PIC lines. Well, if you have a team you have to have someone cover for up to an hour. You don't think the nurse who has the patient is goin to watch yours as she has her own load. It is difficult especially on 3-11 as we had a minimum of 7 patients and were pulled away. It wasn't fair to the staff on my floor either. It would always work out that the "super" supervisor was detained and the patient needed it yesterday. When I first started on the floors the first night I had several horrors. The first was I could not aspirate a subclavian and notified the doc. He said the first thing you don't say "push it in about an inch or so" NO WAY I had my first call to the supervisor and she told me to dc the site. Then I had a 90+ bilateral AKA who went over the side rails and pulled everything out. It looked like there had been a massacre there was so much blood. I didn't think someone had that much. I got good at putting 18s in little ol ladies. The last patient had yelled the entire week. Then on Sunday evening at 4A I noticed something but not sure what. It was QUIET. We all went rushing in and she had an apical of 35 by doppler. All in a shifts work. And I wanted to be a nurse You betcha I miss it so much. There have been days that I have just cried because I missed my repeat offender patients and their families. The floor I worked on was respiratory so they had no veins and diabetics and with the flopping of sugars you need a line. Well, why is it always when you need it it has been either pulled out, not working or never had one.

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Howdy neighbor, I wish we still had an IV team but I don't remember having one from the time I started at Worstoff in 89. It was the staff nurses who were taught how to do a medline and PICC and access an infusaport. Jest Perished still has a team from 6a I think till 10p That way they change all the medlines every 5-7 days depending on the patient.

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Since we didn't have an IV team one of my cachetic patients on mimimal IV fluids 1gtt/24hrs it seemed had to have a site according to his attending. By the way I wouldn't send a dead animal to him or he would swear it was alive and further revive. Anyway, we did all the sticks we were allowed so we then called the idiot and he said if we couldn't get it to call anesthesia to put it in. Well, anesthesia came up and put a 24 in walked out of the room and submitted a bill for over $500. The anesthesiologist also do not know how to tape a site down so that it doesn't come out. Well, it wasn't long, less than 24 hours and the same thing. Anesthesia refused. The attending told the family that we were basically for lack of a better word killing him since he did not have an IV line. His next patient in her mid 40s was getting loopy by the day. Well, the tech went in and asked her some questions while she had a moment and from her family she had what was probably the sign and symptoms of a UTI and she had become septic. Well, with her loopy he ordered a neuro, psych, and any other consult he could. There was never an order on admission for a urine. The tech spoke to him about it as we want whatever is best for the patient and no way could it be a UTI at her age she would still be with it. Well, one of the consults came in and I didn't see him so the tech approached and asked about getting a UA and C+S. Well, the consult didn't want to get involved with the attending by ordering it. He gave in and ordered it. In a coupleof hours we had a Bacti count of 4+ and too numerous to count. The idiot again was called for antibiotics and he said he would see her the next day. In the mean time she is getting worse. Once the antibiotics were started within 36 hours she was completely back to normal and at 48 discharged home. Where do we get these idiots? He comes in to see his patients at 2 am. He from what we have heard is in the office till 8p, goes home with the family for a while and when the kids go to bed he does his rounds. The cologne is enough to kill anyone.

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

Hmmmm, sounds like you needed a good PICC line or someone to donate veins, and just let that guy stay home or whatever! (and I know what you mean about the cologne!!!! WHEEEEEWWW!!)

Actually, I posted about LOCAL anesthesia - injecting about 0.1cc sub-Q (a little wheal) just where you'll enter the skin w/the IV needle.

What an experience w/the anesthesiologist! Most of ours are VERY helpful (we use a lot of CRNAs too) - and very busy.

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Dianah,

On our L & D unit we have standing orders that we can use Lido prn for IV starts. I've never used it, I'm afraid it's gonna obscure the site. Sometimes the patients ask for it. I usually say they're gonna feel a stick either way, might as well get it done in just one poke instead of 2. Most people are fine with this. Anyone use Lido routinely?

Anita

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Originally posted by anitame

Dianah,

On our L & D unit we have standing orders that we can use Lido prn for IV starts. I've never used it, I'm afraid it's gonna obscure the site. Sometimes the patients ask for it. I usually say they're gonna feel a stick either way, might as well get it done in just one poke instead of 2. Most people are fine with this. Anyone use Lido routinely?

Anita

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Anita, I have used lidocaine in the past and have also been on the other side of it as a patient. I have found that it burns much more than the discomfort of a stick and unless someone really needs to use it I don't as it can cause vascular spasm at the site, cause the vein to roll. I would personally not have it done to me and state so if I am able to.

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

That's interesting, Disabled, about the lido causing vascular spasm. The Radiologists maintain that, as well as numbing the site, the lidocaine helps prevent spasm when they're getting access for an angio. I have to go research it now!!

I certainly wouldn't use the lido if a patient wished me not to, and I don't use it on each and every IV start. I do offer it for the more painful sites/more frightened pts, and then I warn them about the stinging/burning (talking to them the whole time, to help distract). I've received positive feedback from the pts I've used it on; wouldn't continue using the lido if I got negative feedback from the pts.

As for obscuring the site, I inject only 0.1cc or so, just a TINY wheal, to numb the skin entry. Some pts do feel when the vein is accessed (I don't numb THAT much, that deeply).

Great BB, to be able to exchange ideas/info/experiences.

Cheers! -- Diana

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I find my IV team semi helpful. As an ER nurse there aren't to many people that I can't get a line in...and most of the time if someone in our department can't get the line then the IV team usually doesn't get one either. But they are a big help in accessing portacaths and such when pt's with that access come through the door and they are able to wait rather then us trying to find a vein that is good enough to use since there poor veins are usually destroyed.

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