arterial line insertion by OR/PACU nurses

Feb 28, 2005 09:38 PM

by jrgrad1912

Does any other hospitals have staff RNs that start art lines for anest?

What is your policy? Do you have special training? We had one RN who started art lines and she is leaving. Anesthesia and the surgeons are on the rest of the PACU staff to start art lines.

sharann · Feb 28, 2005, 11:39 PM

NOPE.
NO WAY.
UH UH.
Unless you are a CRNA or MD. Unless there is some rule I have never heard of.
Do you need to risk your licences for the surgeons and CONVENIENCE? They will bill for the procedure you perform by the way.

shodobe · Mar 01, 2005, 12:00 AM

Way beyond scope of practice. I agree with sharann, you get the blame and the MDs get to bill. If there is a rule I don't know about I would like to see it, we have Resp Techs and ER nurses who draw ABGs but I am not sure where "starting" an A-line falls.Mike

stevierae · Mar 01, 2005, 12:00 AM

Originally Posted by sharann

NOPE.
NO WAY.
UH UH.
Unless you are a CRNA or MD. Unless there is some rule I have never heard of.
Do you need to risk your licences for the surgeons and CONVENIENCE? They will bill for the procedure you perform by the way.

I think that most RNs who have worked at one time worked in ICU--and that includes many, if not most, PACU nurses-- are accustomed to doing arterial sticks to obtain blood gases---hence, no reason why those RNs should not do insert art lines.

In most hospitals, RT techs can insert art lines.

Now, most OR nurses haven't been trained, unless they worked as RT techs or in ICU. That's why anesthesia does it--and, in teaching hospitals, there are CRNA and anesthesiologist residents falling all over themselves to start the art line (or whatever big line they want to insert.)

But, heck, if someone is trained and qualified, why not? More power to them. I like to start my own IVs whenever I can, even though we have anesthesia to do so---I could care less about billing. I have my own agenda, and that is keeping up my OWN IV access skills. If anesthesia lets me start his IV, he's doing me a favor--he isn't taking advantage of me. (I am not trained to do arterial sticks and wouldn't volunteer.)

cwazycwissyRN · Mar 02, 2005, 11:27 PM

[quote=stevierae]I think that most RNs who have worked at one time worked in ICU--and that includes many, if not most, PACU nurses-- are accustomed to doing arterial sticks to obtain blood gases---hence, no reason why those RNs should not do insert art lines.

In most hospitals, RT techs can insert art lines.

Now, most OR nurses haven't been trained, unless they worked as RT techs or in ICU. That's why anesthesia does it--and, in teaching hospitals, there are CRNA and anesthesiologist residents falling all over themselves to start the art line (or whatever big line they want to insert.)

Not really understanding what you are saying here. I do not know any ICU or PACU RNs that start artlines.........are you just saying we are capable of doing it?

stevierae · Mar 03, 2005, 02:29 AM

[quote=cwazycwissyRN]

Originally Posted by stevierae

I think that most RNs who have worked at one time worked in ICU--and that includes many, if not most, PACU nurses-- are accustomed to doing arterial sticks to obtain blood gases---hence, no reason why those RNs should not do insert art lines.

In most hospitals, RT techs can insert art lines.

Now, most OR nurses haven't been trained, unless they worked as RT techs or in ICU. That's why anesthesia does it--and, in teaching hospitals, there are CRNA and anesthesiologist residents falling all over themselves to start the art line (or whatever big line they want to insert.)

Not really understanding what you are saying here. I do not know any ICU or PACU RNs that start artlines.........are you just saying we are capable of doing it?

Yes, I believe so---if as an ICU nurse you are capable of doing an arterial stick (to obtain blood gases) why couldn't you take that one step further and thread a line into that artery?

Think about it. I have heard nurses say that they can't draw labs because they are not phlebotomists and have never been trained in venipuncture---but what the heck do they think peripheral IV access is, if not venipuncture?! If you can start an IV, you have been trained in venipuncture. Same goes for art line insertion--if you can do an arterial stick, why wouldn't you be able to start an art line?

But, you're right--why should you, when there are highly paid anesthesia providers sitting around? I feel exactly the same way about doing conscious sedation--I won't do their job and take on the additional responsibility for what I get paid.

jwk · Mar 03, 2005, 12:26 PM

Originally Posted by stevierae

Same goes for art line insertion--if you can do an arterial stick, why wouldn't you be able to start an art line?

There's a good bit more morbidity associated with arterial catheters than IV catheters. It's a different technique.

Whether one is able to (or thinks they are) or not is not the question. The question is should they be, or is it within the acceptable or legal scope of practice.

*Marie_LPN, RN* · Mar 03, 2005, 12:48 PM

Anesthesia starts the art line.

cleothekat · Mar 28, 2005, 01:43 AM

Hi,
I work in a non teaching hospital in the Med/surg ICU. We can place art lines if you get certified through the hospitals class. It really comes in handy to have one or 2 nurses who can place your line especially in the middle of the night when there are NO physicians available or willing to come in to place it. I think it is a great added task to your resume and skills list.

mcmike55 · Mar 28, 2005, 04:44 AM

Art lines

In our small rural, non teaching hospital, only the docs start the art lines.
I'm not sure I've ever heard a nurse say they'd like to try.
Though, some would probably do a better job than some of the doc!!

RT does art line sticks, when the pt does not have an art line.
RT or the RN will draw ABG'S when a line is already in place.
I suppose there is no reason that an RN, properly trained could not start a line. Let's face it, we do stuff now, that nurses 10, 20 years ago wouldn't have thought of.
We start all the IV's for anes.docs in the OR holding area, they come out and do the art lines.
Not sure what the Ohio BON would say, but right now, I'd say it's out of our scope of practice.
But, hey, never say never

Mike

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arterial line insertion by OR/PACU nurses

arterial line insertion by OR/PACU nurses

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