Quote from mcmike55
Let's face it, we do stuff now, that nurses 10, 20 years ago wouldn't have thought of.
Exactly. Remember when PICCs first came out---for a while there, only docs were inserting them. Now, the surgical residents who used to be so eager to do them consider it scut work, and RNs routinely do them--even in home infusion. Of course, there are classes that one can take and a learning curve associated with inserting a PICC skillfully, but I don't believe there is any national standard requiring one to be "PICC certified," unless INS has recently instituted one. Same thing with doing EJs for peripheral access---as long as you use proper technique and follow the proper precautions, and have been trained and know your anatomy and physiology, AND your state nurse practice act and institution allow it, there is nothing particularly mystical or complicated about EJ access for a peripheral line.
In fact, I know a plastic surgeon who routinely has his office cosmetic surgery nurses do EJ access for his sedation technique utilizing Ketamine & Valium. By using the EJ, the Valium doesn't burn. (Why he doesn't just use Fentanyl and Versed in a peripheral IV in the arm is beyond me, but I digresss...maybe he's just been using this technique for many years, and is reluctant to mess with what's been a tried and true technique for him.) Of course, I am certain he has a CRNA or anesthesiologist for more complex procedures and/or ASA 2 or above patients, when the Katamine/Valium technique is not an option.
Lest you think he is doing something shady or wrong, he is also an inspector with AAAASF, and frequently shuts ambulatory surgery facilities down for unsafe practices.
I remember, too, in the late '70s when RNs were not even allowed to inject NS (we used to use iced NS, back in the day) into a Swan to get a cardiac output--that was a doc's job in some places; preferably a pulmonologist or anesthesiologist. Same with wedging the Swan. Now, RNs do it without a second thought, and have for--what--over 20 years now?