Agency Nurse doesn't know how to start IVs?

[GardenDove]

Yesterday, a new agency nurse showed up in our ICU to fill a hole. He arrived 2 hours early to be oriented because it was his first time at our facility, so I set him to work on a few things while I was showing him around. When I was going to maybe need another line, and asked him if he'd like to start it.

He told me that he doesn't know how to start IVs because the place where he normally works has IV therapy. I can understand that because I had worked at a hospital with IV therapy and didn't learn to start IVs until I came to my present place of employment. Nevertheless, I was surprised that an agency nurse would lack that commonly used skill.

[General E. Speaking, RN, RN]

I first learned to start IVs back in the very early '90s in Paramedics' class -we learned by sticking each other in class. Understandably (imagine the potential liability issues this created) this is certainly not done today!

hehe, so did we! Only the hospital would only give us leftover supplies which included 18 ga needles!!. It's been 17 years and I'm still traumatized.

[newnicurn]

No that's not true for RN schools. I went to a well known school that's affliating hospital has an iv team and phlebotmy team. no ivs or blood draws for nurses. My job taught me how to do it. My job had the fake arm with very worn "veins". It still took me a while to get it down. On my busy meg surg unit sometimes you don't have the time to stick a pt, good veins or not. So your expierence can be limited.

[Reno1978, BSN, RN]

Please excuse my ignorance but don't they teach IV starts in nursing school for RN's?

Reading other responses, this seems to vary.

I'm currently in school and this is something we did practice on "the arm" and we're allowed to perform them on patients under the supervision of an RN.

[clee1]

I would not be so quick to judge or criticize. True that starting an IV is a basic nursing skill, but it is a skill that even some experienced nurses are not very good at.

I am reluctantly forced to agree.

I am a new nurse, with a license 1.5 months old, and just out of orientation. I work with a bunch of great nurses, but at least 75% of them are lousy IV sticks.

As a former paramedic, I am pretty decent with IV starts; rare is the shift that goes by where I am not asked to start a line for another nurse - and sometimes that number is three to four times per shift.

[scallisto]

I feel some of you are being quite rude about a "basic nursing skill". I am an agency nurse in Washington state and we were not taught in school how to start IV's. I was taught at my first place of employment. However, I switched jobs to a hospital where they have an IV team. The policy of the hospital was that only an IV therapy nurse could start an IV. Under no circumstances was a floor nurse even allowed to attempt to start one. I worked there for three years. Now I work for an agency and basically have to re-learn the skill. That does not mean, as an agency nurse, that I should be a 'DNR' (do not return). I pride myself on being a great nurse and love what I do and just b/c I am having trouble with IV's now does not mean I should not be working as an agency nurse.

[Antikigirl, ASN, RN]

I was not the greatest at IV's...but I learned a trick from a chemo nurse I have done and now I am doing them almost 90% first try!

What I do is just get that needle under the skin above my target vein...then I don't really advance as much as press the needle tip stright downwards till I see the flash...advance a millimeter or so and click the needle so it retracts. Now I have just the tip of the catheter in there, and time to float that into the vein with normal saline pushes till it is all the way in! My probelm was I was really using that needle to advance...but really you should just use it stationary if you can to just hit that vein get flash and proceed slowly with only the cannula! Man I am nailing them now! :).

Hope that is helpful to some folks..it has sure worked wonders for me!

[Chaoticdreams33, MSN, RN]

I am an IV Certified LPN and am going into an LPN-RN transition program. Please excuse my ignorance but don't they teach IV starts in nursing school for RN's?

They don't teach it at my school because all of the hospitals in the area require specific hospital based IV classes and certification (don't know if that's the correct term) to be allowed to start IV's on the job.

[newnicurn]

No that's not true for RN schools. I went to a well known school that's affliating hospital has an iv team and phlebotmy team. no ivs or blood draws for nurses. My job taught me how to do it. My job had the fake arm with very worn "veins". It still took me a while to get it down. On my busy meg surg unit sometimes you don't have the time to stick a pt, good veins or not. So your expierence can be limited.

[CVICURN2003]

I hate to start IV's on anyone...and I'm not very good at it. Most of our patients have a PICC or a central line. But I can recover an open heart pt, run CRRT and a balloon pump quite well, sometimes all at the same time....But, because I can't start an IV very well, my clinical skills stink?

[SharonH, RN]

I wasn't taught IV starts in school either; that is a skill that requires practice and if you are not going to be using it for sure, there's no point in wasting time learning it. And in my 17 year career, I've only worked in two facilities that did not have an IV team. It is quite possible for an experienced nurse to not have that skill and as far as I am concerned it is not a reflection of his or her competence.

[TazziRN, RN]

This thread is going off in another direction. I think we've all agreed that nurses should have some experience in starting IVs, but the OP said the nurse claimed the he didn't know how. That's different.

[angel337, MSN, RN]

i think there may be some bias where the agency nurse is concerned because agency nurses are expected to jump in as soon as they hit the floor. i am an ER nurse and i can't imagine an ER agency nurse not being able to start iv's, because just about every other patient that walks through the door gets an IV. when i worked agency it was understood that as a nurse working in a critical care area that i could do at least 95% of commonly used skills.. so yeah, its hard to be very sympathetic.