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.

[GardenDove]

Agency nurses are like any of us. Many of them specialize just like we do. Why not see how things pan out before getting up in arms over lacking one basic skill? Maybe he is skilled in other areas that some lack. You don't know til you get to know him and how well he can do. Agency nurse does not equal "Jack of all Trades".

Did I appear 'up in arms'? I most certainly was not, and I don't think either of my posts on the thread reflected that in any way. I was just asking a question.

[GardenDove]

Ok, now THAT is scary. If a nurse is unsure or just does not KNOW a skill, I pray they DO admit it, and either ask for assistance or seek instruction -not just 'try' and fail, then ask someone else.

I have a lot more respect for those who admit their shortcomings than for those who don't, and will just try anyway. this isn't a puzzle you're trying to fit together, its someone who may suffer if its not done correctly.

I totally agree with this post. It's much simpler to be humble and honest about any skills we lack. Much less stressful than trying to fake it.

[billsilas]

I would have to agree with Floridaguy and nservice. Both comments are very accurate. One cannot judge skills without knowing the facts. The nursing shortage I think has contributed to this as well with what is being taught and what is not. The IV therapy teams created also contibute to this as well. I work in the Emerg and we have had to call the IV team and/or anesthesiology to get a line in someone. I would not criticize my colleagues in this situation as well. I do agree that this agency nurse should have taken some responsibility or at least shown an interest in learning this skill as well. One always has to remember that we are a team and not everyone possesses the same skills where one lacks skill there is another that excels. One has to manage these different skill levels between staff inorder to provide care. This agency nurse is very similar to the experienced nurse that has a hard time adjusting to changes in practice or whatever. It is unfortunate that nurses eat their own instead of sharing knowledge, so that lesser experienced nurses can grow. One would expect an agency nurse to be able to do IV's but there are many circumstances as to why he or she cannot.

[sayitgirl]

So I guess you really did not need the help to begin with ? Sometimes some help is better than none at all... Kindness to each other please, it goes along way. That same agency nurse may go out and advertise how kind your facility was to other nurses "that have IV skills". Sometimes agencies send the nurses that they have available to facilities. And remember not everyone is a ICU nurse nor wants to be...:kiss

[Overland1, RN]

When I was in Nursing school, they did not teach IV starts; had I not been an Advanced EMT, I would not have learned the best/easiest/most efficient ways to "do the stick" (including the use of a B/P cuff as a tourniquet). Now, I have been told that there is minimal education in the IV starts. I know some nurses who avoid the opportunity to do an IV, even on the patients with "garden hose veins". They call the ICU, House Supervisor, or Clinical Leader (clinical support nurse on night shift) to do it.

I teach IV skills to EMT's; the first IV class begins with a "Welcome to Plumbing 101", explaining the basic concepts. Infection control is high on my list; my students will start a clean IV every time or not do it at all...... no excuses. They learn who things are done a certain way and have to demonstrate their ability in a testing situation in class (as well as at the completion of the course). Once they have mastered the "rubber arm", they get to poke each other. If there are an odd number of students in the class, guess who is the "odd man in"...... you got it (me!) . To this day, I would not have a problem with any of my students (past or present) starting an IV on me or my family members.

I recall one of my students many years ago... a young guy (Brian P.) who was doing clinical rotation in my ICU; I ended up being his preceptor for an IV start that none of the nurses could get. Brian walked in and introduced himself to the patient, who gave permission for him to start the IV. He pulled up a chair, found a site, and nailed it the first time . Had another student later that year (Jim Z.) who did the same thing in the same ICU. Both came away with a new found level of confidence and that "kid at Christmas" smile that would not go away.

[RN93]

We have just started sticking our own IV's and are moving away from depending on IV therapy so much. Does anyone have any "tricks" to getting a IV started? I often get "flashback" but end up losing the vein.

[RedSoxRN]

Are you guys kidding me? Why is this an issue posted to this message board? I work with LOTS of seasoned ICU nurses that can't put in lines. It's not required. Doesn't anything more important happen in your life than coming home to complain about this trivial thing on the internet?

[SmilingBluEyes]

Garden Dove: You did not appear up in arms, per se, no. But you were obviously concerned enough to pose the question here. I said "Before you get up in arms" in my prior post, I believe. I did not assume you were there, yet. I just think when we bring on agency nurses, we might want to get to know them before we judge them competent or not. Cut them slack and see what happens. Too many agency and travel nurses are harshly and unfairly judged often, and are often also given the worst assignments by the "regular staff". I have seen this myself and I just want to remember, there is always more than one side to a story.

Since he is a "guest", sort of, on your unit, just try to be welcoming and help him get his feet on the ground wherever possible. If he is not working out, then you can always contact the agency and tell them why.

[jjjoy, LPN]

RedSoxRN-Are YOU kidding me? Why did you bother posting to the message board? Lots of people post things that sound irrelevant or dumb to another person. Doesn't anything more important happen in your life than writing a complaint about 'this trivial thing' on the internet?

Vent over

The OP had thought agency nurses were required to have certain skills in order to work agency. Then she met an agency nurse who didn't have a certain skill. So she asked if this were common. The response was that yes, it's quite common. I don't think it's ridiculous to assume that agency nurses would know how to start an IV, especially if every agency nurse you'd met before could start IVs. At least the OP made the effort to get more information instead of just assuming that the nurse was incompetent.

[SmilingBluEyes]

We have just started sticking our own IV's and are moving away from depending on IV therapy so much. Does anyone have any "tricks" to getting a IV started? I often get "flashback" but end up losing the vein.

Here you go, a site just for YOU:

http://www.enw.org/IVStarts.htm

good luck. It's indeed an art but can be learned with patience and practice.

[SmilingBluEyes]

IT would depend on what the agency requires as to what skills are expected. Like already said before me, there are nurses who work in hospitals where IV therapy teams do all of this. And also as mentioned, many ICU pts have central lines, so IVs are not always started there. Or they come up from the ED or surgery with an IV already in place. A skill not practiced is a handicap, but not lost. It can be regained with practice. But you have to have the opportunity to practice!

If the agency provided a nurse who could not start an IV, it surely would be helpful to know that first, yes. But their backgrounds vary, just like anyone elses' do. And skill sets very by place, too.

[SmilingBluEyes]

Are you guys kidding me? Why is this an issue posted to this message board? I work with LOTS of seasoned ICU nurses that can't put in lines. It's not required. Doesn't anything more important happen in your life than coming home to complain about this trivial thing on the internet?

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