Alright to have your husband start an IV on your patient?

[Nurse Joey]

I just talked to a friend who told me she had her husband, who is a paramedic, come in and start an IV on her patient. She works in a LTC, the patient needed a transfusion, and no one could get the IV. She claims that everyone on the chain of command ok'ed it. My concern is that he doesn't work for that facility, and he was off duty at the time. God forbid something goes wrong with the IV and the family sues, or the state finds out. When I told her this she acted like I was from Mars and speaking in a foreign tongue. She sees nothing wrong with it, being as it was ok'ed by the doctor who wrote the order, and that he was working under her nursing license. Am I totally crazy?

[JStyles1]

I'm not too familiar with LTC places, but is it common to get a blood transfusion while at a LTC facility?

[jlcole45]

I don't have a problem with it. Thank God someone was able to start a line.

[wooh, BSN, RN]

Now that I absolutely would not feel comfortable doing.

I probably wouldn't either (if for no other reason than I wouldn't feel comfortable doing an IJ stick.) But I think my point is, we spend a lot of time second guessing, and coming up with reasons not to do things. And with the litigious environment we work in, that's to be expected. But sometimes, you've got to just say, "What is best for THIS patient, right NOW?" And it's not always the perfect solution.

I'd rather deal with the consequences of having a paramedic come in and start an IV at a facility he doesn't work at than let granny die. If I was a doc, I'd rather claim that I did a stick someone else did than let my patient die.

Sometimes the best solution, in the moment, isn't always perfect. If it's me or my family member being cared for, I'd rather the documentation be falsified and get good care, than end up in bad shape but the documentation be perfect.

Am I advocating for falsified documentation? For violating facility P&Ps? Of course not. I'm just saying, sometimes you do what has to be done. And I'm not going to burn someone at the stake for doing what needed to be done.

[CoffeeRTC, BSN, RN]

The LTC I worked in actually contracted with a pharmacy that had a staff person come and do hard sticks. I'm not sure what this guys educational background was.

What I really remember was that he was pretty cute and everyone got excited when he would show up. Probably why I don't know what his background was....

lol. We had a good looking IV nurse. They are all IV cerified nurses.

Yes, at one LTC I worked..we gave blood. IT was a PITA tho.

I'm thinking it depends on a lot of things. A lot of the paramedics that come to out place for transports know the pts and have been in for emergency transports or codes. Yrs ago I was having a hard time getting a line in on a pt in the next bed while the medics were dropping someone off. They offered to help, the resident said it was okay...They did it with me there.

Me, personally...Id rather have a medic start my IV than some nurses.

[Peetz, BSN]

"No one "works under" another nurse's license, by the way. That's a common misconception. As a nurse you may delegate specific tasks, and you are responsible for ensuring that those tasks are carried out appropriately. But the only one licensed to work by the nurse's license is the nurse, no one else."

Not true. I am a student nurse who graduates in June and while doing my practicum " work under" my CTA's license. I have separate insurance but her license gives me the " right" to do what is within my scope of practice as a student RN. Which is everything that is in her scope of practice as a licensed RN.

As for the Paramedic who started the IV, it is within his scope of practice and I am sure there was paperwork signed to the fact that he had privileges at the facility even if it was one days worth. If he is a licensed paramedic he is more than capable of starting one, regardless of his " duty" status. Is an " on duty" paramedic more competent than an " off duty" one? Facilities call in " specialists" all the time, how is this any different?

[RubyRN,CHPN]

If I posted is it alright to have a paramedic start an IV, then thats a different question. The only reason the paramedic came in was because it was her husband. Not her husband then it wouldn't happen. That's the root.

Alrighty then, I hear yea... I guess that does sound somewhat nepostistic. So the Nurse's husband does not extend his services to the other nurses at the facility to assist them or the other residents which then creates possibly a hardship or burden for them; then the facility allows this to happen....I get it.

I guess I am big into boundaries and work for a healthcare corporoation who has stict codes of professional conduct to insure that all pt.'s and employees have access to the same services and resources. No outside contracts are made with family or friends for personal benefit I have seen where this is lacking in private facilities. Some people just don't get it. I don't know if it is legal or illegal but rather just plain bad form. Yes, IMO it doesn't look right. If there was any legal issue, why would we want to give the lawyers any fodder. I guess if my loved one were in the bed next to Mr. Jones's and Mr. Jones got the service of a private paramedic for an IV start just because Mr. Jones's nurse couldn't start it and my loved one got treated to a 5 hour emergency room stay for his IV start and a huge ambulance bill because no one could start his IV and the paramedic was unwilling to extend his services to my loved one because his wife was not my loved one's nurse.....oh, lordy heads would roll. Fair is fair.

[TwilightRNurse]

Hummmmmm Mom/Grandma in nursing home, hard stick, Who do I want to start the line? Nurse that starts IV once a month, or a Medic that sticks daily?

Give me the medic!!

That's not the issue.

[MC1906]

It's important you were remember the original scenario. If the patient was that sick and needed the blood that bad, they should be in the hospital or getting the transfusion at an outpatient center. When you work at LTC, ALF, SNF,etc..there are so many laws and regulations that need to be followed. I just wouldnt have called someone who doesnt work for the facility. RISK MANAGEMENT issue!