Are RNs allowed to arterial stick at your hospital?

[Deetail]

I find that it's a lot easier to draw blood with an arterial stick on some patients with invisible/rolling veins. I know it's pretty common for nurses to do it in ICUs, but what about in other fields?

[PMFB-RN, RN]

I have never heard of RNs being forbidden to do art sticks for ABGs or blood draws. RNs also place art lines where I work but only selected few who are trained and can do enough to maintain competency.

[TU RN, DNP, CRNA]

Art sticks for routine daily labs? Can't frequent radial arterial phlebotomy cause vasospasm and potential peripheral vascular compromise? I'm pretty new so somebody with more experience could correct me, but I would hope that Allen's test is written into the policy of facilities permitting that sort of regular radial access.

[VANurse2010]

Only RTs can do arterial sticks where I work, but nurses are allowed to draw from an arterial pressure monitoring line if the patient has one. Only anesthesia providers may insert the arterial lines.

This is actually how it works at my hospital also. If the patient already has an art line, then the nurse may draw ABGs and labs off them. However, at my community hospital, art lines are only seen in the ICU. I'm not sure who puts them in - my stint in the ICU didn't last that long!

[Jolie, BSN]

Art sticks for routine daily labs? Can't frequent radial arterial phlebotomy cause vasospasm and potential peripheral vascular compromise? I'm pretty new so somebody with more experience could correct me, but I would hope that Allen's test is written into the policy of facilities permitting that sort of regular radial access.

Thank you for a clear, concise answer to Deetail's question. The immediate need for ARTERIAL blood is the only acceptable reason to perform an arterial stick. And regardless of NPA or hospital P&P, it is never acceptable for a nurse to independently perform a procedure unless trained and competent to do so. In 27 years, I have never worked in a facility that didn't require return demonstrations of invasive skills, including arterial sticks. Anything less would not be defensible in the event of a complication.

[applewhitern, BSN, RN]

Yes, we (RN's) have done arterial sticks for blood gases everywhere I have worked. We would only use an artery for anything else if there was simply no other way to get blood. Remember, however, that arterial sticks can be dangerous. A patient can lose a limb. You would need to know how to perform the Allen test first, and most places don't want you to stick anywhere except the radial.... I have known of a patient who lost their arm due to a brachial artery stick. When I worked PICU, the RN was the only person allowed to stick the child's artery. Now I work at a facility that lets the laboratory personnel perform this task! Everyplace has their own P&P.

[PMFB-RN, RN]

Art sticks for routine daily labs? Can't frequent radial arterial phlebotomy cause vasospasm and potential peripheral vascular compromise? I'm pretty new so somebody with more experience could correct me, but I would hope that Allen's test is written into the policy of facilities permitting that sort of regular radial access.

I can't imagine anyone doing art sticks for ROUTINE daily labs. Never heard of that or seen it done. We do art stick for labs in the ER and ICU in critical situations where the need to get the labs back quickly outweighs the risk AND other acess is delayed or unavailable. Occasionaly I will draw routine labs from an artery if I need to do a stick for an ABG anyway.

[sistrmoon, BSN, RN]

Only RTs draw them at my facility.

[VANurse2010]

I can't imagine anyone doing art sticks for ROUTINE daily labs. Never heard of that or seen it done. We do art stick for labs in the ER and ICU in critical situations where the need to get the labs back quickly outweighs the risk AND other acess is delayed or unavailable. Occasionaly I will draw routine labs from an artery if I need to do a stick for an ABG anyway.

I would think if access is that difficult, then the patient should probably have a midline or central line.

We do art sticks for ABGs and, in a pinch, for STAT labs if a venous source isn't readily available and an IV (ultrasound placed or EJ) isn't necessary.

[Anna Flaxis, BSN, RN]

We can do it for ABGs.

[SummitRN, BSN, RN]

RNs can do them... typically RNs always leave them for the RTs to do. I try to do art sticks as often as possible to keep my skills up. Plus the RTs love it when they don't have to.

We do art sticks for ABGs. You can get your other labs from that ABG stick. Nobody goes about doing arterial sticks for other lab draws except as a measure of extreme last resort. Unless there is an art line in place to draw from...

[KelRN215, BSN, RN]

I have never heard of RNs being forbidden to do art sticks for ABGs or blood draws. RNs also place art lines where I work but only selected few who are trained and can do enough to maintain competency.

We were not allowed to when I worked in the hospital. As far as I know, only the MDs did art sticks and only anesthesia placed arterial lines. Similar to what another poster stated, if there was an existing arterial line, RNs could draw off of it but only in the PACU or ICU as these were the only places where art lines were left in. If we had a patient that was transferring from the ICU to the floor and he had an art line which was used for his q 4hr labs or whatever, it had to be pulled before he came to the floor... and then we got to be the mean people who said "now we will stick a needle in you q 4hrs for your labs."