Being undermined in front of patient

[deefizzle]

Today we had a situation at our urgent care center where we had to send a possible NSTEMI out to the ER. We have a very limited staff (one doc, one RN, one MA, one xray tech and one lab tech) so we need to work together very quickly. While I was preparing meds, the lab tech was initiating the IV. They allow this at my center as long as the tech does not flush the line or push meds. When I went to apply the extension tubing, I primed it as I always do. The lab tech (in front of the patient and family) says "You're not supposed to do that until its connected to the patient". I very quickly said "I needed to prime the line" and went about my business. I'm very upset that he undermined me in front of the patient. He is the lab supervisor so he knows his stuff and is very knowledgeable in his field. But I feel he overstepped his boundaries when it came to nursing practice. The worst part is I think he feels he was right and I was wrong. I know I should talk to him about it, at the very least for educational purposes, but I'm hesitant. Advice please?

[Here.I.Stand, BSN, RN]

Since you typically trust him as one who knows his stuff, is it possible in all that activity that he saw the NS flush and thought you were pushing a med w/o the tubing connected?

On one hand I get feeling undermined, but on the other hand think of pre-procedure time-outs, anyone involved is supposed to say something to the surgeon. It's not considered questioning medical practice.

I guess since you consider him generally knowledgeable and not some clueless know-it-all, I'd be inclined to give him the benefit of the doubt. I'd ask him what he meant by his "correction." Then if he was actually in the wrong, take a moment to educate him on why we shouldn't connect air-filled tubing.

[iluvivt, BSN, RN]

Have you checked the law in the location you are practicing or could you share that please. Since inserting a device that will stay in the body it is considered invasive and a license is generally required. You are correct in that any add on devices should be primed prior to connecting to the VAD. You are not only preventing air from entering into the vascular system it serves to check the tubing for any defects such as crack that can create an air source and cause the IV site to back up.As far as the tech goes I would take him aside and inform him of the reasons why this step is needed and how you would like to be approached in tbe future as to not undermined in front of a patient.

[Lev, MSN, RN, NP]

If this is a one time situation then your response is adequate. Let it go OP. However, if this type of undermining continues, have a face to face chat with him.