Could Be Fired for IV skills.

Published

Specializes in LTC, med/surg, hospice.

SHORT VERSION

I feel like my job is on the line because I'm not at 100% success rate for IVs. This is an outpatient rad center and part of a large hospital system. Would you transfer to another specialty or is there something I can do to be at or near 100% success?

LONG VERSION

It has been brought to my attention (via email) in my outpatient job that I am missing too many IV starts. I made a post back in September when I had a bad IV day but I haven't had a day like that since. Usually, I will need someone to start 1-3 IVs that I could not get after 2 tries.

I do not know what I can do to have a 100% success rate. I've been asked what will help me improve. I've read many tips on here and put them into practice but still can't get to 100%.

I get lots of practice and I have improved since starting from my view but it is not to their satisfaction. I'm thinking of asking to be transferred to a different area where this is not a factor because I don't think I will be at 100% start rate anytime soon. The other nurse that works here (has been a nurse over 20 years) and usually doesn't miss any.

I'm not a new nurse (6yrs) but I've started more IVs in this facility than I have in the past couple of years combined. At my bedside job, I rarely start them.

Overrall I would say I'm at around 75-80% success rate most days better than that. I am starting IVs on anywhere from 10-20 patients per day. I don't know what I can do.

Up Vote Up Vote ×

Is there a skill lab you can go to with the hospital?

Up Vote Up Vote ×
Specializes in Psych ICU, addictions.

Maybe take an IV/phlebotomy course?

Up Vote Up Vote ×
Specializes in NICU.

There is absolutely, positively no way to be 100% accurate with IV starts. There is always the little old ladies that have the tiny, fragile veins that blow no matter how slow you run the fluid. I have seen ER nurses with 30 years experience and done thousands of IV starts struggle starting IVs on random people. Nobody can be 100% accurate. If your issue is that you need help on 7 out of 10 IV starts, then that is an issue. If they are complaining that you need help on 1 or 2 per day then they are asking too much.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

I looked into going around with the IV team when I first started and that was not an option.

The IV course at the local community college is only done certain months and the next not available until February.

I feel like I need someone to just observe me start IVs the entire day but I also fear that won't help if it's a "good" day where I miss 0-1.

Up Vote Up Vote ×
Specializes in HH, Peds, Rehab, Clinical.

Ask the ones sending you the emails if you can practice IV starts on them. Then they can critique as you poke:cheeky:

Up Vote Up Vote ×

The bottom line is.. does your employer feel your success rate is adequate now?

No one has a 100% success rate. If this is stressing you to the point you feel the need to move, than you must make that move.

There are many things that make a good nurse, IV starts should not be the end all be all.

Up Vote Up Vote ×
Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.

totally agree with what Don1984 said.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.
The bottom line is.. does your employer feel your success rate is adequate now?

No one has a 100% success rate. If this is stressing you to the point you feel the need to move, than you must make that move.

There are many things that make a good nurse, IV starts should not be the end all be all.

Starting IVs is the bulk of this position so I should be good at it and I thought that I was doing well. I do have off days and I try to help the staff in other ways so we don't get behind. But with the pressure to not miss any, I think I will actually do WORSE.

I'm at a loss of how to respond to the email and I wish the manager had come to speak with me personally. There isn't a one thing that can make me better at IVs to my knowledge.

Up Vote Up Vote ×

"I wish the manager had come to speak with me personally."

Exactly. The manager needed to speak with you in person, identify the weakness and provide ways you can improve. ( wonder how good the managers IV skills are).

Request a meeting to discuss the problem. Ask how you and management can work on this identified weakness.

Again, if starting IV's is the "bulk" of the position... where are you using the "bulk" of your many other nursing skills?

I would not want any position that hinges on a manual skill.

Up Vote Up Vote ×
Specializes in LTC, med/surg, hospice.

I feel at this point, if they would allow a transfer to another open PRN or part time position within the system I will do so. It seems like I'm being discussed or complained about behind my back and they had the other nurse email to voice their concerns instead of speaking to me while I'm working.

And I don't need to have the pressure of "can't miss more than 2 IVs or else" hanging over me each shift.

Thanks for the input.

Up Vote Up Vote ×

As far as I know the only thing that improves IV skills is practice. There are days when even the most experienced nurse cannot get an IV. Most of the patients come to the hospital being NPO and are therefore dehydrated and thus makes it impossible to get an IV. It may not always be you or your skills!!! You can suggest an IV inservice from the IV team, or do some volunteer time in the lab so you can get practice sticking. I agree with the above posts that hardly anyone is ever 100% with IV sticks.

Up Vote Up Vote ×
+ Join the Discussion