Do all hospice patients now have IV's?

[Blackcat99]

I worked as a hospice LPN in Washington state for 2 years. None of my patients ever had IV's in the 2 years I worked. I have now moved to Florida. Hospice nurses in Florida need to have a 30 hour IV certification class. Why?

Do all the hospice patients in Florida have IV's now? Is this a new trend or what? What about other states? Are you required to have the 30 hour IV certification class? How many of your hospice patients have IV'S?

[leslie :-D]

I work inpatient hospice and MANY of our pts have iv's , its one of the concerns with employing lvns as in our facility they cannot do iv meds. And the IV allows for a more peaceful death, IV's are not simply for fluid admin. which we rarely do .......it allows more control of their pain as well as more successful symptom mgt for pts with acute issues which if they are in are facility they are there for either symptom mgt of nausea , pain crisis ect......

that's my experience as well.

most of our pts have iv's, too...

r/t their acute issues that necessitate immediate responses.

with inpatient, i would say that iv cert is a must.

these folks don't have a chance of a peaceful death, until we get their symptoms under control.

and that requires iv access at all times.

frankly, iv's are the least of their problems.

leslie

[tewdles, RN]

When I worked for a hospice which did not run an IPU, I frequently started and cared for IV patients in the field. Now I work for a hospice which also operates a good sized IPU...so IVs in the field are rare. This makes perfect sense as the patients needing IVs are often either actively dying or having some symptom exacerbation/crisis...so the continuous nursing presence is needed.

I cannot say how thankful I am to work in this environment...and to have my skilled peers in the unit! It is not easy to start and maintain a peripheral IV in an acutely ill and dying person...in my current position I can arrange a transfer into the unit within the hour. The largest percentage of that hour being spent preparing the patient and family for the trip. It is much better hospice care and is a more efficient use of resources.

Field nurses must be able to access and work with ports of all types...if they put them in cancer patients you will see them. Subcutaneous infusions are common...but IVs not so much in the field if you have an IPU.

[Blackcat99]

Thanks all so much. Yes, IV's for inpatient hospice patients who are having trouble getting pain and or nausea relief sounds good to me. Now, it is starting to make sense to me about the IV certification. I am hoping to do private duty hospice 1:1 in the patient's home so I probably won't have any IV's.

[AtlantaRN, RN]

we have iv's in the field, but it's becoming more rare, thank goodness. most pts are managed with suppositories and sl roxanol, atropine, etc. easier to handle in the home expecially for an on call nurse with a wide coverage area.

[tencat]

IPU I think it's perfectly appropriate to have IV's, but not so much in the home setting.