EJ venapuncture by an RN

meownsmile, BSN, RN · Oct 31, 2004

I dont even know if my state does. Dont really care, cause im not doing it. I'll leave it to the anesthesiologist to do. That is usually what we get when we end up having them come in for a stick noone else can get, and im just fine with them doing it.

BittyBabyGrower, MSN, RN · Oct 31, 2004

The only ones that do for us are the NP's that put in PICCS.

Trauma Columnist · Oct 31, 2004

In Illinois, RNs can place external jugulars. These are NOT considered central lines so that is why it is included in the nurse practice act.

tiredfeetED · Oct 31, 2004

Do we do it on a regular basis..NO...do I do it..yea... But the ED is different. Pt comes in with no iv BS is 15..... There is a nice EJ...Head down, line in and amp of D50. The Docs know your skills and if there too busy they would expect it from you. There are alot of medics that become RNs and have these extra learned skills. There have been times when a nurse has tubed a child because of a doc not being able to tube.

ageless · Oct 31, 2004

to clarify, I am asking only about blood draws from the ej... not placing a line. Do any of you use this route for routine labs? thanks for your responses.

RNMedic1977 · Oct 31, 2004

In California an RN can perform Venipuncture and blood draw from the EJ ONLY when the facility you are employed at has a Standardized Procedure (SP) for RN's performing EJ Venipuncture/Phelbotomy (the facility can decide the title of the SP). This must be in writing (Policy)and approved by your hospital, AND any RN who performs this procedure must show documented COMPENTENCY in performing an EJ. Other examples of SP's are: "SP for the Treatment of Anaphylactic Shock", an SP that would allow the RN who has completed the compentency to start an IV, and give Benadryl and Epi without a physician's order. There are many different SP's out there, and they are written so the RN can perform certain procedures that are out of her scope of practice otherwise.

In Calif (and probably many other states) performing an EJ is OUT of the RN Scope of Practice:uhoh3: ....so if you are performing EJ's without that Standardized Procedure, STOP :nono: that practice until the proper SP for performing an EJ are set in place!

Hope this info helps!!

ageless · Oct 31, 2004

thanks it does help.

I witnessed a registered nurse do this last week and I was shocked by her comment that it was considered just another peripheral stick so further cert. was not necessary.

:uhoh3:

any other states have positions on this?

Trauma Columnist · Oct 31, 2004

Illinois - except that my hospital does have a policy about training prior to performing this task. I do not routine use it for venipuncture...arterial is much easier! By that I mean do an art stick - radial artery preferably.

bobnurse · Feb 25, 2005

thanks it does help.
I witnessed a registered nurse do this last week and I was shocked by her comment that it was considered just another peripheral stick so further cert. was not necessary.
any other states have positions on this?

Well its not a "Peripheral" stick being its in the neck........Although there is very little risk with attempting to access the E.J. vein, it does require training. Ive seen a few nurses accessing the I.J., thinking because its dilated that its the E.J. when actually it was the I.J.

In a Code situation, if you cannot access the A.C., the EJ is your next choice.......Not the finger veins many are looking to.

begalli · Feb 25, 2005

We will call our flight nurses if we have a hard time finding a peripheral line. If all else fails, they will start an ej. Also, the flight nurses will replace radial art lines for us (mostly on night shift) so we don't have to make the resident come out of their sleep room to do it.