Embarassing Q's that I don't want to ask my instructors...

[raindrop]

...I asked a coulple fellow students and they didn't know either, so I will ask you guys!

1) What is the difference between a Central Line and a Picc line? Why would one get ordered over the other?

2) When giving IV pushes, and you find that 2 drugs that you are about to push aren't compatable...it's acceptable to *only* flush before giving the second one, right? In my world, I flush before/after giving any med at all, even when it's compatable. It just seems to me that if you give 2 incompatable IV pushes right after eachother, and with only flushing, they will still work against eachother.

I will think of more embabrassing Q's later and ask my fellow students if they have any, but those are the 2 main biggies that puzzle me.

[z's playa]

Is Demerol and Gravol incompatable?

I overheard a nurse tell a pt she mixed them together but I also heard you can't. :)

[cannoli]

When you sample blood from a port/lumen, only use that port/lumen for blood sampling (ie drawing labs). The same goes for administering blood products. So you'll need to label your ports.

We used a book called Phillips, L. D. (2001). Manual of IV therapeutics (3rd ed.). Philadelphia, PA: F.A. Davis. It's a very dry, long read but LOTS of info about all types of IV stuff, peripheral and central.

Sometimes one or more of the ports will clot off, and then people use one port for everything because that's all they have.

[purplemania, BSN, RN]

The ports usually have different colors. In our facility we use the blue for fluids, white for meds or TPN and red/brown for blood. If there is a need to deviate from that pattern the ports are labeled and the info is passed along in report and put on the Kardex.

Please note that no one knows EVERYTHING. You are wise to get the answers you need.

[Mystery5]

It concerns me that you are unwilling to ask these questions of your instructors. Are they over-bearing? Are you afraid of looking stupid?

If the former is the case, then you need to speak to your instructors and/or their supervisors, as it is their JOB to answer your questions in a respectful manner.

If the latter is the case, then get over it. As a student it is your JOB to ask questions and learn everything you can. If you have a question about these things, I assure you that most of your classmates do as well.

Students and nurses who fear asking questions are a real concern to me. They risk doing things (often incorrectly) without understanding the rationale, rather than asking appropriate questions or asking for help. In our profession, this is very dangerous.

One of the frequent posters on the peds forum has a saying after her name that reads something like this, "By all means, ask the stupid questions. They are much easier to deal with than the stupid mistakes." I couldn't agree more!

I couldn't agree with this more. You HAVE to get over embarrassment over asking questions, because you will still be asking questions throughout your nursing career. I get nervous around new grads or new employees who aren't asking lots of questions.

If someone rattles off something in report that I don't know, I ALWAYS ask. I'll just blurt it out in report and what do you know, usually no one else knows either!!! So, then we'll try and find out.

So, here you are a student, totally new to the field, being barraged with a bunch of new info. Yeah, maybe the instructor said it once, but maybe you need to hear it again. I mean, you're SUPPOSED to be learning, for goodness sakes.

Frankly, some of these instructors are a little out of touch and rusty on their skills, so maybe they are covering up their own ignorance. We had a former nursing instructor who got hired at my small hospital. She had excellent credentials, and had worked ICU many many years ago, then had been a nursing clinical instructor. Well, she was not asking questions, was doing some questionable things, like she put a pitocin drip without a pump, made some big mistake with an insulin drip, but appeared to be trying to appear like she knew it all. Finally, she went to get a urine sample from a Foley and deflated the balloon instead. When she was told she needed more orientation, she up and quit. Her pride was getting in the way of her asking questions!

So, practise humilty and always ask questions!!! Speak up for yourself, be proactive in learning. Plus, you can always ask questions here, of course!!!:)

[Fun2, BSN, RN]

My opinion on questions:

"The only stupid question is one that is not asked."

...think I'm going to add that to my signature.

[UM Review RN, ASN, RN]

In our facility we use the blue for fluids, white for meds or TPN and red/brown for blood.

Please also remember to check the lumen size before you do a blood draw. Our hospital's policy is that the lumen must be a certain size or greater, else we cannot draw blood from it. There's usually a number printed right behind the port.

[JustMe]

The other difference between a central line and a PICC line is that a central line must be placed by a Doc. A PICC line can be placed by an RN. Our docs are getting soooo lazy now that they know an RN can put in PICCs!

I agree--no question is too stupid. Any nurse who thinks they know it all is DANGEROUS! Don't forget--we're all here for you to ask and get answers. So ask away! :)