Agency Nurse doesn't know how to start IVs? - page 3

Yesterday, a new agency nurse showed up in our ICU to fill a hole. He arrived 2 hours early to be oriented because it was his first time at our facility, so I set him to work on a few things while I... Read More

  1. by   Reno1978
    Quote from charebec65
    Please excuse my ignorance but don't they teach IV starts in nursing school for RN's?
    Reading other responses, this seems to vary.

    I'm currently in school and this is something we did practice on "the arm" and we're allowed to perform them on patients under the supervision of an RN.
  2. by   clee1
    Quote from NurseguyFL
    I would not be so quick to judge or criticize. True that starting an IV is a basic nursing skill, but it is a skill that even some experienced nurses are not very good at.
    I am reluctantly forced to agree.

    I am a new nurse, with a license 1.5 months old, and just out of orientation. I work with a bunch of great nurses, but at least 75% of them are lousy IV sticks.

    As a former paramedic, I am pretty decent with IV starts; rare is the shift that goes by where I am not asked to start a line for another nurse - and sometimes that number is three to four times per shift.
  3. by   scallisto
    I feel some of you are being quite rude about a "basic nursing skill". I am an agency nurse in Washington state and we were not taught in school how to start IV's. I was taught at my first place of employment. However, I switched jobs to a hospital where they have an IV team. The policy of the hospital was that only an IV therapy nurse could start an IV. Under no circumstances was a floor nurse even allowed to attempt to start one. I worked there for three years. Now I work for an agency and basically have to re-learn the skill. That does not mean, as an agency nurse, that I should be a 'DNR' (do not return). I pride myself on being a great nurse and love what I do and just b/c I am having trouble with IV's now does not mean I should not be working as an agency nurse.
  4. by   Antikigirl
    I was not the greatest at IV's...but I learned a trick from a chemo nurse I have done and now I am doing them almost 90% first try!

    What I do is just get that needle under the skin above my target vein...then I don't really advance as much as press the needle tip stright downwards till I see the flash...advance a millimeter or so and click the needle so it retracts. Now I have just the tip of the catheter in there, and time to float that into the vein with normal saline pushes till it is all the way in! My probelm was I was really using that needle to advance...but really you should just use it stationary if you can to just hit that vein get flash and proceed slowly with only the cannula! Man I am nailing them now! .

    Hope that is helpful to some has sure worked wonders for me!
  5. by   Chaoticdreams33
    Quote from charebec65
    I am an IV Certified LPN and am going into an LPN-RN transition program. Please excuse my ignorance but don't they teach IV starts in nursing school for RN's?
    They don't teach it at my school because all of the hospitals in the area require specific hospital based IV classes and certification (don't know if that's the correct term) to be allowed to start IV's on the job.
  6. by   newnicurn
    No that's not true for RN schools. I went to a well known school that's affliating hospital has an iv team and phlebotmy team. no ivs or blood draws for nurses. My job taught me how to do it. My job had the fake arm with very worn "veins". It still took me a while to get it down. On my busy meg surg unit sometimes you don't have the time to stick a pt, good veins or not. So your expierence can be limited.
  7. by   CVICURN2003
    I hate to start IV's on anyone...and I'm not very good at it. Most of our patients have a PICC or a central line. But I can recover an open heart pt, run CRRT and a balloon pump quite well, sometimes all at the same time....But, because I can't start an IV very well, my clinical skills stink?
  8. by   SharonH, RN
    I wasn't taught IV starts in school either; that is a skill that requires practice and if you are not going to be using it for sure, there's no point in wasting time learning it. And in my 17 year career, I've only worked in two facilities that did not have an IV team. It is quite possible for an experienced nurse to not have that skill and as far as I am concerned it is not a reflection of his or her competence.
  9. by   TazziRN
    This thread is going off in another direction. I think we've all agreed that nurses should have some experience in starting IVs, but the OP said the nurse claimed the he didn't know how. That's different.
  10. by   angel337
    i think there may be some bias where the agency nurse is concerned because agency nurses are expected to jump in as soon as they hit the floor. i am an ER nurse and i can't imagine an ER agency nurse not being able to start iv's, because just about every other patient that walks through the door gets an IV. when i worked agency it was understood that as a nurse working in a critical care area that i could do at least 95% of commonly used skills.. so yeah, its hard to be very sympathetic.
  11. by   jjjoy
    "I don't know how" could mean I haven't vaguest idea and I'm hoping I'll never have to try; or it could mean they never taught us in school and I've never had formal training on it; or it could mean I haven't done this on a real person before and it's six months since even trying on a piece of plastic; it could mean I've tried this a few times before and always blew the vein and unless I'm going to be doing this regularly it would be faster for all of us if someone else would start it...
  12. by   jjjoy
    Quote from GardenDove
    He told me that he doesn't know how to start IVs because the place where he normally works has IV therapy. I can understand that because I had worked at a hospital with IV therapy and didn't learn to start IVs until I came to my present place of employment. Nevertheless, I was surprised that an agency nurse would lack that commonly used skill.
    Agencies are as hard up for skilled, qualified nurses as are hospitals. Ideally, agencies would only select the most adaptable, independent nurses but they aren't always as choosy as they could be. Because there's such demand, agencies can overly rely on the nurse's self assessment of ability - asking someone not qualified for, say critical care, if they'll take a critical care shift.
  13. by   lauralassie
    Maybe he has worked in an ICU where everyone has major lines, if you have plenty of lines you don't have much of a chance to start IV's. Lines are usually the first thing that goes in at our unit. But, if I were him I wouldn't have admitted that, I just would have done it and if I had a problem I would have asked for someone else to try. ICU nurses in our hospital can start IV"S but have some difficulty. They usually call those of us in ER to do it if their is diffuculty. It's not that they are less of a nurse , it's just that in
    ER we do it many, many times a day. If you ask a ER nurse to DC chest tubes or a Swan cath, they would about pass out. Now if the RN was never trained in iv starts in nursing school , well then that's another issue. (a big can of worms will open on that subject)