Agency Nurse doesn't know how to start IVs?

Nurses General Nursing

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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 was showing him around. When I was going to maybe need another line, and asked him if he'd like to start it.

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.

:redlight: WOW! It's crazy to think, in the profession we're in, all of you can be so judgemental. You heard one side of the story. That is just one reason to not be judgemental. Next, while in you profession since day1 have you known everything, have you NEVER been taught how to do something that now you would now think ...that should be a basic skill I would think a nurse should have?

It's a first time for everything. Remenber how some nurses were so unhelpful and rude while you were in clinicals? However you were there to learn. They forgot that they were once in that position , whether months or years ago. Remember this in your daily lives and maybe you'll be what we should all be. A little more understanding , more helpful, and a lot less judgemental. It's like with all we're taught, we often display the opposite.

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in the UK the any practiconer undertaking an activity that is outside their skills knowledge and experince(NMC), skills not practiced often perhaps due to personal abilities and where they work. Means they are working outside their registration and could be liable if harm happened.

iv starts are only begining to be included in RN training in the UK however there are clinical areas where getting enough practice often would put you outside of the code

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Specializes in corrections, LTC, pre-op.
that's ridiculous. what some people won't do to get by....i find it very hard to believe that this guy is naive enough to think that he can work agency without that basic skill. make him a DNR right away (Do Not Return):smackingf
So you judge a nurse by wheither they can start an IV or not? I know MD's who can't start one. Pleeeeeeeeeeeeeezze don't be my nurse if I need one.
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I have been an ICU nurse for 18 months and in that time I have started six IVs. Five of those were started on the day that I had to go around with a staff nurse and prove that I could start IVs.

I went straight into the ICU from nursing school having never started an IV. We practiced on fake arms for school, I never had an opportunity to start one, despite making an effort, in clinicals.

While I am perfectly capable of starting an IV, I'm not exactly proficient by any stretch, which I find common among ICU staff. We only perform draws if we have a line and an enormous majority of our patients either have invasive lines or are transferred to us with a peripheral in place.

Anyway, I say give the agency guy a chance to prove himself. I'd be a whole lot more concerned if he couldn't interpret EKGs or didn't know a

PA pressure from a BP.

Jenn

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

When I FIRST began nursing school only doctors could start IVs. (Believe it or not). The supervisor would whisper psssst and take a chosen few into a vacant room and show them how. (1962)

By the time I retired I guess I started maybe 20-25 a week.

Last month I was hospitalized in one of our sister hospitals -3 hospitals in the Alliance- and was amazed that their policy was only an IV team nurse or a CRNA did IV's. The IV team also did ALL the bag and tubing changes and hung all the minibags. Amazing, just amazing.

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Specializes in Critical Care, ER.

This is a touchy subject for me because I am an ICU nurse who always worked very high acuity ICUs where 95% or more of my patients had central lines or arterial lines that I could draw from, not to mention an IV therapy backup. I was always a bit of a wus about starting IV's because I didn't want to hurt my patients, and I always knew another nurse who was better at it and would start one for me. Mind you I have excellent assessment skills, I am great at many other tasks including difficult NG tubes and foleys and I have personally trained myself to almost a physician's level of knowledge in clinical. Yet this fear turned into a phobia and for 2 1/2 years I avoided IVs like the plague.

Well, just one month ago I accepted a contract agency position in a cathlab. Little did I know I would be starting IV's all day long. At first, I was completely scared and reassured that they would fire me. Yet, the lord blessed me with some really supportive co-nurses who told me the same thing, each and every one of them (2 were ER nurses and one is a previous IV therapy nurse)... practice, practice, practice! It's been a month now and I'm not a certified expert yet but I definitely have improved a million percent! Fortunately they didn't second guess my other skills just because that one was lacking. In fact, I received a midterm evaluation with all "excellents".

I am so happy and relieved that I was surrounded by people who believed in me and helped me gain the skill instead of tearing me down.

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The nursing school I graduated from used computer simulation with fake arms to do IV starts. My clinical group had 10 student in it and we spent a total of about 30 minutes on this skill. Obviously we did not recieve adequate training in this area. The hospital i did my clinicals at, and currently work at, has an IV team, so unless I go into IV therapy I will never have the opportunity to master this skill. I feel for him. Where I work we do not even have supplies on our floors for people that want to stay in practice. All of the iv training is done through IV therapy orientation, where does a peron go to get IV start training?:angryfire

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I say its crap! I would report it to his AGENCY! Tell em to send someone quailified for the job next time... agree its too big of bucks not to get the skills you need.

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I say its crap! I would report it to his AGENCY! Tell em to send someone quailified for the job next time... agree its too big of bucks not to get the skills you need.

Sorry, but I do not agree with that at all. Now in the ICUs most patients have central lines, and those are not started by nurses. Different areas have different skill sets. Pre-op holding, out-patient GI lab, ER; units like that and the nurse gets plenty of experience. In the ICU, the patients are sicker than the used to be by far, and they require different lines, than peripheral in many cases.

When I was in nursing school, I worked as an IV tech at a 600 bed hospital and never lost those skills. This is back when nurses did not even start IVs. I have been a critical care nurse for years and years, among other speciality areas. And over the past year, I may have started a dozen IVs total on my patients. More often on patients that are not mine. Some nurses are also better at starting IVs. Same as with lab techs, even though they draw blood day in and day out, some are better than the others.

But to say that someone has to be removed from a job because of their IV skills is crazy. And what if they have superb IABP skills over even ECMO skills, but never get a chance to start a peripheral line as those patients usually have central lines that were placed.

What about the nurses that have problems with foleys? Should they be denied a position because of that? Each person has a different skill set that they bring to the table, and some are better at certain things than others.

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people are always spouting off about the big bucks that agency nurses make, not necessarily, some areas of the country they make big bucks, some places they make little more or less than a prn hospital position, I speak from experience

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people are always spouting off about the big bucks that agency nurses make, not necessarily, some areas of the country they make big bucks, some places they make little more or less than a prn hospital position, I speak from experience

And that is very true. The agency makes the big bucks, not always the nurse. And they are usually the same or quite similar to the Per Diem rates.

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I just graduated from nursing school December 2006. I started a residency program for L&D/special care nursery in January and starting IVs is a skill that is needed fairly regularly. We were not given much instruction in school beyond practicing on a rubber arm and the rare opportunity to start a real IV on a real patient during clinicals. Sadly, I have a variety of preceptors and one of the preceptors was stunned that I had not come out of nursing school will a solid knowledge of this skill and made me feel absolutely ignorant :o. While I have had good success with other preceptors starting IVs and drawing blood, every time I attempt a start with this particular preceptor, I miss ... probably from her initial negativity.

Please keep this in mind if you ever have to precept

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