Constant Vein Blowing?

Altra, BSN, RN · Jul 30, 2013

My goodness, this patient needs a midline, a PICC or a port - STAT. Have these been considered?

JVoEDrn · Jul 30, 2013

The problem, is that I work at an alternative medicine clinic administering complimentary medicine. So with that being said, this particular patient is recieving these pushes by choice....its a mag push, better known as a meyers cocktail. So a port and picc are extreme for him in particular bc he doesnt have a diagnosis for this push, hes just choosing this for his own well being. ;/ My thoughts would be to obviously find a better way to introduce vitamins and such into your body... especially if I'm not "ordered" by a doctor to have it.... hes so willing, to get these pokes and it certainly strssful for me being the nurse that pokes him so many darn times!!!

BrnEyedGirl, BSN, MSN, RN, APRN · Jul 30, 2013

Is he dry? Perhaps you should suggest lots of water prior to the visits?

chrisrn24 · Jul 30, 2013

If he's just choosing that for his own good and he doesn't mind all the pokes then its his problem.

But if he minds the pokes, explain that most people can get their vitamins and minerals naturally and that this is an extreme way to get his nutrition. This could all be avoided if he ate better...unless he has medical issues which in that case maybe you could convince his primary MD to give an order to place a PICC.

MunoRN, RN · Jul 30, 2013

If he feels that benefits him somehow then more power to him, although physiologically there's no reason to believe he can't get the same end result by taking magnesium, calcium, etc PO. The bioavailability and absorption is different so it may take more of a PO dose to get a dose-equivalent IV dose. But in the end if something makes you feel better, whether actual or perceived, then it does serve some purpose.

One thing to be careful of however is that the same principles that prevent a port being placed apply to you as well. A port isn't indicated for IV access in a patient who doesn't have an indication that is 'legitimate', since that would be performing an invasive procedure unnecessarily, keep in mind you're also starting IV's for a purpose that has no legitimate purpose and adverse events related to this could threaten your license much more than if there was a generally recognized indication.

chrisrn24 · Jul 30, 2013

If he feels that benefits him somehow then more power to him, although physiologically there's no reason to believe he can't get the same end result by taking magnesium, calcium, etc PO. The bioavailability and absorption is different so it may take more of a PO dose to get a dose-equivalent IV dose. But in the end if something makes you feel better, whether actual or perceived, then it does serve some purpose.
One thing to be careful of however is that the same principles that prevent a port being placed apply to you as well. A port isn't indicated for IV access in a patient who doesn't have an indication that is 'legitimate', since that would be performing an invasive procedure unnecessarily, keep in mind you're also starting IV's for a purpose that has no legitimate purpose and adverse events related to this could threaten your license much more than if there was a generally recognized indication.

Exactly. Just seems odd that you would choose to take vitamins/ minerals IV when humans have been getting them naturally from their diet for thousands of years.

Altra, BSN, RN · Jul 30, 2013

It is a growing medical problem -- patients whose habitus, anatomy, medical and social histories and/or disease processes mean they have very poor venous access. You may recall recent state execution attempts hampered by venous access issues which were widely covered in the media.

I personally would probably not participate in continuing to stick this individual, if his access is already that poor. I continually teach my patients who get regular blood draws or infusions that the problem with repeatedly accessing the "go-to" vein is that it WILL eventually sclerose ... and then what do you have? On that fateful day when the patient becomes hypotensive, hypoxic, dysrhythmic, suffers trauma or some other EMERGENCY ... to have compromised their chance of successful resuscitation by sclerosing accessible veins without good reason is just not something I'm comfortable with.

runnergirl86, BSN, MSN · Jul 31, 2013

What about the IO route?

CodeteamB · Jul 31, 2013

What about the IO route?

IO for elective vitamin infusions O.o?

MunoRN, RN · Jul 31, 2013

If your patient is losing their potential venous access due to indications that are not well established, and you're contributing to that, then I'd argue you're going against your ethical obligations as a Nurse and should step back and reevaluate what you're doing.

Esme12, ASN, BSN, RN · Jul 31, 2013

The problem, is that I work at an alternative medicine clinic administering complimentary medicine. So with that being said, this particular patient is recieving these pushes by choice....its a mag push, better known as a meyers cocktail. So a port and picc are extreme for him in particular bc he doesnt have a diagnosis for this push, hes just choosing this for his own well being. ;/ My thoughts would be to obviously find a better way to introduce vitamins and such into your body... especially if I'm not "ordered" by a doctor to have it.... hes so willing, to get these pokes and it certainly strssful for me being the nurse that pokes him so many darn times!!!

What is IV certified ND? Who giving the meds if there is NO MD order?