Could Be Fired for IV skills.

Nurses General Nursing

Published

SHORT VERSION

I feel like my job is on the line because I'm not at 100% success rate for IVs. This is an outpatient rad center and part of a large hospital system. Would you transfer to another specialty or is there something I can do to be at or near 100% success?

LONG VERSION

It has been brought to my attention (via email) in my outpatient job that I am missing too many IV starts. I made a post back in September when I had a bad IV day but I haven't had a day like that since. Usually, I will need someone to start 1-3 IVs that I could not get after 2 tries.

I do not know what I can do to have a 100% success rate. I've been asked what will help me improve. I've read many tips on here and put them into practice but still can't get to 100%.

I get lots of practice and I have improved since starting from my view but it is not to their satisfaction. I'm thinking of asking to be transferred to a different area where this is not a factor because I don't think I will be at 100% start rate anytime soon. The other nurse that works here (has been a nurse over 20 years) and usually doesn't miss any.

I'm not a new nurse (6yrs) but I've started more IVs in this facility than I have in the past couple of years combined. At my bedside job, I rarely start them.

Overrall I would say I'm at around 75-80% success rate most days better than that. I am starting IVs on anywhere from 10-20 patients per day. I don't know what I can do.

Thanks those are good options but above and beyond what I will do for this PRN job. I can't guarantee that I won't miss more than 2 IV starts on a particular day.

I'm in a RN-BSN program that is consuming a lot of free time as well as my other PRN job. It won't guarantee my position and if I'm expected to be 100% after taking a class or two, I won't last anyway.

No one I've ever met is 100% with IV starts.

Now just read that through a couple of times please. If your manager is approaching IV starts in the same manner as informed consent signing there will be issues. I have to ask, have any of your co-workers received this type of email? Or, are you the only nurse available at what I am assuming is an outpatient surgical center?

I really like the department suggestion, but they miss starts too ;). But really, it sounds like you are solid on this. And there is another issue at your workplace that your IV start QC provides a vehicle for someone to start a paper trail with.

I'd be asking myself who is above the person sending these emails, and are these emails compliant with company policy.

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Specializes in LTC, med/surg, hospice.
No one I've ever met is 100% with IV starts.

Now just read that through a couple of times please. If your manager is approaching IV starts in the same manner as informed consent signing there will be issues. I have to ask, have any of your co-workers received this type of email? Or, are you the only nurse available at what I am assuming is an outpatient surgical center?

I really like the department suggestion, but they miss starts too ;). But really, it sounds like you are solid on this. And there is another issue at your workplace that your IV start QC provides a vehicle for someone to start a paper trail with.

I'd be asking myself who is above the person sending these emails, and are these emails compliant with company policy.

This is an outpatient radiology center and I'm the only nurse there. I work PRN at least 1 day week and more occasionally if the FT nurse wants to be off.

The email was from the FT nurse with the management team (my director is a radiology technologist) CC'd. It said "Director/Assistant spoke to me with some concerns about your venipunctures." And it went to ask me what I thought would help me not miss as much.

The CT staff also starts IV and they are always able to get the ones I miss so I'm sure that is reflecting on my skills. And I do observe them to note ways I can improve.

This is the first time I've been told that I was missing too many or making the staff behind. I also didn't know that I had a limit on how many I could miss per day. I know when I have a off day and I'm missing more than 3 but that is rare. I do want to improve my success rate but not under these specific conditions.

I'm meeting in person with my director this week but I will either transfer or resign. I agree about the bolded and I know how something like that can progress to termination.

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This is an outpatient radiology center and I'm the only nurse there. I work PRN at least 1 day week and more occasionally if the FT nurse wants to be off.

The email was from the FT nurse with the management team (my director is a radiology technologist) CC'd. It said "Director/Assistant spoke to me with some concerns about your venipunctures." And it went to ask me what I thought would help me not miss as much.

The CT staff also starts IV and they are always able to get the ones I miss so I'm sure that is reflecting on my skills. And I do observe them to note ways I can improve.

This is the first time I've been told that I was missing too many or making the staff behind. I also didn't know that I had a limit on how many I could miss per day. I know when I have a off day and I'm missing more than 3 but that is rare. I do want to improve my success rate but not under these specific conditions.

I'm meeting in person with my director this week but I will either transfer or resign. I agree about the bolded and I know how something like that can progress to termination.

I agree with you. I think that this email is the start of a paper trail, and that you may as well find employment elsewhere.

They may not even want to get rid of you for the IVs, but that is the route they are choosing because it is documentable.

Good luck!

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Specializes in Acute Care - Adult, Med Surg, Neuro.

How are you supposed to be 100% successful. Have you seen renal patients or chronically ill patients who absolutely have nothing left for access or blood draws? Patients that have been in and out of the hospital their entire lives and have been stuck hundreds of times. It is a very frequent occurrence where I work that peripheral access is limited (i.e. IV team RN tells me protect this PIV with your life, because there is likely not going to be another one if it goes bad) or just unobtainable, even with an ultrasound machine and expert hands. I think this is an unreasonable expectation.

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Specializes in LTC, med/surg, hospice.
How are you supposed to be 100% successful. Have you seen renal patients or chronically ill patients who absolutely have nothing left for access or blood draws? Patients that have been in and out of the hospital their entire lives and have been stuck hundreds of times. It is a very frequent occurrence where I work that peripheral access is limited (i.e. IV team RN tells me protect this PIV with your life, because there is likely not going to be another one if it goes bad) or just unobtainable, even with an ultrasound machine and expert hands. I think this is an unreasonable expectation.

I agree but they are allowed their expectation so we shall see what transpires tomorrow. I used to enjoy going to this job.

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Specializes in Emergency, Trauma, Critical Care.

I'm a nurse in a trauma ER where we get some of the hardest sticks ever. None of us is 100%. I'm trained on ultrasound pig placement and I still have misses. I'm guessing they are comparing you to the nurse who has been a nurse for 30 yers and expecting you to be as good as her. In that case they are being extremely unrealistic.

On the other side the only way to get better is to practice. IVs were one of my worst skills when I started in ER,now they're one of my best. But it took time...

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Specializes in LTC, med/surg, hospice.

I'm sure they are comparing us. I looked over the records and she had no misses recorded for the month. The 12 unsuccessful attempts all belong to me. I was successful 62/74 IV starts.

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Specializes in cardiac/education.

No advice but I am going through this right now as well at my new surgery center job. LOL. IV anxiety big time!! Lots of helpful suggestions though but I can't imagine purchasing my own vein finder!

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Specializes in Mental Health, Gerontology, Palliative.
I'm sure they are comparing us. I looked over the records and she had no misses recorded for the month. The 12 unsuccessful attempts all belong to me. I was successful 62/74 IV starts.

Thats an 83% sucess rate.

Now, if you were only just hitting 50% of your IV starts that might be a cause for concern

Sounds like someone is full of it

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Specializes in LTC, med/surg, hospice.

Update.

Seems it was a misunderstanding and this is exactly why these things should be discussed in person.

They said my IV skills have gotten better and they know will continue to improve with experience. And that there aren't any issues.

I'm on my phone so can't post more but I did express to please let me know things in person because her email painted a completely different picture.

And lastly I got 8 of 9 IVs today including one port.

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That is awesome. Glad to hear that things were not negative. I agree that they in the future they should not put this sort of info/issue in an email. It creates so much unnecessary stress.

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Update.

Seems it was a misunderstanding and this is exactly why these things should be discussed in person.

They said my IV skills have gotten better and they know will continue to improve with experience. And that there aren't any issues.

I'm on my phone so can't post more but I did express to please let me know things in person because her email painted a completely different picture.

And lastly I got 8 of 9 IVs today including one port.

Now that's more like it!

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