On my unit it's policy that we need to have at least 2 peripheral IVs.
During my shift last night, I had a pt with a dialysis fistula thus only 1 arm. He originally had 2 IVs at the beginning of my shift but during my initial assessment, one of them was leaking when I tried to flush it so I took it out and tried to put in another one. I wasn't confident in my ability to put another in because his veins looked really beat up so I brought another nurse in. We both tried with no success. The doctor came in to attempt to put an IV in with an ultrasound and the pt responded by yelling at the doctor and refusing any more sticks. The pt was not receiving anything IV so the doctor verbally informed me he was ok with only 1 IV.
Later during my shift, I get an admission who also had a left arm fistula. The ED only was able to put one IV in. Once again, I had another nurse look with me and we both tried and didn't succeed. This patient also started yelling at us for our failed attempts. I told the doctor about the access issues and she said as long as we don't need to give anything IV she was ok with it as well.
When day shift arrived, I let the oncoming nurse know that I wasn't able to get a second IV in both my pt's but there were no plans for infusions and the doctors were okay with only one.
Despite these tasks, all my labs were drawn, electrolytes repleted, baths done, and all that other good stuff. I normally never leave these kinds of tasks for other people, but both patients were to the point of verbally abusing out staff and refusing our care. I felt bad and kind of a push over for not continuing to attempt to put in an IV despite the patient's complaints.
How do you overcome patients like this? Is it okay to leave things for the next shift?
