I have only been a nurse since March of 2011, and I haven't had alot of experience with IV's or venipuncture. It's a skill I love to do, but have yet to master. I just started a new job in May, and one of the things the nurses are required to do is give medication via venipuncture-the needle does not stay in the vein, we just puncture the vein and push the medicine directly into the vein, then remove the needle. We are an outpatient clinic, so we do this whenever we have a procedure, which is daily. I just started doing these on my own maybe two weeks ago. At first I was doing ok, but lately it seems like the veins have been infiltrating more than usual, in which case I have to get the doctor and he has to give the medicine. I'm not sure what I'm doing wrong, but any tips would be helpful. Thanks!
I agree with just because something has always been done that way, doesn't make it right as far as the safety of the patient. If there's only 2 of you, perhaps approach the MD and ask it you could do IV placement instead? Otherwise, it is just not good practice, and not safe for the patient. Even a butterfly has some flashback, although unless anchored well, can penetrate the vein as you are pushing. If you find out that it is NOT within your scope to push meds, you could research putting the med to be "pushed" as a secondary on a pump so that you know the med is going in at the correct speed, with a saline flush after for the patient to receive the full amount of medication. Or a syringe pump. If one is a certified medical assistant, they have lee way as far as the MD taking licenced responsibility for anything they train them to do in their own practice/clinic. As a licensed nurse, you would take the fall for a poor outcome. And it would be a really hard sell to say that "it has always been done this way" as the reasoning behind a not so safe practice that would cause a patient harm.
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
I agree with just because something has always been done that way, doesn't make it right as far as the safety of the patient. If there's only 2 of you, perhaps approach the MD and ask it you could do IV placement instead? Otherwise, it is just not good practice, and not safe for the patient. Even a butterfly has some flashback, although unless anchored well, can penetrate the vein as you are pushing. If you find out that it is NOT within your scope to push meds, you could research putting the med to be "pushed" as a secondary on a pump so that you know the med is going in at the correct speed, with a saline flush after for the patient to receive the full amount of medication. Or a syringe pump. If one is a certified medical assistant, they have lee way as far as the MD taking licenced responsibility for anything they train them to do in their own practice/clinic. As a licensed nurse, you would take the fall for a poor outcome. And it would be a really hard sell to say that "it has always been done this way" as the reasoning behind a not so safe practice that would cause a patient harm.