Home Health IVs w/new grad nurse

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Specializes in LTC, Rehab.

I'm a middle-aged new grad, looking at job listings, and my immediate thought on a 'Home Infusion RN' listing is that I might not mind doing it, but given one particular experience in clinicals, where I couldn't find ANYTHING on this guy's arm or hand, what do you do in that situation? You're by yourself at their house. To save a bunch of you from responding 'well, you just gut it out and get it done somehow' ... yeah, I understand that, but again, there are some very difficult patients to start or change IV's on. Just wondering if anyone has any special advice there.

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Specializes in Trauma Surgical ICU.

I was under the impression these pts had PICC lines or porta caths ??

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Specializes in LTC, home health, critical care, pulmonary nursing.

99.999% of the patients we infuse in the home have PICCs or ports or the occasional central line. It's extremely rare to have a peripheral line in the home. My agency at least, I have no idea what others do.

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Specializes in LTC, Rehab.

Thanks for the replies!

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Specializes in Pedi.

I have never seen a peripheral line in the home and my agency will not take a patient who needs infusions without permanent access. The vast majority of my patients have ports, double lumen broviacs or PICC lines. Ports and CVLs more so in the oncology population and any child who goes home on IV antibiotics has a PICC line.

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Specializes in Home Health, MS, Oncology, Case Manageme.

I've been in home care for 11 years and I haven't put in a peripheral IV in 11 years.

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I get many PIV patients,and one particular one was a very hard stick that even her MD was surprised we were able to get anything in.

If i can't get it in after 2-3 tries,they send another RN to try. I also brought a vein light I use and sometimes it helps. The majority of the patient's have a PICC,Hickman or port.I think Port accessing is worse for me then placing PIV.

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Specializes in LTC, home health, critical care, pulmonary nursing.

Why is port access worse than a PIV? You can't miss.

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Specializes in Med/Surg,Cardiac.

I work in a hospital setting but I have had outpatients come in for IV antibiotic infusions and go home with PIVs. I'm sure in a HH setting you'd have protocols if you needed peripheral access and couldn't obtain it.

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Specializes in Pedi.
Why is port access worse than a PIV? You can't miss.

You most definitely CAN miss with accessing a port.

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Specializes in LTC, home health, critical care, pulmonary nursing.

Well of course you CAN miss, it's just pretty unlikely. I just don't get how that's harder than a PIV?

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Depends on the pt. If it is a pediatric pt with a pediport and an emaciated sunken contracted upper torso and the thing rolls, yeah.....you can miss. Really though, I would say in gerenal, on 99% of pts, portacath access is a snap compared to peripheral IV access. BTW I really admire you guys with good peripherial IV starting expertise. In my 15 year career I have never had to start an IV & it really intimidates me. I worked inpatient Onc for the first 5 years of my career where the pts had central lines mostly and if they didn't, we had an IV therapy team. Now in HH for the past 10 years, we don't do home IV therapy unless the pt has a central line.

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