Hi IVRN, I am not on the IV team at work, wanted to be on it, but they never gave me the orientation.
Anyway, I have used PICC lines in the hospitals, and central lines in critical care, and as far as I am concerned, you are correct. If placement wasn't important, why would cxr even be necessary? Obviously it is important! Though, I will say this, in the open heart unit I worked in, caring for infants after congenital heart defect repair, we gave all meds into a direct Right atrial chest wall line, which as the name implies is placed in the RA. We gave AB's, inotropes, everything, in codes all drugs went through that line, and if it was safe in babies, I assume it is safe in adults. These lines were extremely flimsy and delicate though, not like a larger line meant for large vein placement, so not sure if it is actually the tip that is the concern, irritating the atrial walls, or puncturing through the septum, etc...
If I were you, I would write to the IV nurses association. It's probably listed on this site under associations or just try www.ins1.org
They would be the experts to consult. Sounds to me like your agency is just like any other agency, the bottom line for them is money. Time is money and doing all these safety checks costs them time, that you could do another case no doubt. Start keeping a log of all the referrals you get w/o x-ray placement.
BTW, is your intake dept asleep on the job? Why aren't they requesting a copy of the x-ray report along with the referral? They could save you nurses a lot of time by getting the info that is needed to expedite your job. NRSKaren has a good intake dept, maybe she can shed some more light on this for you.
Stick by your instincts, they are usually right, until you are proven wrong, with literature by clinical experts.