This has probably been covered before but I missed it so please bear with me. I got to work the other night and had a male pt. in his mid forties who was newly admitted earlier in the day. After report I started browsing through his chart on the computer and noticed an entry in the nurses notes that stated a 20ga. angiocath had been inserted in his wrist x11 attempts. Huh? Must be a double clutch on the number 1 key, right? I looked at the IV assesment tab and there it was again - 11 attempts, all by the same nurse. I might add there was no mention of dehydraton or edema anywhere in the dx. or notes.
I went to the pt.'s room and found a very unhappy camper. He was very vocal about being stuck so many times and his wife was almost in tears over the incident. I started checking him over and to me his veins didn't look all that bad, except for the bruises where he had been stuck. I went back to the nurses station and asked the charge nurse about this and she told me that that particular RN is known for multiple attempts. She said there have been a number of complaints about this very subject but since she is married to one of the county comissioners who oversee the hospital nothing is ever done. (God love small town politics!)
The nurse in question is an older RN who works prn as a charge nurse. She will not allow anyone else to start IVs when she is around. There was at least one other RN, a couple of LVNs, and a couple of EMTs in house at the time but she refused to ask for help. No one was aware of what was going on until it was over.
My question is, how many attempts is too many? How many attempts do you make before you call in someone else to try? My own personal rule of thumb is three strikes and I let someone else take a stab at it. (Sorry about that)
I might add the site infiltrated later in the night. I restarted it in the other forearm on one try. It was still working 48 hours later.
