Infusion RN for new grad with lots of IV experience prior to RN school

Specialties Infusion

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How do you guys feel about this line of work for a new grad that has a lot of IV experience prior to nursing school? I did them a ton while I was in the Navy, then I worked as a phlebotomist, so TONS of sticking experience, but I haven't worked with a lot of ports and such. I accepted a position, and have made it clear that I do expect training before I do something new (I have a funny thing about being SAFE). I know they have a lot of IVIG infusions, something I haven't yet done, but I'm not familiar with what's different about IG infusions (yet). I do my paperwork Monday, and will be finding out more, of course, but I wanted to get input from those already in the field.

Thanks in advance! :)

Specializes in L&D, infusion, urology.
I didn't realize that there was an IVIG section here, since I live and breathe it. I started out in IVIG as an LPN in an office infusion suite setting, now I'm an IV instructor and a RN with credentials!

Main things to worry are the following:

Proper rate: You can't go running all patients at the same rate. Gamma globulin whether its Privigen or Gammagard to Gammaked to Bivigam, you could cause side effects such as headaches, low flank pain during or post infusion or nausea and vomiting or even a nice CVA or MI. Even if it's someone who has been getting it for years. It's based on weight and also comorbidities. Go slow or say no!

IV Port Access: Please make sure the port is well flushed. 9 times out of 10, the two reasons someone has a port is because of chemotherapy or incredibly horrible vein access, so make sure you flush according to your protocol. Also, make sure it's a well sterile environment, God forbid you don't access it right and the patient ends up with an infection. Trick I use, a non sterile pair of gloves and an alcohol wipe prior to using a chloroprep kit. This allows you to feel the port and find your target without jeopardizing the sterile field.

Vitals: We all know taking vitals manually can get old and annoying, sure. But in an IVIG setting, it will and can save or at least alarm you of an upcoming turn of events. If you notice their vitals are elevating or decreasing slightly, that's fine. But if the first set of vitals are low and half way in the infusion it gets even lower, put their feet up and monitor. Also, check their pupils for dilation. If it gets higher and higher, lower the rate and definitely notify the MD.

Last but not least, Premeds: If a patient you've never started before tells you, "I'm a strange case, I'm allergic to everything. I this and I that and I get nauseous easily and suffer from headaches and sometimes I get diarrhea when the weather is grey and I've got 13000 other doctors that say I shouldn't get this. Don't run for the hills. Pay attention and if the md doesn't request it, be ready or at least ask why not. It's usually just Tylenol, prednisone and some sort of antihistamine taken by mouth or SoluCortef IV push. It's better to be safe than sorry.

I hope this helps you guys out there in the IVIG world. Need anything just drop a line, eh?

This is very helpful! Thank you! I plan to shadow another RN doing these infusions, and I am going to do my own research as well. I really appreciate your input!

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Specializes in L&D, infusion, urology.

I still haven't seen the IVIG pt (I suspect she and her nurse have a close relationship/comfort level at this point), but I will be seeing my first patient in the morning. Seems like a nice guy from our conversation. Yay! :)

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RunBabyRN so how did it go? I will be doing home infusion soon so just wondering.
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Specializes in L&D, infusion, urology.
RunBabyRN so how did it go? I will be doing home infusion soon so just wondering.

My first client yesterday was awesome. I will see him 3x/wk for the foreseeable future. I also got a call about another pt, with whom I start weekly infusions tomorrow. Both pts are really nice, and thus far, with my whole ONE experience, it's been good.

Good luck with your new position!

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Specializes in L&D, infusion, urology.

I'm starting with a new IVIG pt next week (my third client thus far, though my second client's insurance has decided to deny her the infusions that are working VERY well for her condition- so frustrating). I'm reviewing port access (since she has a port) and how to administer the IVIG, but any additional tips (the ones above are awesome!) are much appreciated. She has diphenhydramine as a premed, and her last nurse pushed the infusion too fast and she had a reaction after the RN left. Long story short, she has requested a new nurse (me). We'll be using the Curlin pump.

Also, any tips for PIVs with pts on chemo? My first guy is almost halfway through his chemo txs, and I can tell from his veins. Poor guy. They look fantastic of course, but they spasm and are very finicky now that he's undergone a few txs. I am sticking to the spot we know works, but doing it 3x/wk, it's sensitive, and everywhere else seems to fail, even with proper redirection.

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Hi there! I know this post is old. I'm a new grad with some office experience starting venipuncutures, IVs, and injections. I have an interview as a Home infusion nurse. Does anyone have any advice feedback on new grads starting out with infusion nursing? I love patient care and prefer 1:1. That is why I am interested but above all I want to be safe. Any advice is appreciated. Thanks 😊

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Specializes in Pedi.
Hi there! I know this post is old. I'm a new grad with some office experience starting venipuncutures, IVs, and injections. I have an interview as a Home infusion nurse. Does anyone have any advice feedback on new grads starting out with infusion nursing? I love patient care and prefer 1:1. That is why I am interested but above all I want to be safe. Any advice is appreciated. Thanks í ½í¸Š

I recently left the home infusion world and, I can tell you, that the nurse manager in the office I worked out of was more than willing to hire new grads. Whether or not that's a good thing is up to interpretation. She typically had difficulty filling nursing positions so she took what she could get. These positions involve a fair amount of on-call and the territory the nurses cover is usually vast. Plus I found there to be a lot of downsides to working for a for-profit company, which most home infusion pharmacies are. The last 3 years have completely turned me off from ever wanting to work for a national company or a for-profit company ever again.

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Specializes in Pedi.

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