Is this common?

HouTx, BSN, MSN, EdD · Jul 28, 2016

You're very lucky to work in that setting. The amount of time that is required to handle Discharges (as well as admissions and transfers) is normally not accounted for in the staffing numbers... so nurses just have to 'suck it up' and deal with all that churn in addition to caring for their other patients. Your organization has apparently made an effort to ensure that staff nurses can focus on patient care instead of dealing with extraneous tasks that can eat up a significant amount of time. Like I said, LUCKY!

Proficiency with IV starts is only obtained through experience. It's a catch-22 for staff who are trying to develop the skill because in the meantime, patients are subjected to "less than optimal" sticks. Patient satisfaction is far higher & adverse events (phlebitis, extravasation, infection, etc) much lower with IV teams. Drawing labs is an add-on that was dumped on nursing in order to save the cost of phlebotomists. Again, a major time-waster (unless you can draw from lines) and more error prone if distracted nurses are doing it along with their zillion other tasks.

If you go to work at a different organization that doesn't have these support services, your orientation will include the training you need.

EllaBella1, BSN · Jul 28, 2016

Our hospital has phlebotomy that comes and draws labs for PCU/med surg floors, but in the ICU we draw them ourselves. Their hours are limited though. We also have a PICC team that will do tough stick peripheral IVs via ultrasound guidance, or will put in midlines. But they are here M-F 8-5. Night shift it's up to the RNs or the rapid response nurse. We rarely discharge from ICU directly, but what I do know from floating to other floors is that nurses do their own discharges.

Been there,done that, ASN, RN · Jul 28, 2016

Not common at all, you have most excellent ancillary staffing. I bet you even have nursing assistants to clean the buttocks.

If you were to ever leave this sweet set up, the new facility will train you.

flymaxwell05 · Jul 28, 2016

I have a friend who used the term, "watered down nursing" I think nurses lose their skills, when they cannot practice the way they were taught. Nursing sure has changed. In a dire situation, (you know, one where no *specialty* skilled nurse is around), what are you going to do? I would say, stay up with your skills (insist on it!) no matter where you go. If you cannot in the organization where you are, then perhaps think of researching organizations that will allow you to be a nurse! I am a psych nurse and we do not have certain nurses who take care of only depressed people, or certain nurses who take care of acute schizophrenic patients. You may also want to think about working part-time as a staff (bedside) nurse and part time IV nurse, if your organization allows this.

Asystole RN · Jul 28, 2016

I have a friend who used the term, "watered down nursing" I think nurses lose their skills, when they cannot practice the way they were taught. Nursing sure has changed. In a dire situation, (you know, one where no *specialty* skilled nurse is around), what are you going to do? I would say, stay up with your skills (insist on it!) no matter where you go. If you cannot in the organization where you are, then perhaps think of researching organizations that will allow you to be a nurse! I am a psych nurse and we do not have certain nurses who take care of only depressed people, or certain nurses who take care of acute schizophrenic patients. You may also want to think about working part-time as a staff (bedside) nurse and part time IV nurse, if your organization allows this.

You stating that you are a psych nurse but do not believe or approve in specialty nursing is humorous.

You need to have surgery to fix a broken leg. Do you ask your family physician to perform the surgery? If not then that is the reason for specialty nursing.

I agree that every nurse should have a broad knowledge and skill set but as patients become sicker and more complicated we will see more and more specialty nurses, and other specialty professions, arise.

Is it better to have a single mediocre person or a team of experts?

smf0903 · Jul 28, 2016

Out of that scenario the only thing our facility has in common is lab does draws, unless the patient has a line. I those cases the RN draws the labs. :)

quazar · Jul 29, 2016

Never heard of a discharge nurse, that's pretty swanky. My facility has an IV team, but you only call them if it's a difficult stick or you don't have time/can't do it for some reason. Lab does draws on non-critical care floors, but since I'm L&D I've always started my own IVs and drawn my own labs.

I'm jealous, sounds like an awesome set up to me.

sallyrnrrt, ADN, RN · Jul 29, 2016

Luxury.....oh how grateful, I would be .....

AceOfHearts<3 · Jul 29, 2016

My hospital has an IV team and phlebotomy does the labs for noncritical care floors. I wish we had a d/c nurse. I had 3 discharges one day this week and 2 another day, plus several admissions both days (some that were train wrecks). Suffice to say I haven't been having a great week (finally getting quick break to eat 10+ hours into my shifts).

RNperdiem, RN · Jul 29, 2016

Add on the transport nurse for ICU patient trips to MRI, IR, etc and you can understand why I have remained at my workplace.

IV team and phelebotomy are more "as needed" but they are available.

I see this as a good thing. Would I complain that my skills in certain housekeeping tasks are weak because my husband does some of the work? Not me.

These extra staff to help nurses help their patients are really not that common. In budget cuts, they can be cut easily. More common are nurses who are everything from chaplain to TV repairman.

Hangin'On,RN · Jul 29, 2016

It sounds like the hospital you're at really has the right idea!

The hospital I used to work at did have a team of phlebotomists to draw all the labs. Years ago they did have an admit team, but they did the admissions histories, med lists, etc., but that was short lived. I'd say you won't find many hospitals that have discharge nurses and an IV team.

If you decide to move, it will not matter that you've never done a discharge because you will be orientated and trained to do those things at a new job. Who knows, you could even strike it lucky again.