Is this common?

NurseOnAMotorcycle, ASN, RN · Jul 29, 2016

Let me put it this way:

Would you roll your eyes if a veteran cardiac nurse asked for help with a neuro assessment on a neonatal patient? Of course not! And I wouldn't even blink if you came on as a new hire and never had a chance to learn IVs. You still have other skills that you have become so proficient in that you could help with.

A different way to think about it is this: Physical skills can be picked up, but it takes experience to learn that gut reaction that the patient, families, and doctors depend on us for.

It's easy for me to say "just don't sweat it" but what would make you feel better is this: request to go for IV and phlebotomy training. (And don't sweat it!) :up: :)

NotYourMamasRN · Jul 29, 2016

I have worked in 5 different hospitals (In two different regions) as a float pool RN, through a majority of units. I have never seen this in any of the hospitals. In most, the 'IV team' consisted of ER and ICU RN's who came to help out when floor was having trouble with an IV. PICC team worked Mon-Fri and was never happy to help with anything. Lab would draw on very hard sticks, after 15 minutes complaining about it. Nurses did their own discharges unless the charge was free to help. On weekends we never have an admissions nurse. In a way, I hate the fact that we usually have zero support. But you bring up a great point about experience. I have started probably thousands of IV's over the course of 5 years, done tons of discharges, and have drawn blood from a ton of people. Maybe thinking about it from the experience perspective will make me less grumpy about it all. The best group has always been wound care! They are always eager to help and I thank God for it, I don't like wound care.

sevensonnets · Jul 29, 2016

Where I work the function of the phlebotomists has morphed into calling the nurses to remind them to draw the labs. You have a set amount of time to do it before they call your manager and rat you out. God help you if you are busy admitting a patient when labs are due! They will call you back from lunch to do an admit if they can get away with it. Or the patient will be sitting there waiting for you when you do get back unseen by anybody but the transporter that brought them from ER!

NursesRmofun, ASN, RN · Jul 29, 2016

Without reading any other answers, I would say it is less common than hospital units that have to start their own IVs and do their own discharges. That's my educated guess.

Adding: You may have somewhere around a 50/50 split on hospitals that have or don't have phlebotimists.

ComeTogether, LPN · Jul 29, 2016

I would have to say its exceedingly rare.

As an aside, you likely won't find the grass to be greener elsewhere, it sounds like you're nursing in NCLEX land, lol.

mmc51264, BSN, MSN, RN · Jul 29, 2016

We have phlepo to draw labs (I work on an intermediate floor-MICU/SICU/CICIU have hickmans or PICC lines) we can draw off of a line if there is an order. We have an IV team. We have clinical transport nurses and regular transport personnel.

I work at a teaching hospital and pretty high acuity, I am a specialty certified nurse (orthopedic). We have plenty of off service patients, so I can manage ostomies, wounds, wound vacs, ex-fixes, traction, I am an EPIC super-user and a diabetes expert for my unit-I have plenty to do and I don't feel that my nursing is "watered down" because I don't draw blood or start IVs. I am very lucky and I appreciate those that do those things as they are much better than I am and it is easier on the pts.

HeySis, BSN, RN · Jul 29, 2016

My hospital has the phlebotomist come draw labs unless it's off a line... but then they'll come with the right tubes and label everything as they hand it too you and you hand it back, and they whisk it away.

We don't have an IV team, but our Infusion therapy nurses will come if you ask and they aren't slammed, they do the PICC lines Monday- Friday and are on call those evenings.. not on the weekends at all. usually if it's a hard stick people will call ICU or the House Sup for help. The floors do their own discharge teaching, but the case managers have all the apps, equipment and such set up.

I work in the PACU, We can go months between doing an IV start, inserting a catheter and such... while Same Day Surgery and ED nurses do several an hour. I don't feel our skills are watered down by that at all.

My nursing abilities are related to being able to anticipate, assess, understand, draw conclusions and intervene for a patients health and safety in a critical care setting where most of my patients are not able to advocate for themselves (or even hold an airway themselves). Your nursing abilities will develop based on your patient population.

If I need the skills some else has, I'll call on them and ask for help (via a rapid response team if needed). And if you need a jaw thrust to keep an airway patent for the next 30 mins... I'm your nurse!!

Sydryth, ASN, RN · Jul 29, 2016

Are they Hiring?

To answer your question. Both facilities I work at just have phlebotomists, unless it's ICU and we do our own.

allnurses Guide · Jul 30, 2016

I personally can't imagine how it would be possible to have certain skills not "get rusty" given the vast number and variety of places nurses are employed. One place had an IV team and phlebotomists, and a workforce in the hundreds. Another place I drew, spun and separated the blood myself, as part of the nurse's job there, because there were 3-4 people doing everything on any given day in that office.

Where I work the function of the phlebotomists has morphed into calling the nurses to remind them to draw the labs. You have a set amount of time to do it before they call your manager and rat you out. God help you if you are busy admitting a patient when labs are due! They will call you back from lunch to do an admit if they can get away with it. Or the patient will be sitting there waiting for you when you do get back unseen by anybody but the transporter that brought them from ER!

I'm getting acid indigestion on your behalf-- grrrrrr :madface:

sevensonnets · Jul 30, 2016

Thank you for getting acid indigestion on my behalf! I think in my hospital it's the phlebotomists whose skills are rusty!! I fully expect we'll soon be required to come in a couple of hours early to make breakfast because you know the kitchen staff is very very busy and needs help only RNs can provide....

calivianya, BSN, RN · Jul 30, 2016

I have worked places that had pieces of those things, but not all of them together.

My full time job has phlebotomists to stick all the patients for labs, but we do not have a discharge nurse, and we don't have CNAs. IV team can be consulted for difficult IV placement, but most everybody has some sort of central/PICC line, so we don't have patients that need peripherals very often, so we suck at them. IV team helps us out a lot.

My PRN job has no phlebotomists, but we sometimes have an ADT (admissions, discharges, transfers) nurse, and we have CNAs who can also stick people for labs. Many of the CNAs are better sticks than the nurses because some nurses don't like sticking people and always delegate it away. This job's IV/PICC team leaves at night, and fewer of the patients have central lines, so I feel like I am restarting at least one blown IV every shift. It sucks.

calivianya, BSN, RN · Jul 30, 2016

Usually if it's a hard stick people will call ICU or the House Sup for help.

It seems so weird for anyone to call ICU for hard sticks. My full time job is very high acuity - so almost none of the patients have peripheral IVs and most of the ICU nurses really suck at them. I'm saying this as an ICU nurse. Med/surg nurses start IVs way more often than I do. I probably start a peripheral IV four to five times a year, tops, at my full time job. I'd wager most of my coworkers could count the number of IVs they start in a year on one hand.