Is independently doing central line dressing changes within my scope of practice?

[kcaley]

Hello,

For background, I'm a newly graduated RN (as in, I'm licensed, and I start my first nursing job in two weeks).

A friend of mine I went to school with growing up reached out to me and said her brother is getting IV medications through a PICC line and needs weekly dressing changes and was wondering if that was something I would be able to do.

Is that within my scope of practice? Obviously the dressing changes are, and I assume her brother is under the ongoing care of a physician, but I'm not employed by that physician and wouldn't have a physician supervising me specifically or giving me orders directly. Is that something the family can be taught to do themselves for something like this? Also, is this something I should even consider as a brand new nurse? Help!

I live in Pennsylvania.

Note: Of course I'm aware I need to review these skills and would like to watch one and have someone watch me do a dressing change before doing them on my own (would that be enough practice? We did skills check offs in nursing school, and I observed one in the hospital, but that's the extent of my experience). I asked if she had considered home health, and she said her brother had been unable to find home health that met schedule and insurance needs, so they were looking for an independent RN.

[caliotter3]

It is generally not a good idea to become involved with providing care for which you are not getting paid. You should consult with your malpractice insurance carrier.

[meanmaryjean, DNP, RN]

Whoever placed the PICC should arrange for the care of said device.

[kcaley]

I do think they are planning to pay, just for a nurse privately (although we haven't discussed it). Thank you! I will check with them.

[kcaley]

Makes sense to me! Thank you!

[iluvivt, BSN, RN]

A patient should never be discharged with any type of VAD without a plan in place to care for it. There is an IV pharmacy providing the antibiotics I presume but they are not always the one to provide the instruction and PICC care. Something is missing in the details here. The patient can always go into the providers office or an an outpatient infusion suite to have the dressing change,needleless connector change and assessment. It is not just a dressing change by the way. The RN must assess for PICC related complications and take the appropriate actions if any are found and assess the patients response to the IV medications and assess for any complications related to those. Unless you have experience in home health, vascular access and maintenance and monitoring for all potential complications it's better to have their provider arrange the care.

[MikeyT-c-IV]

Whoever placed the PICC should arrange for the care of said device.

In my environment physician support and/or the case manager arranges care after the patient is discharged. I wouldn't have time to place a PICC if I was required to arrange care for all of these patients. :)

To the OP, I'd stay away from this situation. I agree with the PP's as this is just not a good idea. Iluvivt offers a perfect explanation.