IV Safety: Response to Arlene

[MB RN]

Thanks for your reply, Arlene. Your questions are certainly valid. I didn't directly get the Supervisor involved. She was called by the LPN who complained to her that I was horning in on her side and she felt sllighted. She arrived on the unit in response to the (agency) LPN.

The pt. needed the IV because she is unable to take anything by mouth reliably. Everthing we are giving her is washing into the colostomy bag as she has end stage bowel cancer.

The IV tubing had no ports to flush, unfortunately, so that was not an option. This occured on a Sunday evening and the supervisor was unwilling to call the MD. At my facility MD's are called by Supervisors or only with their permission. I should also tell you there was no DynaFlow or Pump. This IV was being regulated by the nurse. The pt. is only semi alert; cooperative but too confused for a discussion of options.

MB RN

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[PICCONE]

I feel for your situation. We recently have had to work with more agency personel and much of the time I feel things would actually run smoother understaffed. How do you feel about LPN's in general? I work with only a handful. My regular LPN is great but even so many days I resent doing some of the work she can't do and I know even on good days I have to watch her patients a little closer as some of the problem solving skills just aren't there.

I guess I should feel lucky that if my supervisor gets called she generally will let the RN handle the problem and make these kind of decisions. Also we call the MD ourself if the resident can't handle the problem directly.

Maybe you could sit down with such a manager and discuss roles for the future. Sometimes managers are pleased and agreeable to giving more responsibility to the Staff RN if she feels confident in them. It also makes her job easier to delegate some of this type of role.

Arlene Cowen RN

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