IV Skills for Hospice?

[4boysmama]

I'm currently a SNF unit nurse, just accepted a new position with home hospice. In my current job, we have an IV team that places all lines and phlebotomist that does lab draws, so I've got virtually NO experience in either. I'm anxious about having to do them once I'm out in the field (though I'm confident that my new company will train me well beforehand, I'm still nervous about being alone in the field without "backout" in case I miss). I'm curious how often you have had to do IV starts or blood draws in your home hospice work?

[pfeliks]

In my three years as a RNCM, I have never had to start an iv or do phelbotmy.

[Jensmom7, BSN, RN]

I don't even HAVE any IV or phlebotomy supplies in my bag!

[QuiltDog]

When I did home hospice (now in an inpatient hospice unit), I probably had one blood draw and one IV start in about 3 years. We always had a nurse on our team that was proficient at this so we could use her as a resource.

[Jack Hazz, BSN, RN]

So far, I have yet to draw blood or start an IV. Hospice frowns on IV because the disadvantage actually outweighs the benefits by a lot for someone who is dying. Plus medicare (if they have medicare, which is most of my patients) does not think hospice to consider IV therapy (though I heard medicare has changed their position on this and given hospices more leeway). My current hospice company does consider IV but we have a dedicated infusion team to do it for us. I'd love to do it though as I sometimes miss the time when I started hundreds of IV when I was still at the ER and ICU before.

[vampiregirl, BSN, RN]

We don't do peripheral IVs. We access ports and PICCS, sub-q is another option. Have you asked your company what methods of med administration they use?

We do some blood draws - mostly PT/INR, occasionally something else is ordered.

Is your hospice affiliated with a hospital or do they provide home care also? If so, there may be more opportunities for gaining proficiency.

[GrumpyRN63, ADN, RN]

Never blood draws or peripheral IV's. Accessing POC's, PICC's and SQ's for pain pumps.

[PghRN15]

I work on a hospice inpatient unit. I do start IVs regularly, I also worked in the field and did do them but not regularly. Don't let this stop you, they will train you and you will be great.

[softrbreeze]

Once a month x a few months, I may have to flush a port. Occasionally, I have a patient/family that insists on IVF for "dehydration". We teach but also try to accommodate. Blood draws maybe 2-3 times per year on average.