need help with tpn/blood/heparin drip admin

[dayshiftnurse]

hi, im an RN and really need a lot of help feeling comfortable administering blood products and TPN. i do agency nursing and so at many facilities ive been able to dodge these skills--they ususally prefer on-staff to administer blood and unless you have been given proper training to the nomograms used, they don't let agency admin the heparin drip and especially not TPN.

i am starting to feel useless everytime i have to ask someone else to hang these things for me...is there any learning tools/dvd's i could watch to refresh my learning in this area? we were only taught theory of TPN and i never was 'exposed' to it in school. the local college in the area, these refresher courses keep getting cancelled due to low enrollment and so i am just stuck wishing i felt more confident and no real way to help myself.

any suggestions? you can pm me too, thanks.

[clee1]

Could you go to the EdNurse at the facility you work at most and see if s/he will let you use their material(s)?

I would think it would be in their own best interest to let you.

[HappyNurse2005, RN]

could you look up a facility's policy and procedure?

are you friendly with any of the nurses, like comfortable enough to ask them to demonstrate it for you? to let you shadow them whileyou do it? that would be the easiest way, i think.

good luck. I hate feeling like i don't know what i'm doing, and having to admit it to someone i'm not comfortable with.

[Daytonite, BSN, RN]

the reason some of the hospitals won't let you have anything to do with the administration of the heparin drips or tpn is most likely for liability reasons required by their insurer. the hospital has policies in effect which their insurance company demands they enforce. so, don't take these things personally. it's for your protect as well.

i listed two links you can check out on blood transfusion and one on tpn which has quite a bit of information. the main thing with blood transfusion is you want to know what the signs and symptoms are of a reaction and what the hospital protocol is if the patient is having one. like a previous poster mentioned, it's a good idea to start collecting and looking at the different hospital policies and procedures as guidelines in beginning to learn and understand these procedures.

http://www.muw.edu/nursing/iv.htm - iv fluids, the different types and why you would use them. also includes information on blood transfusion in the second half of the document

http://teach.lanecc.edu/nursingskills/blood/blood.htm -- transfusion procedure

http://www.generalsurgerynews.com/htmreader.cfm?artid=4447&file=chapter_3/03.html - type of nutritional support. the majority of this article focuses on tpn. at the left side of the page are links to more information on tpn including management and complications.