Nurse cannulating and phelbotomy

CNA_Timmy · Jan 27, 2009

Well in the US PCT's and Phelebotomists (typically trained for several months in veinipuncture) draw the blood, and nurses place peripheral IV lines. As a matter of fact, I would sonner be stuck by a hornet than by most physicians I work with. As far as central lines, they are placed by the doctors, CRNA's, and we have one NP who is part of the IV team who does PICC lines.

April, RN, BSN, RN · Jan 27, 2009

Also in the US:

RNs can and do draw blood, but at my hospital the nursing assistants do most of our lab draws. Some nurses place their own IVs but the IV team (nurses) usually place them. IV nurses also place PICC lines. MDs place central lines.

strugglingnurse · Jan 28, 2009

In the US, it IS within the scope of all RN's to draw blood and start peripheral IV's. However, as people wrote above, each hospital has its own policy on whether the RN or a tech or IV team nurse draws blood and starts IV's. Where I work I am responsible for my own blood draws and IV starts.

A PICC line usually is placed only by an PICC line certified nurse.

All Central lines are placed by MD's or NPs.

queenjean · Jan 28, 2009

Same here (I'm in the US, too).

All our PICCs are placed by RNs who have taken an additional class/training. RNs start all the IVs in our area. I was in a sketchy situation one time where we needed to get an IV in stat, and I was having problems even finding a vein. I asked the doc if she wanted to try, and she looked at me, horrified, and said, "If you can't get this we are screwed, because I don't even know how to start an IV anymore, it's been so long."

In my state, you don't have to have anything but on the job training to draw blood. The phlebotomists don't have any special certifications or degrees in my hospital.

Also in my state, as an IV certified LPN, I could start and maintain peripheral IVs.

I can't imagine working as a nurse and NOT being able to start IVs. Interesting what is or is not considered routine in the various geographical areas.

travel50 · Jan 28, 2009

I agree with CNA_Timmy in the first reply....I'd rather be stung by a hornet that have most doctors start an IV on me or draw blood.

April, RN, BSN, RN · Jan 28, 2009

I agree with CNA_Timmy in the first reply....I'd rather be stung by a hornet that have most doctors start an IV on me or draw blood.

I guess this goes to show the OP how often MDs in the US draw blood.... hardly ever!

eimhear · Jan 28, 2009

This is interesting reading, in Ireland there is only one level of nurse, RGN (Registered General Nurse) or Registered psychiatric nurse (RPN) etc... so we do all patient care, in ED, and ICU some staff cannulate and draw blood but the norm is doctors cannulate and draw blood, you can imagine a busy Saturday night one medical house officer for the hospital and you need a cannula, you could wait 2-3 hours. Scope of practice is a big issue but hospital policies do not support the practice and therefore cannulation and phleboomy courses are few and far between. I am really grateful for all your replies, Thanks.

P_RN, ADN, RN · Jan 28, 2009

When I first started Nursing School in the 60's indeed doctors were the only ones who did these things (except for the few nurses the supervisor would take aside and show how to do them.) Fast forward to the 90's and nurses RNs and LPNs were given a one hour course in drawing blood including what color tube etc to use and one stick of the rubber arm. That all went sort of OK until the hospitals were informed by Medicare that since Nurses drew the blood they could no longer bill for venipuncture. All of a sudden the phlebotomists were back and Nurses had time to do all the stuff we used to do. ( BTW I believe the charge was $15 per venipuncture.)