Offering your nursing skills to help?

[KatieMI, BSN, MSN, RN]

So, I am rounding as an NP student, internal medicine inpatient. Labs, notes, exams, blah, blah. I enter the room, and hear someone screaming. Go see what the heck is going on, it is another RN trying to start a new IV on my patient and pushing 18g in like it is a nail through cardboard. Sure it gets infiltrated right away, then the RN innocently tells me that "she's such a hard stick!!" While she is not at all, just a LOL with crooked veins and lots of arthritic pain.

Would it be acceptable to nicely offer help, get pair of gloves on and do it myself, if I know that I would be able to do it?

[sailornurse]

Are you employed at this facility?

[KatieMI, BSN, MSN, RN]

Honestly, I do not know how to answer. I have computer access and went through student orientation. I have contract between me, my preceptor, school and the facility. But I am obviously not paid, do not have mandatory hours. So, the answer should be "no", but it is written in the contract that I can, basically, do what I am trained to do. I pretty much run rapid responce on that very patient not long after because the RN just came in and knew little more than nothing, and the team was only happy with it.

[rninme]

It may be a "liability" issue. Check with the powers that be. I started one IV as an NP student at an outlying clinic. Patient was diabetic, dehydrated and need IVF. RN was out of the office that day, and no one else to start the IV. Took several phone calls, a conference with the MD head of the clinic, and pleading by the patient because she did not want to go to the ED for fluid resuscitation (someone I knew and had worked with in the past -- "just let her do it - I've seen her start IVs on hundreds of people!").

[applesxoranges, BSN, RN]

I would say no, especially if you are employed by the facility. The exception would be if you were a student in an ER but I think ER in general is a different ball game.

Also, keep in mind that some nurses do not get a chance to start an IV every day. Some complete nursing school without ever starting an IV. If an IV is good for at least 72-96 hours depending on policy (with policies changing to site assessment), then many patients may not need an IV changed. I was wrong when I was critical of a floor for not getting an IV on a drug user who had great veins. A resident tried to be nice and told me that maybe I just had a magic touch.

I would offer a hand by offering to take a look and seeing what I see and then suggesting a size and a spot.