arterial line insertion by OR/PACU nurses

[jrgrad1912]

Does any other hospitals have staff RNs that start art lines for anest? :) What is your policy? Do you have special training? We had one RN who started art lines and she is leaving. Anesthesia and the surgeons are on the rest of the PACU staff to start art lines.

[lmridd]

Hi,

I work in a non teaching hospital in the Med/surg ICU. We can place art lines if you get certified through the hospitals class. It really comes in handy to have one or 2 nurses who can place your line especially in the middle of the night when there are NO physicians available or willing to come in to place it. I think it is a great added task to your resume and skills list.

Hi,

We are trying to get a standardized procedure and classes going at our hospital to allow RN's to insert Arterial lines. Can I ask what Hospital you work at that allows RN insertion, I would love to speak to your educator and maybe get some insight!

Thanks

[PostOpPrincess, BSN, RN]

It is not in our scope of practice. I am not comfortable going into that realm unless I was a surgeon, CRNA, or anesthesiologist.

[Ruffzan]

Ok I saw the phrase "Respiratory Therapists stick for abg's and insert arterial lines for heavens sake" Most RN's do not understand that we have the same education that they do, same anatomy, physiology, chemistry...etc we just specialize in mechanical ventilation and respiratory pharmacology (Much more extensive than albuterol) while RN's specialize in I.V drugs. It is in RCP's (Respiratory Care Practitioners) scope of practice to insert arterial lines, however it is not in nursing scope of practice. with all that said, who cares Nurses need to respect the respiratory profession and vice versa. Are there ignorant lazy RCP's? Absolutely, but there are just as many ignorant and lazy RN's. If we all learn that it is not you patient and it is not my patient but it is our patient we would all get along better. The insertion of an art line is much much more intensive than an abg. Lets not be jealous of what each other does RN's do some things that RCP's don't and RCP's do some things that Nurses don't. I teach physics, ACLS, PALS and NRP as well. So lets respect each other and we will all benefit, especially the patient.

[Ruffzan]

oooops, your patient

[PageRespiratory!]

"Back from the dead 'yall.........back from the dead"

[RN1980]

in our unit we have a skills policy and procedure, icu rn's may stick for radial and ulna art abgs after attending a abg inservice and 10 witnessed and documented correct attempts. we also are able to place radial/ulna art lines after attending inservice and having icu doc and or anesthesia doc sign off on you after x number of correct attempts. abg's are relatively simple with much lower complications compared to art line placement. even though we my be "certified" in art line placement we are still required to get a md order for placement so no staffmember is just arbitrarily sticking art lines in pts. we are also required to have attempted x number of art lines every quarter to keep "certification" or we have to start the process over again.so far it has worked very well for us, we are able to get a art line in much faster in many, many cases..esp with pts that are fixin to be put on strong pressors and so forth. with all that being said, we are by no means cavalier with this. the staff here are very aware of our limitations and you will be able to tell if this pt requires a more skilled and versed hand such as a md to place a line instead of trying a near futile shot and butchering a once promising site. a good poliy can be worked out, but the staff must be aware of their limitations and be sincere in keeping their skills current. there is no shame in backing away and saying i'm in over my head.

[Charity, RN, APRN]

It depends on your state's Nurse Practice Act. Nurses in my state can start art lines if trained by their hospital. (all policy/procedure written, naturally) I don't know of any that do, however. We have hospitals here (not mine, thank God!) that don't allow RNs to do any arterial sticks, even for gases. Our docs would love for us to, I know. But the little residents have to learn something while they are here!

[katkonk, BSN, RN]

I think whether it is out of the scope of practice would be dependent on the HOSPITAL's policy. I do not believe it is beyond the scope of practice per the Nurse Practice Act as an RN WITH THE RIGHT training. Nurses take certification courses to do PICC lines, why not art lines? They are trained to do ABGs properly, and Respiratory Therapists do ABG's (as previously mentioned). I believe that this would squarely be upon the shoulders of your internal Risk Management director. Risk Management will run down the full legal end of things, make sure the right training protocol is in place, etc. And I am fairly certain that there would be a document that would certify that you have had the training. Because it is RISK MANAGEMENT that will be in the attorney's office and have to answer in case of any legal action. If your hospital will pay for the training, and you WANT to learn the skill, then why not? It only increases your worth as a RN.

[katkonk, BSN, RN]

OH MY GOODNESS, I did not realize that thread was begun SOOO long ago!

[retepimage83]

i'm an ICU nurse working in a small hospital where the PPG does not allow us to insert arterial lines neither take ABG but i have done a lot (i mean A LOT) of ABG's and arterial line insertions and out of 10 i get a 9/10 success. i guess my experience in inserting IV access to new borns, neonates and pedia in my previous jobs helped a lot. I can also say that i am the one of the only two(2) nurses in our hospital who can do that. the problem is, some doctors are just intimidated at how good we are but i do not blame them coz when things gets bad, it's their license on the line. i'm just saying, if you have the opportunity to do such... go for it... as long as it does not compromise the patient's health.