Peripheral Line Not for ABT?

[FutureRN_NP]

One of my pts pulled out his PICC Line yesterday night. When I got in today, the AM nurse said he had it done and PICC is back on. When I was to start next dose of ABT, no PICC line found. I called Supervisor. She called another nurse who IV certified started Peripheral IV for temporary. Well, I am a new nurse I did not know it is not practical to use Peripheral IV for ABT such as Vanco. I used it for Piperacillin. Anywhere, the third shift got pretty upset because she learned that the pt did not have PICC and she has to hang Vanco. She said pt could lose his arm for that. I did not know what to say. All I could say was it was not my call, it was the supervisor who went a head with this plan. Who is to blame at this point?! The AM nurse who claimed pt had it or me and/or the supervisor? Somebody is going to get their tail chew for this I think.

[Ellie G]

If the vanco is just for a couple of days and you have a good peripheral, it's okay. If they're getting vanco for longer than that or they have multiple antibiotics to run, I'd say get a picc. If nothing else vanco tends to "eat" veins and require numerous restarts of the PIV. Our facility does piccs after hours (I do them at night along with the rest of my duties) but we try to keep that for new admits with no veins or someone whose condition may have deteriorated. For example needing transfusions or just started on an incompatible med such as amiodarone that has to run by itself