bethchpn

Just wondering if any PICC nurses are using N95's when they place PICC lines

Well I was called in to the ED and the patient was sick with a high fever of 103. I have read some things about CV and they are now feeling it can be airborne. A lot is unknown. I am 70 yrs old and my husband is high risk. Am I being paranoid? My da...

We are a small hospital that has about 100-120 PICCs a year. We are trying to get updated equipment that uses ECG guidance but at this time we can't afford it or it is being decided somewhere in the financial planning for next year. We use US and She...

Small town in Oregon, 44 yrs nursing experience, 16 yrs at this hospital. Close to top salary (one more step to go) 48.31/hr. Oncology certified so 1.50/hr more. No weekends, call and 8-5. Best job I have had in all my years of nursing. Salary isn't...

I agree with all the ideas Vascular nurse 1006 has. i would add two more. My favorite if a pt is awake to have them cough at the point right before it goes up the jugular. Second I have had some really tough ones that I have just waited a short tim...

As a nurse of 44 yrs others might disagree but I have different advise. I feel the best action would be to let your supervisor know that you have learned a lot from the experience and will be able to give better care for patients in the future. You a...

It took me a long time to learn one simple fact.... If you make a bad choice you can always make a different choice. I have been a nurse for 42 years and it probably took me 30 years to learn this. I was raised that once you made a decision you had t...

Been a nurse for 40 years and my only advice is to learn quickly that the only thing we can change is ourselves. The sooner you learn it the better. You in general will always want, nurses,patients, loved ones etc to change but it is fruitless. Conce...

I wonder if any of you have used Ports for long term use of TPN. How do you keep it from getting a sluggish blood return. Do you TPA. It seems like it is more from the TPN that from a fibrin sheath. Like to have some feedback here. Thanks

Thanks for all the feedback. One question. This particular pt is an outpatient that infuses 12 hrs a day. Do you all instruct pt to pull back for blood? I have read some instructions say to just have pt saline flush and not check for blood return and...

When this happens I pull back from the jugular and then have the patient cough and it usually drops down.

Totally agree with iluvivt. Don't let them put you out on your own after 3 PICCs. It is a cost saving technique for the hospital but you will be much happier if you get more experience if you do more with an experienced RN. In our hospital now we hav...

The angle of insertion is related to how deep the vessel is. More shallow less angle, deeper more angel. Will come with experience.

Iluvivt could you send me a copy of you protocol and procedure also. I have been placing PICCs for 8 yrs and did my precasting at OHSU in Portland Or but they do not do that now so I have to train them. What is required for someone to be PICC certifi...

I have been a nurse for 38 yrs. I have maybe seen 5 court cases but usually it was against the hospital or MD and the nurse just needed to testify. I went to a conference probably 25 years ago on malpractice and one thing the presenter said has alway...

I have been placing PICC's by ultrasound and with Sherlock for 10 months. I only place 1-4 a month as I work in a small hospital. I have had good success but my measurements are deep a lot and I have to pull back 2-4 cm often. I measure from insert...

Thanks for the reply. Very helpful. I do agree that Rad all disagree. Do you have or know of a good picture with landmarks on it. I received a book when I was trained but the chest x-rays and photo of the heart/landmarks was photocopied and hard to s...

I also lost a brother to alcohol and drugs and would love to give you an e-hug!!! What helped me so much was going to an al-anon meeting. Look it up in the phone book and they will lead you to an appropriate meeting. What ever you think it is not you...

We have a new order that asks for 5FU to be given at 60 minutes after Irinotecan and LV has been running. It would be along with the 2 drugs. It is written as a modified ILV. Please respond soon if you have given it, thanks. I cant find anything abou...

I have several hobbies that help me but I think yoga helps me with my work the most. I have done oncology for 5 yrs and hospice the 5 yrs before that. I have done yoga for 3 yrs and am so happy I found it. It helps me both physically and emotionally...

Chemo certification is a two day class. To become oncology certified you need to have 1000 hrs experience and take a difficult test that takes many hours of study. If you look on the ONS site it will be more clear. After you are oncology certified yo...

That sounds not too bad. I think it would pay for itself. We do order bard and I think we have been thinking of getting the basic kit with microintroducer and then put our own extra stuff in a kit to go with it. I cant wait to start putting them in. ...

Good info. Thanks for the response. Do you know about how much they cost. We were planning to get one but now with the economy falling apart we are not so sure.

I went and trained at a university hospital and used it for 12 PICC placements. I really liked it and the nurses there really liked it. It sometimes does get some interference but in general it worked very well. you really tell when it went up to the...

I too am grateful you are out of this situation. However dont feel that all oncology is bad. We have wonderful patients and it is a very rewarding field to work in. That is, if it is a safe situation.