Rexie68

I'm an RN on the IV team at a hospital. We very rarely suture in our PICCs. Our home health care agencies have had no trouble getting Statlocks and we've had no trouble with that. The statlocks that we use don't tear other than the original one in the PICC kit....that ones seems to be made of a foam-like material while the stock Statlocks are made of a cloth-like material and don't rip.

All 27 nurses on our IV team are trained to insert peripheral IV's using ultrasound guidance. I can't imagine why your manager wondered if it were in your scope of practice...it's non invasive and you're not diagnosing anything. Our LPNs also use it when needed. I can't imagine not having that tool to help with very difficult IV sticks. We don't have a specific policy, just that the nurses need to be trained to use it before doing it independently. Good luck...and you'll be so happy you are using it!

In a horrible twist of fate, my 17 year old step-daughter was in a major car accident (recovering now and hopefully all will be well in time) and has a PICC line. I'm an RN on the IV team and insert and care for PICCs all the time. I guess I never realized that there is such an opposition to them in some departments of our hospital. Radiology didn't want to use it (it's a power PICC and OK for use for everything except gadolineum (?sp)), the OR didn't want to use it, and some of the nurses were upset that she's a nurse draw for labs. This poor kid has horrible veins and doesn't need any more pokes....my colleagues had trouble getting a 4 french in. I can't imagine how many times she would have been poked by now if I weren't insisting that they use the PICC. Does anyone else run into this?? I would have laughed if it hadn't been so ridiculous when the pre-op nurses said "well, we don't use PICCs. the meds don't get into the pts system as quickly as an IV!" Practically had to throw myself on top of her to prevent a poke and anesthesia finally agreed that the PICC was adequate access (and if they did have to add another line, wait until she's asleep). OK, done ranting, but is it just at my facility or do you find it elsewhere?

Well, we can agree to disagree. My facility does not repair any central lines....not picc, dialysis, presep, multi-lumen, etc etc etc. It works for us. We're very lucky to have a "specials" unit that has a physician who works under flouroscopy to place/replace any line that IV team or the docs on the units can't get with ultrasound guidance. Our central line infection rate is less than .05% so we must be doing something right!

I would have done the exact same thing. Much less likely that "germs" will infect a new PICC placed under max-barrier precautions than a PICC found with the cap off. We would also do the same thing if a PICC were found with the dressing off. Again, perhaps some think it's overkill, but it works for us. We're very, very protective of any of our central lines and have an infection rate to prove it works.

Untrue. Once it's mentioned in the nurses notes, it can be used in court. It's happened to my employer and that's why they'll go so far as to fire someone if they chart anything about an incident report. It's only a confidential, in-house document unless it is in the chart. Anything in the chart is fair game.

Every facility I've ever worked in would has a policy that you NEVER mention incident report in nurses notes. Perhaps some you worked at don't care if it's pulled into court, but most would. I'd be seriously reprimanded and perhaps even fired if I mentioned an incident report in my notes. We just chart what happened. The incident report is an internal report and really has no bearing on the patient or their care.

Never, ever, mention "incident form" or incident report in your nurses notes. The form is for in facility use but if you mention it in your nurses notes it can then be pulled into court in the event of a lawsuit!

I only know that 90-95% of our EMS pts come in with an IV...never smaller than a 20 gauge and usually an 18 gauge and most likely in the AC or hand. We change them within 48 hours....if they last that long. Even if the site was placed in another hospital, we change it within 48 hours since we're now responsible for that site. Also, if we place an IV emergently we also replace it ASAP since asceptic technique isn't our top priority when someone is crashing.

I'm so glad you brought that up....I'm SO tired of people saying things like that! Ummm....we see the docs when they're sweaty, icky, bedhead gross and they see us with our hair back in a ponytail and no makeup and oh-so-flattering scrubs and neither one of us has time to pee let alone grab a quickie in the stairwell!!

glad you found your calling and are paid well for it! i took a $3/hour pay cut when i went from an lpn in ltc to an rn in acute care....but that was my choice because i wanted something different. god bless you for sticking with it!

[color=dimgray]perhaps a bit off topic, though i don't think so, because it's another example of someone not "getting it." i'm a nurse on the iv team. most of the time i can get an iv in just about anyone. today, i was attempting to put an iv in a patient and, for one reason or another, i tried twice and just couldn't get in. certainly uncomfortable for the patient and embarrassing for me, but it does happen sometimes....no one is perfect. the patient had a sitter and the sitter looked at me and said "are you a rookie? why don't you go for the ac? my dad puts in ivs and he makes it look easy." i just bit my tongue and left the room because if i had said anything it would have been inappropriate. my coworker returned to the room and was able to get an iv in. she then pulled the sitter aside and explained to him that his statement was inappropriate and upsetting. his response was "well, i was being an advocate for my patient. she was hurting him." my coworker was very polite but reminded him that ivs hurt and that i was doing my job and, that he was a sitter/pca, not a nurse and should not be criticizing me. hats off to her for having my back. the pca/sitter "just didn't get it."

i'm sure those who aren't nurses can empathize with some of our feelings, but unless you've walked in our shoes, you have no idea what we go through. it's a job unlike any other. i'm not saying it's more important than others, but it is unique unto itself and those who haven't done it can't possibly totally understand......though they could at least give us a thank you and a place to vent without fear of being scolded. and, obviously, if you're not agreeing with the majority, you're not "getting it"....meaning you're not getting how we feel.

sorry!! i'm an iv team rn. we replace all pre-hospital iv's within 48 hours....even if they were placed in another hospital. we have a 24/7 iv team that can insert iv's with ultrasound guidance if needed and/or insert a picc, and our docs can put in a central line at any time. 98% of the time we can get you an iv and almost the same percentage of the time i can put in a picc. if you need access fast and we can't get it, the doc can do a femoral line. for ivs that are started in our hospital, we replace them every 96 hours and/or prn.