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Rexie68

Rexie68

Vascular Access Nurse
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  1. Rexie68

    Sutureless devices for PICC securement

    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.
  2. 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!
  3. Rexie68

    PICC becomes personal

    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?
  4. Rexie68

    Found cap off port of PICC

    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!
  5. Rexie68

    Found cap off port of PICC

    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.
  6. Rexie68

    Incident Report Documentation

    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.
  7. Rexie68

    Incident Report Documentation

    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.
  8. Rexie68

    Incident Report Documentation

    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!
  9. Rexie68

    "You cannot have BSN or MSN on your nametag?"

    The other day I asked a Doc if he was a DO or an MD......he replied "MD BS". Thought it was kind of odd, but since he's from another country perhaps that's how they do it there.
  10. Rexie68

    "You cannot have BSN or MSN on your nametag?"

    Same here....it doesn't matter if you're ADN, BSN, MSN, etc. The only time it changes from RN is when someone gets their NP.
  11. Rexie68

    Absence of Manners

    My hospitals meals also work like this....in fact, it's called room service! The pt or family member can call any time and as many times as they like to order how ever much food they want. It's supposed to be only for the pt, but I've never seen Grandma eat 10 cheeseburgers in a day!
  12. Rexie68

    Field Start IV policy

    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.
  13. 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!!
  14. Rexie68

    Absence of Manners

    I don't know about y'all, but I go out of my way NOT to tell people I'm a nurse when I or a loved one is a patient.....unless things are greatly inappropriate...which rarely happens. Just treat me like I don't know a thing...because I may know a lot about a few subjects, but I sure don't keep up to date on everything and wouldn't question the knowledge of a nurse in their specialty. It's usually those who say "well, I'm a nurse at such and such" or "my sister is a nurse and says that XYZ drug is causing all this trouble" that generally know the least about what's going on! IMHO
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