accessqueen

I think the population you serve really determines the sizes. We use primarily DL 4's because our adult population tend to be of smaller stature (native americans from mexico, central america, etc). When we used all 5's we definitely had more throm...

There is a wide variation in how VA dept are run in different hospitals. In smaller hospitals, (such as mine), we combine outpatient infusion with inserting PICC lines, and being the go to nurses for all things IV as needed. We work 8-5 Mon-Fri, exc...

I make the nurses I precept take a tray home and practice setting up for the PICC insertion. I tell them to memorize the tray and repeat setting up until they can do it automatically. I tell them to even use a pretend arm so they get a feel for the...

Duriing vanco tx trough levels must be drawn. They used to be before the third dose, our pharm is now doing before 4th dose. Therapeutic levels have changed as well. If the pt is MRSA the recommendations have become 15-20. Other infections the lev...

My favorite thing to do when people start being verbally abusive is to just stop what i'm doing and quietly stand there, calmly, and NOT SAY A WORD. The people rant and rant. And if they pause to breathe, I still don't say anything, so they continue...

DO NOT cut down a PICC. Someone is going to think it's a picc, because it looks like a picc and they will hook up TPN or something equally innappropriate. Seen it happen too many times. BARD for one makes midline kits. I know other companies do to...

One thing that hurts a lot of people is the old advice to "go in at a 20-30 degree angle, and once you get flash to lower the angle". Forget the angle. Go in at as flat as an angle as you can. As a previous person noted, go for a vein that you c...

Wearing a head covering is a religious issue. For you to wear a head covereing would be hypocritical. Living in this country they encounter scarfless women every day, I think if you wore one it would be disconcerting. That is different than making...

The place to get started would be to call the reps from whichever company would be supplying the PICCs. As an example, BARD which is who we use, has an on-line PICC insertion course. That is the starting point. When you complete the course they send...

I live in Las Cruces, New Mexico. They are ALWAYS looking for nurses. I make 31.00/hr but that's with 30 years exp. However, the housing is ridiculously cheap, and the cost of living overall is way lower than just about any warm climate areas. The...

You have to remember that you are dealing with a '70's female who just lost her husband'. The same thing may have happened even if you h ad spent all day in her room. You can take all your meds and still have a stroke. May be she lost her will to...

Bottom line, when you're in a professional environment don't say anything about anybody that you wouldn't want repeated in front of that person. A huge percentage of the posts on this site are related to issues where people are saying things, repea...

I don't know as I'd call it hierarchy, it just seems that you tend to socialize in the groups that you have the most in common with. I've worked in places where people were very standoffish all the way around, and other places where everyone is frie...

Your describing a different situation, with different legal ramifications. Reporting something about a fellow emplyee, without proof can be labeled slander. The person who supposedly saw the picture taking should have been the one to report it. Th...

The original post states "I was told of another nurse taking pictures. . . .etc". You were told???? and then reported this 'hearsay' to a supervisor??? Did you have any proof?? I'm not surprised people are out to get you.

Yes, I think they were referring to PIV's. I agree with both points of view on this topic. Usu you don't want to use a stroke affected limb, for the previous mentioned reasons. However, in the real world, y ou gotta do what you gottta do. Typicall...

In my experience the PICC class is just a small part of PICC training. You can get PICC certified on line. The real dilemma is getting precepted. The majority of companies that give PICC classes, do not precept. Don't bother getting PICC certifie...

I wouldn't call venous thrombosis in arms "common", but they certainly are not rare. I've seen plenty of patients with multi-vessel occlusions in the upper extremities. re:previous post that said that they noted an increase in clots in edematous arm...

The factor to consider: are the CNA's private or from an agency. The agency should have parameters on what the CNA's are and not allowed to do. If they are private, they can do whatever.

I go into patients' rooms to put in PICC lines. I get told about the patients' pain all the time. I then take this info to the nurse. The nurse may or may not want to hear it, but it is my duty to report it. And I have had many situations where the...

Anyone got a good solution for where to place the tape when preparing for a PIV insertion?? Sticking tape on siderails, bedframes etc is a no-no, except we all do it. But I would like to find an alternative.

Thank you, you are brilliant. I thought I was brilliant, but I racked my brains and wasn't really coming up with any good solutions. Not only easy but FREE!! Some suggested securement devices to eliminate the need for tape, but my facility is NOT ...

The other important question is which do you want to DO the most?? Are you an adrenaline junkie and will never be happy until your in the thick of things?? Or are you intimidated by the acuity of the level II and would feel safe and comfortable in le...

Yes if the bag runs out the line could clot. Are you using a pump? Set the alarm for less than the bag, i.e. if you hang a liter, set the volume for 950, then you'll be safe.

One of the best ways to learn things when you are new is to understand that wherever there is one thing that you missed, (i.e. pre op checklist), that's the time you go to someone and say "ok, now I know about pre-op checklists. What are the other a...