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Hello, I am new to this blog, gave my notice at hospital that I have been working at for 19 yrs on May 7th and will be starting my orientation with Hospice on June 21st. I have been looking in this direction for a long time, and have finally made the move......will be here often looking for advice I am sure, I have taken a position as case manager and have been reading through the posts, finding it all very interesting and various situations all around. I have been an RN for 23 yrs started out in Labor and Delivery for 8.5 yrs, Med/Surg for 3 yrs, Outpatient Pretesting Area for 9 yrs and Radiology Nursing for the past 2.5 yrs....... I am very excited about my new job any suggestions would be greatly appreciated. I have also had Hospice for both my parents, and nothing but a very heart warming experience.....Atlanta, RN (Linda), I would really like to talk to you to get some advice....I liked your posts...........I will be taking a pay cut, but I really need to get back to the nursing that I went to school for......many years go...............LOL.

It's too bad nursing has gotten into the business for making money and not caring anymore.......what happened to responsibility to the patient???

I don't know what is being taught in nursing school anymore but it isn't Nursing 101...............fundamentals of nursing, taking care of the patients is what you are supposed to be there for, boy what do we have to look forward to when we are patients, and the techno nurses are taking care of us, when we are extremely ill and in need of a caring nurse...............it's too bad these nurses who are doing these kind of things on the job can't imagine themselves or one of their family members in the position of their patients, what kind of care would they want for one of their own??????? Shame on the facility and the other employees who think this is ok..........

Have a new issue to discuss about our IR, he places drainage tubes and now he has told us it is our responsibility to " check on the amt of drainage daily the pt. is putting out so we will know when to remove the drain." I have been working in this department for 2 yrs now and it has always been the floor nurses who do the I & O, and report to the ordering MD about the drainage tube and if he wants it to be removed they write an order......our IR will just tell us to go remove it but he won't write the order. If the pt's MD has written the order for removal is it ok for us to remove after checking with the radiologist who placed it or does he have to write an order also? He says we don't need an order, as a nurse, this just doesn't seem right ....... would the one order be sufficient? Please advise and if anyone knows where I can find written documentation on such an issued please let me know.

Iluvivt, I have a question for you since you have your CRNI, what information if anything specific do you have on the placement of Midlines? I work in a special procedures department and have been there for 2 years and we place PICC lines but have requests for Midlines as well......over the past 9 months our Midlines have decreased tremendously because of teaching that our area is doing, personally I really don't think there is a place for Midlines at all.....since decreasing their use we haven't had any calls that lines are leaking or pt's have pain in their arms....imagine that.....I think they are finally getting what we are telling them. Also I think that it was such a habit for nurses to just ask the Doc's for a midline when they couldn't place a peripheral.......Our hospital doesn't have an IV team, they did years ago but got rid of it and we all had to start our own IV's having worked in Labor and Delivery doing peripheral's starting with 18 G only I had good skills, but new nurses are not getting proper training and pt's are being stuck continuously in our hospital..... everyone wants a midline......do you have any statistics or studies that have been done on midlines causing thrombus's etc......we now are seeing younger patients who we have difficulty accessing for PICC lines because they have had Midlines in the past and thrombus's......and when we try to explain this to the floor nurses that we can't get a line in them cause or scarring, they get upset or when we explain that a pt should have a PICC they want to see the documentation or literature that tells why......there are only 2 of us who place lines in our 319 bed hospital, we work in special procedures, but they want us to show them proof......don't forget we are also doing diagnostic procedures all day long.......we also have to do the declots with cathflo because the med/surg floors don't want their nurses to do that they are too busy.......we are gearing on serious burnout.......lol....Any help you can give would be greatly appreciated....

not sure how to PM you??????

This is for Radnurse55, hello I found you here and I am also from Bradenton, started in Radiology in October 2007..........boy is it different, but I needed to keep my synapses going after working in OPS for almost 10 yrs doing pretesting for surgery.....We also do PICC/MID line insertions..............would love to chat sometime......I have thought about taking the exam but I need more practice at what I am doing, sounds like a tough exam, but that would be something to have under my belt.......I've done L & D, Med/Surg, OPS pretest and now this..................very interesting. Been in Bradenton going on 18 yrs.....how about you? :paw:

I have started them without tourniquets before also, the other day I placed a PICC line and found after I went to remove the tourniquet that I forgot to tie it......but it went in fine.........if you do things enough sometimes it's like you can do it in your sleep.......I really enjoy that part of my job alot. And your right hanging the arm down does help quite a bit.

I hate to say it but I think the Management is eating their RN's more than we are eating our own........I love teaching new skills to younger nurses. Feel free to e-mail me if you have any questions I may be able to help you with........and good luck...........just remember we are here for the patients they are the ones who are looking for us to make them well....we are the ones who know what is going on with them since we are there 24/7, and remember as a nurse "to be right is only half the battle to convince the physician is more difficult."

I work in radiology been doing IV's over 20 yrs and started with 18 G straights in OB, now doing PICC/MID lines also, totally different than starting IV's but yes it is important to have all your equipment ready. Once the tourniquet is on have the patient make a fist, they can pump the hand but once you get ready to stick the vein have then just hold the fist tight. Really as far as finding the vein it should be about feel......if you have veins that stick out of your arm or you know some guy with big veins, practice the feel of the vessel, of course with and without gloves.....but the vein to me feels like a soft, spongy, tube. Some ppl have veins you can see but if they aren't soft and spongy they are problably sclerosed from scar tissue and very difficult to access......

dianah, I will definately present these questions to the US Supervisor and my Director. We don't have a department manager for special procedures and I don't believe we have a head radiology tech either......CT & MRI, US, and radiology have supervisors.........and we are pretty much 2 new RN's on our own, but thanks for the info.......I will be back I'm sure..

Dianah, could you please tell me if it is within the scope of the US techs to assist the IR in the performance of thoracentesis and paracentesis without the nurse present. This is what I have been told is going to happen at our hospital........he also told the director that we don't need to go to the biopsies...........................is that the CT,RT ®'s responsibility? And wouldn't they require some formal instructions from the education department or us to train them before they are pulling the catheters out of the para's and thora's??????

I'm not sure but I am also in Florida.......they have alot of different laws and I think they make them up as they go along LOL.....and they get away with enforcing them......Florida is a work at will state, so in other words I guess they feel that if you don't like things you can go some where else......I'm from Mass originally been here 17 yrs just keeps getting worse........where you from? Florida nursing is like being in a different country.......

dianah, we do go to breast care, US, CT, and our own area doing all the procedures with the IR, plus the PICC/MID insertions, there isn't an IV team, they did away with that years ago.....but I am hoping they start it again.....patients come to us after being stuck multiple times, and they complain about it too, sometimes I will go to the floor and put an IV in for them.....but I get reminded that we aren't an IV team......I see you are in S.Cal.....I am in Florida, probably should have stayed in MA.....I really like what I am doing but to me there is a safety issue, this past pay period I had 109 hours (2 wks), and yesterday I broke down at work......they keep telling me what a great job I am doing, but I get to the point where I can't think straight.......and doesn't seem like they care. I am concerned for the patients, that's why I went into Nursing in the first place. The hospital is for profit, and that seems to be what they are more concerned about. There's only so much a person can do in a day, and oh well just needed to vent some more......I will look into your suggestions too, they sound good.....thanks '

Tell me does it sound a bit much for 2 RN's to do special procedures with the IR and different areas of radiology, plus do all the PICC/MID line insertions for a hospital with 319 beds......................I am worn out...............any suggestions????