Putter

So I have been reading up on materials in Re: to PICC care because many of us still do not have training. I have heard and read two different things when it comes to the PICC dressing change with a stat lock. Do you remove the stat lock when removing the dressing and biopatch with clean gloves. Or do you remove the old dressing with clean gloves and then put the sterile gloves to remove the stat lock. Does anyone have any visual educational materials that demonstrate changing a PICC dressing change with a stat lock? I am on the night shift and have yet to receive training along with the rest of the night crew. I am off for the next few days and have time to research topic more. I could use all the help I can get because I'm not getting it from work. Thank you everyone. I watched my friend do a dressing change but it all went so fast, I need to replay it over and over again. Maybe I could share it with my fellow co-workers on the night shift.

Hi thanks everyone for your feedback. Unfortunately we do not have an IV team at our facility and we are not affiliated with the hospital. I took it upon myself to contact a friend who does home health care and she had a patient with a PICC and is currently on Vanco like the patient at our facility. She just happened to have to go to this clients house to do a PICC dressing change, flush the line, and drew labs. I am so thankful because I would not of known to tell the patient to turn there head or what to document or that you have to measure the arm and line. But she advised me with out any orders not to change the dressing, because that is when patients end up getting infections and I should just send the patient to the ER or urgent care. So still with out orders my hands were tied. That is why I spoke up because I am aware of the risks a patient can have with a PICC. We finally do have supplies now but we still do not have Dr. orders in re: to PICC cares, or policies in place. The facility I work for printed off info as to how to change a PICC dressing. That info is fine but if you have someone who has never done this procedure what do expect the nurse to sit and read through the procedure as she is changing the dressing. Even after watching her do all of this on a patient I would like more training. The only orders we have in place right now is to flush the PICC before and after hanging the bag of Vanco. My friend told me she knew of a situation where a nurse ended up in court because she was not properly trained in PICC cares and the patients PICC became infected. The nurse did not have good documentation as to the care she provided. So that in itself was good to know. A staff member wrote a note to change the dressing Monday, but like I said before no Dr. orders. Not sure where the note came from because there was no signature or date and it was just shoved in her chart. I get so frustrated because I feel like patient safety and quality care is becoming a thing of the past. I work nights and just told the staff watch that site and document everything. If the dressing becomes soiled or starts to fall off I guess to protect our nursing license we will just have to send her to the ER and they will have to provide PICC cares. With out orders and proper training that is what I was advised. I am not willing to take the risk because I don't want to take want the risk of worse case losing my license or harming a patient. So once agian I sent a friendly e-mail saying we need orders. So hopefully when I come to work tonight there will be orders if not, I am going to report this to the state. I just find it troubling when we have to demonstrate we can do blood sugars, and upt test, and checked off on our skills list. But they admit a patient with a PICC and staff is not trained or signed off for skills. Thanks everyone for your advice and I will continue to keep you posted. Thanks for listening to my soap box moment.

The facility I am currently working normally does not except patients with IV because the nurses are not trained. There had never been any policy or procedure book at out facility in re: to IV infusion. Well two days ago I came to work and to my surprise we have a patient with a PICC in place. There is no Dr. Orders as to when the PICC dressing should be changed. We are a psych facility that recently moved from the hospital, and relied on the IV team. Now we are not part of the hospital and can not rely on this team. Our census is down and I am almost positive that is why we have this patient. I am not sure if I did the right thing and may loose my job, but I like the many other nurses have still not recieved IV training, nor PICC training. I find it very unsafe for the patient and staff so I wrote a letter to the my boss, my bosses boss, and the man that is in charge of the facility. We have to demonstrate that we are competent in taking blood sugars, but yet they through a PICC with vanco at us. We don't even have sterile gloves that is how non medical the facility I work for is. I have worked the last two nights and still do not have orders for PICC cares. The facility I work for has 0 standing orders. I am debating if I should continue to work there because you ask a person if they no anything and they don't. In the letter I mentioned that the facility should educate there staff and have policy and procedures in place before accepting patients that have PICCs. It is a huge unsafe mess, did I cross the line by writing the letter to upper management? What would you do in my situation>

Thank you for your responce that is a great help. I am from a town of 15,000 and currently commute an hour and a half to and from work each day, so I would be willing to commute. I would like to get into a teaching hospital if possible. I prefer not a nursing home, but would consider it as a possibility. Thanks for your help.

I hear about this nursing shortage and it makes me sick to my stomach. I have lots or friends who are graduating and do not have jobs. Yet I am a nurse who works at a hospital that is always short staffed, and lately has not been so safe for the patients. Hospitals used to hire new grads at least on a med/surg unit and now they won't even hire. Nursing shortage my ***. It is so frustrating as a nurse who has a job. I can only imagine the frustrations that those who graduated in May of 2009, and still do not have jobs.

I am also moving to Colorado and share the same questions and concerns. Please help us Colorado Nurse!

Hi, I am new to this site so forgive me if this ends up in the wrong place. I am relocating to Colorado from MN, I have know idea where to start to look for employment. I am hoping that it is not like to state of MN, where there is a surplus of nurses and NO job opportunities with job growth. Do you think that I should start with a medical staffing company? I need HELP!! Thanks