UnbrokenRN09

UnbrokenRN09 BSN

Cardiac step-down, PICC/Midline insertion

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All Content by UnbrokenRN09

  1. Strange symptoms after flushing PICC....suspect arterial placement?

    UnbrokenRN09 posted a topic in Infusion, Intravenous

    Just wondering if any of you have ever taken care of a patient that had a picc line inadvertently placed in the artery and what symptoms the patient had, specifically when flushed or during or after...

  2. Policy writing?

    UnbrokenRN09 posted a topic in Nurse Management

    Can anyone give me some guidance on policy writing? I work for a small infusion company. We previously had a DON and now no longer operate with one since we only have 3 FT nurses. I discovered some...

  3. Strange symptoms after flushing PICC....suspect arterial placement?

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    My boss read a case study about a patient with an arterial PICC and that particular patient had symptoms that were similar, although it didn't make much sense to me.....I would tend to think the...

  4. New to placing picc lines

    UnbrokenRN09 replied to crumbsRN's topic in Infusion, Intravenous

    You actually want to decrease your tourniquet time to reduce the risk of blood clots. I undo it after I've marked my spot, then I set up my field and I re-tighten just before gowning up. I also...

  5. Vascular Access RNs

    UnbrokenRN09 replied to wolfgangRN's topic in Infusion, Intravenous

    I would say you’re more than qualified. Unless they want the 2 year minimum to ensure you’re dedicated? I would look for something else honestly. lol. I don’t think I’d stick around for 2...

  6. Vascular Access RNs

    UnbrokenRN09 replied to wolfgangRN's topic in Infusion, Intravenous

    I think it just depends on the needs of your particular facility ?‍♀️. Most ads I see for PICC nurses require experience. It’s a highly specialized skill. I didn’t have to be on the team...

  7. Vascular Access RNs

    UnbrokenRN09 replied to wolfgangRN's topic in Infusion, Intravenous

    At my hospital we learn to place USG PIV’s first, then start placing midlines. After so many successful PIV’s and midline placements, you start on PICCs. It’s definitely easier to learn PICCs...

  8. Picc line accidentally pulled out 5 cm.

    UnbrokenRN09 replied to ncrete1220's topic in Infusion, Intravenous

    We do wire exchanges fairly regularly at my facility. Not a single one of them has resulted in a Clabsi. When proper sterile technique is followed the risk of infection is not much different than an...

  9. Drawing blood from picc, air? collapsed lumen?

    UnbrokenRN09 replied to zacarias's topic in Infusion, Intravenous

    If you ever have trouble drawing blood from a picc you shouldn't force it. Sometimes it's positional and you just need to move the arm a bit, there could be a small clot inside, or there's a fibrin...

  10. Measuring picc length

    UnbrokenRN09 posted a topic in Infusion, Intravenous

    I'm a brand new picc nurse. I'm a perfectionist lol....and never want any of the picc exposed. Is it realistic to measure so accurately that this can be done on most patients? I know with some...

  11. Measuring picc length

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    That's a very interesting point cxbf and I will bring that up to our head picc nurse. Our catheters are reverse tapered and only come in 1 length. Our facility only allows for 6 cm to be exposed....

  12. Measuring picc length

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    We use statlocks to secure our PICC's, and they hold it in place great, but it's difficult to change the dressing and lock, especially if you have more than 3 cm exposed. That's why I personally...

  13. Measuring picc length

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    No I haven't heard of that particular organization but sounds like something I need to check into! Glad to finally see another fellow okie here lol. Anyways, my hospital has a really big picc team...

  14. Can RNs remove temporary pacing (pacemaker/epicarial) wires?

    UnbrokenRN09 replied to deweydecimal13501's topic in Cardiac

    At my facility RN's can remove transvenous wires but not epicardial. Personally, I feel like removing epicardial wires is too much liability for an RN. I don't want to be responsible for removing...

  15. Tricks of the Trade for PICC placement

    UnbrokenRN09 replied to Infusion50's topic in Infusion, Intravenous

    Sometimes they can flip into the IJ after insertion, particularly if they are on a vent or coughing a lot. You can try to power flush with them sitting straight up, hoping that gravity will pull it...

  16. PICC RN Career Advice Needed

    UnbrokenRN09 replied to Jessicacritters's topic in Infusion, Intravenous

    Most PICC jobs are filled from within, not outside. I worked at my hospital 9 years before i finally got the opportunity to train for PICC. I was a baby nurse when I started, which is partially why...

  17. Midline insertion question

    UnbrokenRN09 posted a topic in Infusion, Intravenous

    So I put in a midline this morning and ran into an issue I havent encountered yet. Got access easily and guidewire slid in like butter. There was very minimal blood, it didn't drip out of the needle...

  18. Midline insertion question

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    It was the basilic. This was a very sick patient and there had been multiple failed IV attempts and the ones we got, didn't last. It was nightshift, I'm midline certified, so I chose the best vein...

  19. Midline insertion question

    UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion, Intravenous

    That makes a lot of sense. The catheter occupied around 42% of the vessel by my ultrasound measurement at the insertion site but it was much smaller farther up. Another nurse later was able to do a...

  20. Is this true?

    UnbrokenRN09 replied to OyWithThePoodles's topic in Infusion, Intravenous

    I never stick these areas unless they have a very prominent palpable vein and there isn't anything else. If they require long term access, vesicants or irritant medications then they should have a...

  21. Midline Orders

    UnbrokenRN09 replied to MikeyT-c-IV's topic in Infusion, Intravenous

    Our facility doesn't require a physician order for a midline and we use the bard power midline product, which is basically a short picc line and is put in the same way. The reasoning behind that is...

  22. Tricks of the Trade for PICC placement

    UnbrokenRN09 replied to Infusion50's topic in Infusion, Intravenous

    My preceptor pulls the catheter back a bit and then pulls several cm of the guidwire out of the line and then flushes it while advancing it. Makes the tip flimsy so it will drop instead of going

  23. Midline/PICC line insertion certification

    UnbrokenRN09 replied to Kindatheart35's topic in Infusion, Intravenous

    From what I've heard you kinda have to just get a job in a hospital with a picc team to "get your foot in the door" and then get on the picc team. That's what I had to do. I'm now mid-line certified...

  24. Transporting TR band patients from Cath Lab recovery to inpatient room

    UnbrokenRN09 replied to montyb79's topic in Cardiac

    We have very specific protocols for air removal from our bands. But transporting patients with partially deflated bands is not an issue, provided protocol was being followed during deflation process....

  25. Being called an idiot

    UnbrokenRN09 replied to historylovinglpn's topic in Patient, Colleague Relations

    I just laugh when doctors are rude. And make snarky sarcastic comments back. And then I report them for being disrespectful. I don't lose sleep over a-holes that never matured past the angry,...