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 of our policies are lacking.
What are poli...
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 an infusion? I don't honestly see how this can hap...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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 symptoms would be instant with an arterial placement. ...
UnbrokenRN09 replied to crumbsRN's topic in Infusion
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 suggest adjusting your contrast on the US to a lig...
UnbrokenRN09 replied to wolfgangRN's topic in Infusion
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 years waiting to train. You have clearly mastered the US ...
UnbrokenRN09 replied to wolfgangRN's topic in Infusion
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 x number of years to get trained, just demonstrated interest...
UnbrokenRN09 replied to wolfgangRN's topic in Infusion
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 if you already know how to set up sterile field and acce...
UnbrokenRN09 replied to ncrete1220's topic in Infusion
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 initial insertion. That being said....we don’t e...
UnbrokenRN09 replied to zacarias's topic in Infusion
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 flap over the catheter opening that's being sucked ...
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 patient's anatomy you can't be spot on with the measure...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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. Our piccs are 55cm so, on average you would have 8-1...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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 don't like having more than 3 out. But yep I'm in tot...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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 so I've seen lots of different measurement methods....
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 wires placed by a surgeon. What if the surgeon used...
UnbrokenRN09 replied to Infusion50's topic in Infusion
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 back down. But at our facility we usually just end...
UnbrokenRN09 replied to Jessicacritters's topic in Infusion
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 it took so long in my case. Just pick a good hosp...
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 like it normally does. I put the introducer in, ...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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 that I was able to find. We cannulate a vessel as ...
UnbrokenRN09 replied to UnbrokenRN09's topic in Infusion
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 wire exchange for a picc through the midline I pla...
UnbrokenRN09 replied to OyWithThePoodles's topic in Infusion
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 midline or picc as soon as it's feasible. I dont th...
UnbrokenRN09 replied to MikeyT-c-IV's topic in Infusion
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 it's not entering the central vasculature, so risks ...
UnbrokenRN09 replied to Infusion50's topic in Infusion
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 up.
UnbrokenRN09 replied to Kindatheart35's topic in Infusion
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 and hoping to move on to piccs asap. It's very e...
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. I find it odd that RN's aren't transporting cath...
UnbrokenRN09 replied to historylovinglpn's topic in 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, temper tantrum stage....