ParadoxxRN

Hi all, I tend to just lurk and learn but I would like to hear from you regarding getting signed informed consents. Until just recently, the nurses on my team were required to have a signed consent, after we explained the PICC line, procedure, risks and benefits. We had the attending RN sign as witness as we were told that if we witness the consent, it could be considered coersion. Recently, due to some Joint Commission recommendations, our corporate offices developed a new consent with wording that excluded nurses. We had a separate consent we used and therefore thought we would continue to do so. However it has been confirmed that the PICC team would no longer be getting signed consent. We would continue to explain the procedure, including the risk and benefits and if the patient said okay, would proceed with the insertion. In our documentation we do mention the explaination we provide. The hospital is saying that the general consent to treatment the patient signs when they are admitted covers us for this "invasive" procedure, much like it covers all nurses when we insert peripheral IVs, place foleys, and sink NG tubes, the type of procedures we all learn, whether we are in diploma, ADN, or BSN programs. Doctors who insert PICC lines continue to get consents as they are independent practitioners unlike nurses who work for the hospital. I guess when we have a patient who is unable to give consent, we would just place the PICC also without calling the family as we don't call them to place a foley in that type of a patient. I know this is long but tell me what do you think of this. I am thinking I need another position.

I rarely have trouble seeing the needle on the screen, and if I jiggle it a bit, I can easily distinguish the needle tip. But the angio is a bit more difficult to visualize. I will try your tip ACE as it may help to just practice seeing the tip in a safe environment. Thanks.

Do these hospitals you are talking about have PICC line or IV teams? My plan has been to relocate to North Carolina. I probably won't for a while yet but It is interesting to hear you guy talking about it. I mean you make working in this area sound really pleasant and that is always good to hear.