certjunkie87

I have just started a the new stroke and cardiac care coordinator at my hospital. We are a certified primary stroke center. Before me, there was no one in the position and I came from an ER/ICU background. I'm still trying to figure things out but one of the things our policies do not cover at all is tele and the stroke patient. Right now all our stroke patients either go to ICU (tPA, massive hemorrhage, intubated) or our tele floor, which only has 35 beds. They stay there until they get discharged, our inhouse rehab or in house TCU. The problem is we are having to keep patients who have been admitted with TIA or a stroke but have no deficits on the tele floor even if the doctors D/C the tele because no one on our med floor is trained in the NIHSS. We are holding patients d/t placement issues or family problems, and we need the tele beds. We are trying to get all the nurses trained but until then... does anyone work at a hospital that has a policy in place for monitoring neuro patients on tele, transferring off of the stroke floor, or transferring them out of the stroke service (ex, r/o TIA patient gets diagnosed with tumor, do you just quit following them or do all the docs have to chart they don't think it was TIA, just because of the charting requirements for all patients who code out as a stroke/TIA/CVA?) Sorry for the long and rambling questions, but any help would be insanely appreciated!!

I've placed multiple breast IVs in the ER. We don't always have time for a sono guided IV and for drug users it might be just enough to give the meds and get them home. I don't use the breast if the patient needs pressors, K+, ect. But I've given lots of meds through breast IVs and I've never had a problem. Patients also say they hurt less than someone digging around in their arm.