RN's who cannot insert IV's being Fired???

Published

Hello! just wanna know if it is mandatory for all RN's to insert IV's? Because a fellow nurse who is more than well experienced and very skillful in other procedures and previously IV certified too who refused to do IV's was terminated. Nurse claims she developed phobia to it after a very bad experience with a patient. Can a person really be forced to do anything that she is not comfortable and has developed an aversion to it. Is it fair to the hospital and to the nurse? Thanks!

Specializes in Day Surgery/Infusion/ED.

Then you learn how to do it, plain and simple.

Up Vote Up Vote ×
A) Inserting IVs is a pretty universal, generic RN skill -- I think it's v. reasonable to hold RNs responsible for being competent and willing to do this at work.

I don't know how universal and generic it is. I've been an RN for 21 years and I was never good at IVs. We didn't learn it in school--we weren't even allowed to flush a hep lock. Most of my hospital experience was with central lines: Swans, TLCs, etc. I can manage IVs really well, just not start them. We had IV team nurses for the peripherals, and phlebotomists for the blood draws. I did get "IV certified" at one point, but I had very little opportunity to practice and usually had to have a vein big enough to drive a truck through in order to be successful. I've been mostly away from the bedside for several years now, so I'm even more rusty. We have IVs in the facility where I'm now the ADNS, but there's no way I'm torturing those poor veins with my poor skills. If that makes me an incompetent RN, well, so be it. I'm pretty darned good at a lot of other things.

Up Vote Up Vote ×
Specializes in Ante-Intra-Postpartum, Post Gyne.

I do not like doing ear lavages. Ear wax so big it "plunks" in the emessis basin....ew. But that does not mean I can get out of doing them. Is this person expecting other nurses to do I.V.s for her....along with the 50 million things they are already doing for their patients. If it is in the job description and she will not do it, I think it is on grounds for firing.

Up Vote Up Vote ×

Yes, I realize people are not getting the experience with IV sticks (and lots of other skills -- don't get me started! :)) in school that we old fogeys got. But, c'mon, folks -- there's a BIG difference between needing to improve your "sticking" skills and refusing to do IV sticks because you've developed a "phobia". If I were that nurse's manager, my immediate thought would be, to what other basic, everyday job expectation is she going to develop a "phobia" next? As another poster pointed out, would it be okay for her say that she refuses to clean poop? What else should she be able to refuse to do?

In my last two positions as a psych CNS, the hospitals required me to demonstrate in orientation that I was competent to start IVs -- even though there was no conceivable chance that I would ever be asked to do so! It was a standard part of the hospitals' RN orientation, and I am an RN, so I was required to be checked off (it was not a problem for me, as I have worked and taught enough med-surg over the years to keep my basic clinical skills intact). And I had no problem with them requiring it -- most hospitals consider this a basic, generic RN skill. They are generally ready and willing to provide remediation for nurses whose skills are not up to snuff (this is why hospitals have nursing education departments), but I think it's v. reasonable to draw the line at a nurse who is unwilling to do IV sticks.

Up Vote Up Vote ×
Specializes in Med-Surg.
I'm with Tazzi. If you can't do the job, you don't have a right to keep it.

I agree.

IVs therapy is Nursing 101.

They should have offered teaching and followup first, but if she flat out refused, I think they are justified.

No, people shouldn't be forced to do something they are uncomfortable with. However, if you accept a job and it's your job description, you need to learn the job.

Up Vote Up Vote ×
Specializes in ER/Trauma.
But, c'mon, folks -- there's a BIG difference between needing to improve your "sticking" skills and refusing to do IV sticks because you've developed a "phobia".
Therein lies the rub.

Thanks.

Up Vote Up Vote ×
both hospitals in my area used to have iv teams; now they don't. what then?

suebird

then you learn just like you'd have to learn any new skill your job required. those hospitals should provide their nurses with a course and then chances to practice. i only put in a couple of ivs in school, but my first job recognized that and provided a course followed by an entire shift in day surgery starting ivs.

Up Vote Up Vote ×

There's only one side to this post. There are steps to the discipline process before one gets fired, unless the patient outcome is very very severe. I have a feeling that there is more to the RN beingt fired than what has been posted.

Up Vote Up Vote ×
Specializes in LDRP.

OK, i am a 2005 nursing school grad, and we WERE taught to do IV"s, had a fake arm (complete with kool aid looking blood for the flash) to practice on. We got to practice in clinical if the skill came up. in my hospital orientation, they went over starting IV's with us on a vein board thing (since our IV's were different than some people used).

When we switched from the old IV"s to the nexiva's we all had inservices, had to stick fake hands, etc.

we don't have IV teams, but we do have resource nurses to come get the "hard" sticks that you can't. of course, you do have to try 2 times first, and attempt to get others to stick the person before you call resource.

like others, i think its a basic skill. if you aren't good at it, thats one thing. refusing on phobia is another (esp if one previously did the skill)

i don't like colostomies. I dont like emptying them b/c i feel like i'm putting my hands on poop. yuck. if i say i have a phobia of them, can i not do them? (please?)

Up Vote Up Vote ×

I am not good at starting IV's. I am not ashamed of that truth. I am so glad starting IV's was not on the NCLEX. Maybe I get 40% of my attempts after trying twice. Should I leave hospital nursing, or might I be fired? Maybe I should be. One of the biggest complaints of patients at my hospital is painful, inept IV starts. It's been 5 years.........is there any hope for me? I want to master this skill just don't get enough opportunity to reinforce the skill.

Up Vote Up Vote ×
Specializes in NICU.
I am not good at starting IV's. I am not ashamed of that truth. I am so glad starting IV's was not on the NCLEX. Maybe I get 40% of my attempts after trying twice. Should I leave hospital nursing, or might I be fired? Maybe I should be. One of the biggest complaints of patients at my hospital is painful, inept IV starts. It's been 5 years.........is there any hope for me? I want to master this skill just don't get enough opportunity to reinforce the skill.

Again, it's not how good you are at starting IVs - it's that it's expected of you to at least be able to try to get the stick. Without practice, we never improve at anything! It's the nurses who absolutely refuse to even TRY that we're talking about here.

I had a coworker (now retired) that refused to start IVs or do arterial sticks on our patients in the NICU. So we had to pick up the slack. The problem was that when we started to do the clinical ladder, she got up to Level 4 (regular staff nurses start at Level 2) by doing other stuff like teaching parent classes. A lot of people were annoyed because a Level 4 nurse should be excellent in all areas of bedside nursing, and she wouldn't even touch an IV cath.

Up Vote Up Vote ×

iv's, been a nurse 35 years and can count on one hand the times i have had to start one...thank goodness, because i bite at it.

but, unless it is out of my scope of practice i have never refused a task. i

agree that it is our responsibility to be advocates for patients...so i wouldn't want to do something for which i lack experience...but refusing?

got to be more to her getting fired than that

Up Vote Up Vote ×
+ Join the Discussion