Sticking a patient twice?

JentheRN05, RN · Oct 17, 2006

Not usually - you should use the IV line you just put in. Unless it's a stat I suppose you get where you can get it. I'm not in ED so I don't know for sure

jojotoo, RN · Oct 17, 2006

I draw about 95% of my labs through the IV to prevent the patient from getting a second stick.

busyernurse, BSN, RN · Oct 17, 2006

As my experiences as an RN in the ER, we usually make every attempt to save a stick and draw blood while inserting the IV. Saves work for the nurse, and pain to the pt. When I stick, I go ahead and draw a "rainbow", because the ER docs here are notorious for waiting until 5 minutes after the patient has been stuck, and "Oh, by the way, when you stick the patient, add a ---- top so we can check a level." I try to draw enough for the pt's c/c (CE for chest pain), or for med levels if the patient is on Dilantin, ect.

Of course, our hospital is one of the big ones that have cut back and lab does not stick for venipunctures, and resp therapy does not admin. nebs. so it saves the nsg staff to consolidate nsg duties.

Anne

nuangel1, BSN, RN · Oct 18, 2006

As my experiences as an RN in the ER, we usually make every attempt to save a stick and draw blood while inserting the IV. Saves work for the nurse, and pain to the pt. When I stick, I go ahead and draw a "rainbow", because the ER docs here are notorious for waiting until 5 minutes after the patient has been stuck, and "Oh, by the way, when you stick the patient, add a ---- top so we can check a level." I try to draw enough for the pt's c/c (CE for chest pain), or for med levels if the patient is on Dilantin, ect.
Of course, our hospital is one of the big ones that have cut back and lab does not stick for venipunctures, and resp therapy does not admin. nebs. so it saves the nsg staff to consolidate nsg duties.
Anne

we do the same in my ed the only time i would do a second stick is if the iv doesn't draw well or you need a second set blood cultures .ie 2 sites.otherwise a ranbow off the iv .

TazziRN, RN · Oct 18, 2006

The only time I do a second stick is if I miss the first time or if I get the IV in but can't draw back for some reason. If my line is good and 2 blood cx are ordered, I'll go back 15 minutes later and draw the second one from the line again.

ERNP · Oct 18, 2006

Whenever possible, I have always drawn blood with the IV start also. When I order blood work I usually just order a saline lock also. It is easy to take out and it leaves a line available in the event it is needed.

am17sg05 · Oct 18, 2006

same thing.when i was in er,we usually start iv's upon pts' coming in.at the same time while we work on it,we get the blood to spare the pt another stick and saves time for the phlebotomist as well.

teeituptom, BSN, RN · Oct 18, 2006

I usually draw blood when I start the IV, sometimes it doesnt work though, and some people deserve to be stuck a secnd time

jojotoo, RN · Oct 19, 2006

I usually draw blood when I start the IV, sometimes it doesnt work though, and some people deserve to be stuck a secnd time

Some people deserve to be stuck a second time? I've had some nasty, repulsive, abusive, assaultive, ignorant, stupid, manipulative, whining patients; but I never thought that anyone DESERVED to be stuck a second time. Nor would I ever use unpleasant procedures (NGT, foley, restraints) as a punitive measure.

TennNurse · Oct 20, 2006

We've always done it this way- RN starts the IV, draws a rainbow from it, flushes with NS, and pt is all set to go with one stick. However......

Went to work yesterday and one of the techs told me that we are no longer drawing our own blood, but a lab person will be in the ER full time just for this purpose. The reason given was that too many samples drawn by us hemolyze.

Well, butter my a$$ and call me a biscuit, but that is about the dumbest idea I ever heard. 1) Lab freqently comes back to ER several hours after above action taken by RN, stating that they need to recollect b/c the sample hemolyzed. It takes 3 hours to notice this?? 2) This ER has been doing it this way since God was a child, and it is just now a problem that warrants a major procedure change? 3) No pt appreciates 2 sticks, minimum. 4) Under this da*n fool system my sweet CHF/LOL yesterday was in her little bed for well over 2 hours before lab stuck her. She was not a difficult stick, I got her IV on the 1st try, so why did she sit there for 2 hours before some know-nothing managed to stick her, when I could have had the BNP in my hot little hand before the half hour was up? These were lab personnel I'd never seen, and our hospital is small enough that we know all our lab people. These kids were so new they didn't have the wrapping off them yet, and the timely treatment of our patients' health issues were left up to them. :monkeydance:

By the very grace of God, when I got to work today, this policy had been rescinded. Makes me even more suspicious about this whole "hemolysis" story than I already was. And so the moral of the story is, God gave some people veins that necessitate a lot of sticks, and these pts usually are both familiar with and resigned to the process. But if there is a way to streamline this process, minimize the number of sticks, and the RN knows the labs were drawn and sent, why do otherwise?

Can you tell it's been a rough week? :rolleyes:

CritterLover, BSN, RN · Oct 20, 2006

some people deserve to be stuck a second time? i've had some nasty, repulsive, abusive, assaultive, ignorant, stupid, manipulative, whining patients; but i never thought that anyone deserved to be stuck a second time. nor would i ever use unpleasant procedures (ngt, foley, restraints) as a punitive measure.

[color=sienna]oh, i don't know. i'm pretty kind and compassionate, but even i have to admit i've met the occasional patient that i have sworn deserved a 14 or 16 gauge to the hand....the one throwing up in the sink instead of the bath basin next to his bed is one of them.....mind you, i don't know that i would ever do it just for the sake of doing it.....but it sure does feel good talking about it.....and while i'd never place an ngt or foley just to put the patient through the discomfort, i've certainly remarked that i didn't feel so bad doing xyz procedure on some patients......