Student Attempted IV 7 Times

Nurses General Nursing

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Not sure where to post this but I saw something today in clinical that was just eating me up. My school has an agreement with a few clinical sites to allow students to return to clinical early, and I saw something today that made me very uncomfortable. A nurse allowed myself and another student to go into her (sedated) patient's room, and offered to let us start an IV. IV insertion is strictly prohibited and the clinical coordinator specifically told us not to even attempt it, as it can result in "major consequences". I told this to the nurse, but my classmate decided to try to insert the IV anyway. The classmate poked the patient 1, then 2, then 3.... until the nurse finally stopped her, at 7 attempts. 7 insertions, including one on a different site which was not cleaned. 

The school's clinical coordinator showed up on site about 30 minutes after the event, and she asked me if we had gotten to do any IVs. I had the feeling that she knew about it, and I told her about my classmates IV attempts. It turns out that she had no idea about the event, she just happened to show up and ask. She was angry at me for reporting it and told me not to tell anyone about it, or there would be consequences. The student and I are paired to go into the ED this week, and she was going on about how she hopes that we'll have more tries at starting IVs and that she'll make sure I can do it next.

I have no idea what to do. I feel that if I report it further, the clinical coordinator will do something to take it out on me. I can't stop thinking about how that patient was sedated and didn't have any idea a student was involved in their care, the potential pain, or the risk of infection from all of those repeated insertions, including a site that wasn't cleaned at all. 

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

WOW a lot of stuff to unpack. This is wrong obviously. I don't like that a "clinical coordinator" is floating around, not directly observing and supervising students. You guys pay hella tuition and this is what you get?

That patient suffered needlessly, regardless of no long term harm. IV sticks hurt after all.....

I guess things have changed a lot since the 90s w hen I went to school. We had an instructor on each unit there were students except ICU, where we were one on one with a nurse (agreed to by said nurse ahead of time).

This is wrong cause nurses should not have to be student instructors and responsible like this; they have enough to do. Schools are making bank and you are not getting what you pay for.

Infuriating.

18 Votes

When I first started in the ICU, I was pretty bad at IVs so common advice I got from other nurses was to try on sedated, vented patients LOL. So I can see why the nurse asked you guys to try.

But if your school stricly allows no IV insertion, just don't risk it. It's not worth having a meeting with the dean and being risked kicked out of your program for it. You will have plenty of practice when you get your first job don't worry. But why is this a rule for 1st semester nursing students only? Or for your entire program? Seems like a dumb rule but whatever

2 Votes

Did these sedated patients several of you, including the OP, mentioned actually need the IVs? 

7 Votes
Specializes in retired LTC.
1 hour ago, carti said:

When I first started in the ICU, I was pretty bad at IVs so common advice I got from other nurses was to try on sedated, vented patients LOL. So I can see why the nurse asked you guys to try.

 

I kind of like this idea. Seriously, I'm not encouraging the prospect of using pts as 'guinea pigs. But I do understand the critical urgency at times when you just 'have to get an IV'. And you just have to keep on trying .... But in a hospital, 7 attempts does seem overly excessive, Surely, there must have been some other avenue to get a line in!?! But I can justify a reasonable amt of tries by the staff.

In much of my career, I worked NOCs in LTC as the supervisor. There was RARELY anyone else to try for the IV. So my skills became pretty good over time - had to. In retrospect, I think I can thank all those early career pts (when I did hospital) that tolerated my timid attempts. But it made me the better nurse for subsequent pts to come.

The major confusing issue here for me is that prohibiting restriction for students NOT allowed to start IVs. This is the bigger problem to me!

That and the clinical instructor.

4 Votes
1 hour ago, amoLucia said:

I kind of like this idea. Seriously, I'm not encouraging the prospect of using pts as 'guinea pigs.

I don’t think having someone who needs experience try on a sedated patient who needs an IV is an issue but I sure as hell hope nobody thinks it’s okay to practice on a patient just because they’re sedated. I also cannot fathom someone letting anyone, outside of a life or death situation,  attempt 7 times which, at the very least, is likely a policy violation but even more so is an ethical violation. Every facility I’ve worked at it’s two sticks and then get someone else. This entire situation is appalling. 

19 Votes
4 hours ago, SmilingBluEyes said:

This is wrong cause nurses should not have to be student instructors and responsible like this; they have enough to do. Schools are making bank and you are not getting what you pay for.

That's for sure.

This isn't a matter of "times change;" it is a straight up decrease in standards by which schools are operating. Nursing students are not paying to be taught by unaffiliated people who are subject to the whims of their employers and who, by necessity, spend every shift compromising on patient care. Nursing students are there to learn something taught to a particular standard that is not driven by (and does not revolve solely around) the interests of corporate healthcare.

Beyond sad.

7 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

RIGHT?!  I am outraged. School standards have changed. "call me on my cell or text me if you need me". ARE you KIDDING me????!

Glad I am no longer in the hospital. I would be annoyed (and it would not be the student's fault) if I became de facto instructor for said student in addition to all the madness endured on an average shift in any hospital these days.  Do they even do post-clinical conferences anymore? Cause we spent an hour post clinical discussing what was learned, what we observed and our care plans.  I bet they don't bother with this either.

Who is being cheated most? The student paying a steep price to go to school to be tossed at a (likely unwilling) staff nurse to be his/her instructor for the day. UGH.

4 Votes

I'm curious if or how the seven IV insertion attempts were documented on the patient's record.

7 Votes
Specializes in Psych (25 years), Medical (15 years).
4 hours ago, KrysyRN said:

I'm curious if or how the seven IV insertion attempts were documented on the patient's record.

"Seven IV insertions attempted to no avail. Sedated patient tolerated fails well."

4 Votes
On 1/19/2021 at 8:24 PM, ChickenHealer said:

A nurse allowed myself and another student to go into her (sedated) patient's room, and offered to let us start an IV.

First of all sticking a patient 7 times whether they are sedated or not is uncalled for.  What else was she letting you practice without the patient's permission? Was there an actual need for an IV to be inserted or were you participating in an event where a patient was being used as a guinea pig? 

From someone who has issues with getting an easy IV insertion done.  Even for experienced nurses it usually takes at least 2 sticks.  I have ended up with terrible bruising and sore arms from these IV insertions and even just blood work.  In this case if you were just "practicing" your fellow student may have caused the patient harm for no reason.

Remember you are the patient's advocate and if you are witnessing something that should not be happening it is your responsibility to take care of that patient.  Just because they are sedated and will not be aware of what is happening does not mean they are to be disrespected in any form whether it be IV insertion, prostrate exam, or lady partsl exams.  If there is not an actual medical need for it, it should not be done without the patient's permission or knowledge.  

After having been on my soapbox, learn from this experience.  Stick with what you are supposed to be doing and keep in mind that at times you are the only advocate a patient has.  

6 Votes

So far nobody has answered my question regarding the necessity of the IVs being attempted in sedated patients. This leads me to believe that there are nurses and students who are using living human beings as some sort of uber cool sim-lab. I am so angry and disgusted right now. What if it was your family member or friend. What would you think about someone doing that to them?  How do you know they can’t feel it? Just because they don’t move? Where has our morality gone? Our humanity? If you are doing this...STOP IT! If some idiot nurse offers it to you refuse and report. Sedated, vulnerable humans are not there to be our guinea pigs. It’s sick. There are anonymous reporting lines at every institution for things like this. For God’s sake we’re nurses we should be  better than this. 

13 Votes
4 minutes ago, Wuzzie said:

So far nobody has answered my question regarding the necessity of the IVs being attempted in sedated patients. This leads me to believe that there are nurses and students who are using living human beings as some sort of uber cool sim-lab.

Haven't seen it personally but you are right that this thread is concerning for the above.

I'm with you and completely agree with your sentiment.

5 Votes
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