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. 

Intraosseous (IO) Line/Access /Insertion        What you'd do in an emergency if you couldn't get an IV in--------as opposed to trying to trying multiple IV starts when the patient has "no" veins

 

9 hours ago, LC0929 said:

...can anyone tell me where exactly “IO” fits into this *** show ???? ....asking for a friend....??

I wouldn't say that a student piercing or digging or doing something 7 times is an indication for an IO. It indicates a lot of other things, but not that.

Or did you mean that you know someone who endured a lot of IO attempts?

18 hours ago, JadedCPN said:

All of that not to brag but to say that I don't think you have to learn that skill in school in order to be a successful nurse - whether you are taught it in school or not, it all comes down to practicing over and over again and that just comes with time.

Exactly....my daughter is currently in nursing school, because of COVID the  clinical experience has not been really great - they are so limited on what they can do, where they can go and more than half the clinical hours are in the lab now.  I keep telling her to not worry about the the hands on skills part she feels she is missing, she will have plenty of opportunities once hired. 

Specializes in LTC.
17 hours ago, amoLucia said:

How about one of those red jelly Colace pills that an agency RN nurse attempted to 'gently' smash to push thru a GT tube!! Fortunately, the State surveyor stopped the nurse right at the point it would have been bolused during the supervised med pass.

Needless to say, we got 'dinged' with a deficiency. 

 

Wait what? What was she thinking? 

Specializes in ICU.
On 1/25/2021 at 6:42 AM, TheMoonisMyLantern said:

I miss Ruby Vee, she's a wise woman, I always enjoyed her posts and the fact that she was always realistic and honest with posters.

MOM IM that's a new one for me

Where is Ruby Vee? I’ve just realized I hadn’t seen a post from her in a few months.

Specializes in Mental health, substance abuse, geriatrics, PCU.
1 hour ago, 0.9%NormalSarah said:

Where is Ruby Vee? I’ve just realized I hadn’t seen a post from her in a few months.

Good question, she still posts occasionally, but it's very rare. I'm not sure why she quit being active, though I think it's because sometimes her opinion wasn't well received by some newer nurses that felt she was being to forward or to the point, I figure she just got tired of dealing with that.

It's a shame, she has a lot of wisdom and I enjoyed following her posts.

Specializes in Dialysis.
5 hours ago, TheMoonisMyLantern said:

Good question, she still posts occasionally, but it's very rare. I'm not sure why she quit being active, though I think it's because sometimes her opinion wasn't well received by some newer nurses that felt she was being to forward or to the point, I figure she just got tired of dealing with that.

It's a shame, she has a lot of wisdom and I enjoyed following her posts.

I totally understand her pov. I've been called mean (at the nicest, as well as worse) on here more than once for not giving the answer that the poster was looking for, saying what needed to be said instead of what they wanted to hear. Many long timers on here, as of late, are posting less and less, and I'm pretty sure that's a good part of the reason. 

 

Specializes in Mental health, substance abuse, geriatrics, PCU.
27 minutes ago, Hoosier_RN said:

I totally understand her pov. I've been called mean (at the nicest, as well as worse) on here more than once for not giving the answer that the poster was looking for, saying what needed to be said instead of what they wanted to hear. Many long timers on here, as of late, are posting less and less, and I'm pretty sure that's a good part of the reason. 

 

I've been noticing the pattern as well which is unfortunate. A lot of posters seem to already know what they want to do when they post, they simply want the validation. That can be hard on the internet. Providing realistic feedback shouldn't be seen as a personal attack.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

It's not just on-line, it's in person, too. On our unit, a number of us have been labeled "mean" because during orientation we haven't let the orientee sit around on their phone and then praised them for their stellar work in critical care. If we dare to mention that they need to be a bit more proactive in their patient care, or we bring forth any valid concerns about them coming off orientation, our manager will pull us aside to tell us we need to be more positive. Two nurses have even quit their orientations, gone back the floors they were from and told everyone how mean the critical care nurses are. I'm sorry, there's a difference between being mean and having expectations of competency when you're going to be taking care of the sickest patients in the entire hospital. 

Specializes in Dialysis.
49 minutes ago, JBMmom said:

It's not just on-line, it's in person, too. On our unit, a number of us have been labeled "mean" because during orientation we haven't let the orientee sit around on their phone and then praised them for their stellar work in critical care. If we dare to mention that they need to be a bit more proactive in their patient care, or we bring forth any valid concerns about them coming off orientation, our manager will pull us aside to tell us we need to be more positive. Two nurses have even quit their orientations, gone back the floors they were from and told everyone how mean the critical care nurses are. I'm sorry, there's a difference between being mean and having expectations of competency when you're going to be taking care of the sickest patients in the entire hospital. 

Amen! If I'm in ICU (or any unit, really) needing care, I don't care how many cute selfies or emojis you post, or how sweetly things are worded. I need competence. Not someone who is afraid of the word no or getting their feelings hurt. Life is full of disappointment, and while some messages can be given a little kinder, they cannot be totally avoided

Specializes in ICU.

Had a very cool and very bored ED Triage nurse who allowed us students to try two attempts on her. She was a former fire department EMT.  Two students equal 4 pokes. The nurse gave us pointers then allowed us to poke patients and collect labs, ua and ekg. 7 pokes is way too many! I get wanting to try skills since we've been out of clinicals but what about patient safety/rights? Covid has caused us to miss so many clinical hours but IV skills will definitely come as we work and honestly aren't as important as recognizing a decompensating patient or understanding patho. 

Specializes in CRNA, Finally retired.
On 1/25/2021 at 4:32 PM, Crystal-Wings said:

How else are you supposed to learn if you don’t actually do it? Yes, I think 7 tries is excessive and the nurse should have stepped in after a few misses but I think it’s stupid that your school or instructor doesn’t want students to practice. I know a BSN trained nurse who told me she never learned how to insert an IV during the entirety of her program because the school said “you’ll never have to do it anyway so we won’t teach you “. 

There's plenty of skills that we learn on the job.  I didn't learn IV's in school but became very proficient in chemo administration before ports were invented.  Many new grads may have jobs where the IV starts must be left for interns and residents.  The OP was misguided by a staff member into doing something was prohibited, so maybe her "instructor" should guide her towards making better clinical judgements.  Do don't have to make an awkward offense to BSN programs to get your lack of a point across.

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