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Discussion

They almost had me fooled

I have been very skeptical about the hospital I work at. It changed ownership almost 10 years ago and since then the profits have gone up but the care not so much. Lately they made changes that almost had me believing they cared: better staffing, more visible management. Then today I hear we no longer have an IV team! No more help for the hard sticks. Patients will go to radiology for PICC lines (you know that will take longer). Shame on me for letting them fool me.

Featured Replies

That doesn't sound bad whatsoever. Now that you have more staff and more management to assist, you can work on your IV skills.

  • Author
4 minutes ago, Snatchedwig said:

That doesn't sound bad whatsoever. Now that you have more staff and more management to assist, you can work on your IV skills.

When you put it that way, I guess it would sound good. On the unit I work on I am one of the better IV starters. Still, when someone is a terrible stick that can only be gotten by those trained to use the US guide, it would be nice for the patient to have someone available. As it is, we can't call the IV team until multiple people have made multiple attempts. We use them as a last resort. Now the patient will just have to keep getting stuck which means more pain and more time not getting what they need.

I am confused. PICCs are great! You don’t have to try and re-site every X days. You can draw blood without a stick. The patient doesn’t have endure multiple sticks to get IV access.

  • Author
9 hours ago, Pepper The Cat said:

I am confused. PICCs are great! You don’t have to try and re-site every X days. You can draw blood without a stick. The patient doesn’t have endure multiple sticks to get IV access.

Because of the hospital's desire to keep CLABSIs down, PICCs are only last resort. Because of this, many of our patients go through multiple IV sticks and lab draws. I work on a PCU, many times our meds are not compatible and they need more than one access. The IV team was our great resource and it bums is out that it is being taken away.

19 hours ago, HaggardRN said:

When you put it that way, I guess it would sound good. On the unit I work on I am one of the better IV starters. Still, when someone is a terrible stick that can only be gotten by those trained to use the US guide, it would be nice for the patient to have someone available. As it is, we can't call the IV team until multiple people have made multiple attempts. We use them as a last resort. Now the patient will just have to keep getting stuck which means more pain and more time not getting what they need.

Ask your manager to get an U/S machine and provide training for US-assisted IV starts. It's not rocket science, you just need a specific type of US probe.

I, and I bet many other nurses, never worked where there were IV teams.

With repitition and luck, I improved my skills. We learned what nurses on our unit/shift were extra good at IV's. We could notify the house supervisor if we were really stuck, no pun intended. She could ask a nurse from ER or ICU, or wherever, to help us. She could even ask the in-house, on call anesthesiologist, this was on 11 pm to 7 am shift.

It will hold you up from getting your work done, so if that is your fustration, I get it. I worked at a hospital similar to yours. Some of the nurses were trained to do the US method for IV sticks but still, since IV's tend to get infiltrated more often than not or get pulled out, you will be held up in getting those IV fluids in the patients, which will hold you up in getting off on time but what can you do.

Yeah, I like IV teams too. I love PICCs though. It would be best to have both, but maybe ask to float to the ER once in a while....or just go down there 2 full shifts and do nothing but start IVs and draw blood. It’s a real skill booster.

  • Guides

Change is hard. The more mobile you get with change, the happier you will be. I am sorry you are struggling. This is doable and you will get used to it.

On 9/1/2019 at 9:23 PM, HaggardRN said:

When you put it that way, I guess it would sound good. On the unit I work on I am one of the better IV starters. Still, when someone is a terrible stick that can only be gotten by those trained to use the US guide, it would be nice for the patient to have someone available. As it is, we can't call the IV team until multiple people have made multiple attempts. We use them as a last resort. Now the patient will just have to keep getting stuck which means more pain and more time not getting what they need.

Patients have the right to refuse multiple sticks and well, may want to remind them of that ?

  • Experts
On 9/1/2019 at 8:33 PM, Pepper The Cat said:

I am confused. PICCs are great! You don’t have to try and re-site every X days. You can draw blood without a stick. The patient doesn’t have endure multiple sticks to get IV access.

And a major infection possibility, and expensive. We also have vascular accesss RN with an ultrasound, but she can do midline, these are not central lines, can draw blood, and are not that costly.

On 9/1/2019 at 6:01 PM, HaggardRN said:

I have been very skeptical about the hospital I work at. It changed ownership almost 10 years ago and since then the profits have gone up but the care not so much. Lately they made changes that almost had me believing they cared: better staffing, more visible management. Then today I hear we no longer have an IV team! No more help for the hard sticks. Patients will go to radiology for PICC lines (you know that will take longer). Shame on me for letting them fool me.

I miss doing IVs! ?

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