Ticked Off/ Major Vent/ What To Do?

[bshaw96]

I have only been in HH since February, and genuinely love it. Although recently, I'm starting to see things I don't like. Here's the problem.

I have posted before about trouble accessing one of my patient's ports. It has tilted and migrated. She is on IV's at home and the needle is changed weekly. Anyway, I attempted x 2 on admit, and couldn't get it. Sent her to ER, and IV team got it. The next week, I tried x 2 again, same problem. The next day, they sent another nurse to try, one who had worked IV's for 12 years. He couldn't get it either. Back to ER she goes. I had discussed this with my clinical manager and we'd decided to simply have her scheduled to go to outpatient every week t o have it changed as it was not fair to patient to keep trying when we clearly couldn't get it. No problem.

Well, today I get an email from the same manager stating she spoke with her manager and we need to at least try every week. States if no success, send to ER. Why? So the visit will be billable! Now this just ticks me off. We've already established we cannot access it in the home for whatever reason. Not just me, also the most skilled IV nurse we have. But there's no budging on this with them. Every week, for the next month, I have to needlessly stick this lady. Unless of course, she refuses and requests it be done at hospital :wink2: She was quite OK with the idea of a weekly trip to the hospital vs. having us all attempt without success when I first told her those were the plans. I'm just so peeved! And we're supposedly a not for profit agency. What would you do?????????

[cookie102]

how about getting an order from the doctor that says pt to go to outpt for mediport access???

[accessqueen]

How about sending the patient for a flow study to determine if the port is properly positioned. Sometimes the sutures securing them get loose and the ports flop around. This could potentially cause someone to access incorrectly and lead to infiltration.

[bshaw96]

The first time I sent her to the ER it was supposed to be for a flow study. They never did it, and the IV nurse just accessed it and sent her back. I was in the process (today actually) of calling to get the orders to have her set up for outpatient q Friday when I got the notorious email. Pretty much trying to tell me I had to keep trying. That's alright, because I know my patient, and she's gonna request to have it done at the hospital and that will be that. I just hate seeing the greedy side of healthcare although I Know it exists.