Update on new IV nurse...5 months in, so far, so good!

iluvivt, BSN, RN · Sep 17, 2009

See....you did it!!!!!!!!. Congrats to you!!!!.:heartbeat:heartbeat:heartbeat How rewarding it is to get in an IV that is difficult and the patient get their pain med and IV therapies.........I was going to make a pit stop in IV therapy..and then go into SICU...but I fell in love with IV therapy and never left and soon realized I was gifted in being able to access veins. The next thing I did was started to study and read on my own...I got my CRNI next...started writing policies and procedures and educational material. Every day is an adventure

tinnnk · Oct 3, 2009

Iluvivt, I have a question for you since you have your CRNI, what information if anything specific do you have on the placement of Midlines? I work in a special procedures department and have been there for 2 years and we place PICC lines but have requests for Midlines as well......over the past 9 months our Midlines have decreased tremendously because of teaching that our area is doing, personally I really don't think there is a place for Midlines at all.....since decreasing their use we haven't had any calls that lines are leaking or pt's have pain in their arms....imagine that.....I think they are finally getting what we are telling them. Also I think that it was such a habit for nurses to just ask the Doc's for a midline when they couldn't place a peripheral.......Our hospital doesn't have an IV team, they did years ago but got rid of it and we all had to start our own IV's having worked in Labor and Delivery doing peripheral's starting with 18 G only I had good skills, but new nurses are not getting proper training and pt's are being stuck continuously in our hospital..... everyone wants a midline......do you have any statistics or studies that have been done on midlines causing thrombus's etc......we now are seeing younger patients who we have difficulty accessing for PICC lines because they have had Midlines in the past and thrombus's......and when we try to explain this to the floor nurses that we can't get a line in them cause or scarring, they get upset or when we explain that a pt should have a PICC they want to see the documentation or literature that tells why......there are only 2 of us who place lines in our 319 bed hospital, we work in special procedures, but they want us to show them proof......don't forget we are also doing diagnostic procedures all day long.......we also have to do the declots with cathflo because the med/surg floors don't want their nurses to do that they are too busy.......we are gearing on serious burnout.......lol....Any help you can give would be greatly appreciated....

iluvivt, BSN, RN · Oct 10, 2009

Personally I do not like midlines as I have had the same experience as you...I only place one in very special circumstances. For example..they are going home to die and only need a few days of pain medication....they have a few days of an antibiotic and it is acceptable to use the ML They only can be used if the ph of the IV medication is between 5 and 9 and only for isotonic or near isotonic solutions....That basically wipes out most hospitalized patients. What was happening to me is that I would insert a ML and of course I would check the PH and osmolality of the medications and infusates and all was OK to use a ML and I would even leave instructions for the nurses...then I would come back in a day or more and they were infusing something through it that they should have not been...and then the patient would get a whopping phlebitis....We will just place a PICC....we all hate midlines and if an MD orders them we just NO...but we can place a PICC...if you need more info let me know....it sounds like they were used without checking to see if the medication was appropriate to infuse through it....Do you need any more info?