I had to take the 2 day class (UGH UGH UGH) because the 1 day would conflict with vacay (nothings getting in the way of me and Harry Potter land at Universal-especially now that I just saw the last movie!!)
So, I'm sitting there (thankfully one of my old buds was in the class she too had a conflict and had to do the 2 day) and they were talking about IO's.
A woman from the other side raised her hand and says "What is all thsi talk bout IO's what are these"
Okay, I'll give it to her, floor nurse, might not know, new nurse might not know.
The Instructor states intraosseous. She literally looks like she's confused. She goes "Okay, what does that mean?" The instructor asked "what do you do?" She answers with an indignant tone "I'm a registered nurse" The instructor broke it down and said "It's a catheter that inserts through bone, which can be used if IV access can't be established" She than askes "you can give meds and fluids through this?" (again with the confused look) The instructor goes "Yes, if placed properly you can infuse through those just like you would a regular INT"
She than shakes her head side to side still looking confused. The instructor asks what still has her confused and the response was "IF it's in the bone, the fluid would just pop back out the bone is solid all the way through!":eek:
The instructor drew a picture of a bone on the white board. She was still confused and was told to stay after on the next break.
Later on we go to lunch, my buddy and I are in line for the sandwhich line and she's talking to another nurse "I think the ER people make things up, who in their right mind would put a needle in bone? It's ridiculous, ER people think they are Gods":cool:
I was a good girl and just ordered a tuna on wheat with no tomato and kept my mouth shut. Am I missing something? Or would other's be as flabergasted as I was (yes, my spelling stinks tonight 1 word Vicodin)
We were taught IO at my nursing school and it is still a Diploma school......its currently in the process of getting a joint B.S. with Penn State...But as it stands now its just a Diploma school....GO Aria Health School of Nursing....We also discuss in depth on our care plan the patho of medical diagnoses of our assigned patients as well as formulate nursing diagnoses.
Nope, it's used anytime good access is needed in a hurry, they go in a lot faster than dropping a CL.
I get a squicky knot in my stomach seeing them placed.
And they do hurt like a mofo and can be very sore for a couple weeks afterward. But they sure beat the alternative of not having access when it's needed.
My instructor talked about IOs briefly. She mentioned it is only meant for immediate access and that it can't stay in for longer than 24 hours. After that, either peripheral or central access should be established. That seems accurate.
Not medications, medicine. We still learn lots and lots of meds in nursing school, and do dozens (hundreds?) of drug cards! But what the commenter meant was that we aren't allowed to do is say something like, "I think my patient has pneumonia," because that's a medical diagnosis. We have to say, "My patient has crackles in his lungs, a 101.0-degree fever, and an elevated WBC count," because those are "nursing observations." We are taught that only the doctor can say "That's pneumonia." It's stupid, but that's how they're teaching us.
Actually, it's: "My patient has ineffective gas exchange related to bacterial consolidation in the lungs as evidenced by crackles in the lungs, a 101.0 degree fever and an elevated WBC.
It's one thing to not know what an IO is, but totally another to not accept or understand it after it's been explained. Sheesh!
We have 2 EZ IOs at my facility, but they never get used. Had a post cardiac arrest come in not too long ago with one placed in the field, doc didn't want to use it.
I wonder what's different about physician training and our training that makes the docs less interested in using IO access?
My instructor talked about IOs briefly. She mentioned it is only meant for immediate access and that it can't stay in for longer than 24 hours. After that either peripheral or central access should be established. That seems accurate.[/quote']
It's true that they should not be used longer than 24 hours. However, in some situations, I have seen them used longer, however the risk of complications increases significantly. Also, these are not only placed in the ED, as we use them in the PICU I work in. They really are amazingly simple and quick to get in place, and work quite well in emergency situations.
I remember the Twist and push and the phrase "Once it pops you can stop!"
I think out of this was my main concern was 1. it was ACLS you have to do the pre-test, and you have to READ the book. Even if you skim through it you would have been introduced into this material so she wasn't prepared. and 2. ANATOMY people ANATOMY.
If she doesn't know basic anatomy that's majorly concerning. I would assume if I was on a med-surg floor I probably would have NO knowledge of IO's but, once it's explained I would get the concept and not argue with the instructor.
The entire I'm here just pass me mentality is a little unnerving especially with the new changes to ACLS and the whole this is how you treat this and this is how you treat that. If your not willing to accept a basic anatomy lesson from an instructor, what makes me so sure you would accept anything else?
The problem is not a lack of intelligence among students; the problem is that those who have control over the direction of nursing education are steering it sharply away from learning medical knowledge.
Agreed. Things are steered more towards learning how to CYA "cover your a**" (a term my instructors used daily) and what is needed to comply with medicare and state regulations. too bad.
The entire I'm here just pass me mentality is a little unnerving especially with the new changes to ACLS and the whole this is how you treat this and this is how you treat that. If your not willing to accept a basic anatomy lesson from an instructor, what makes me so sure you would accept anything else?
Totally agree with this... that's what I enjoyed about TNCC. The instructors had no problem failing students.
A very experienced provider and instructor who I have great respect for tells students and newbie docs and nurses, "If after 2 minutes of poking around a critical patient you still have no IV access ... you should be putting in an IO."
Resistance to utilizing IOs is a paradigm that needs to shift!
nep1980
128 Posts
We were taught IO at my nursing school and it is still a Diploma school......its currently in the process of getting a joint B.S. with Penn State...But as it stands now its just a Diploma school....GO Aria Health School of Nursing....We also discuss in depth on our care plan the patho of medical diagnoses of our assigned patients as well as formulate nursing diagnoses.