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Who starts IV's at night at your workplace?

Posted

Specializes in Oncology, Hospice, Med-Surg. Has 4 years experience.

The hospital I work at requires that iv therapy start iv's from about 7:30a-10:30pm. After that you have to call the nursing supervisor who finds a nurse from somewhere else like ICU, etc. The average floor nurse doesn't start IV's. I wonder what other places do about this? I had to throw out some plasma on a patient who was a hard stick because it took over an hour to get a new iv site. One night it took 3 hours to get an iv started because so many nurses called in on halloween night! I think it is ridiculous that they don't have just one iv therapy nurse overnight and I'm sure they could find things for them to do in between that'd be productive.

ChristineN, BSN, RN

Specializes in Pediatric/Adolescent, Med-Surg.

Neither of the hospitals I work at have IV team, so the floor nurses put it in. If it is an especially hard stick I would ask charge nurse to try. After multiple failed nurse attempts, the doctors can get anesthesia involved to try to start an IV.

cocoon2butterfly

Specializes in Psych, Pediatrics, GI, Diabetes.

Either our charge nurse does, then the floating preceptor, and if all else fails, someone from PICU will come over and put one in - if we know in advance it's a hard stick, we just call the PICU from the get-go...(I work in a pediatric hospital... :) )

amarilla, RN

Specializes in MS, ED. Has 2 years experience.

We do our own IVs, day or night. If someone is particularly hard to get and multiple nurses have already tried, we might ask an ICU nurse to come over, (we're next door to the SICU.) We are a teaching floor, though, so many times our especially 'hard sticks' were evaluated by surgery for a line when they were admitted and usually have one placed by the residents, even if it's just an EJ.

We do all of our own lines...if something is especially difficult and we can't find anything even on the feet or EJ, we use the ultrasound and someone in the departmenet that is credentialed will use it. I don't work inpatient so I may be asking an obvious question, but why aren't floor nurses allowed to start IVs at your facility? I've never heard of that :confused:

of the hospitals I have worked at two had PICC teams that were sometimes an option if you had a tough stick, but over all all the floor nurses put them in. We actually would call ED sometimes only because when we would call ICU they would remind us that they do less IVs then us because most of their patients have central lines. Off shift we also used the hospital supervisor where there was only a day shift PICC team....and yeah like someone else said anesthesia.

Its really best if you speak to your hospitals DON and let her know that this practice (that may be in place due to a high infection rate at IV sites) is causing a delay in care. Another plan needs to be put in place before a serious problem or even death occurs. Maybe 1 or 2 night IV team nurses. But still the floor nurses should be trained to put in a basic IV. If infection is an issue for the hospital-- this is why some use only IV team--all the floor nurses, experienced or not should need an inservice on insertion and how to prevent infections. A basic IV is really not that hard.........actually it's one of the things I miss since leaving medicine! Not too many IVs in Psych! lol

Everyone on my floor starts IV's. PICC lines are done during the day with the interventional radiologist. we don't have picc teams, unfortunately. i remember just one time when anesthesia was called. they placed an IV in the foot. i believe the patient was seizing or something along those lines. If we can't start it, we just call the house MD. our house MD who use to be a pediatrician (now emergency medicine) is excellent. one stick wonder.

StayLost, BSN, RN

Specializes in CVICU, CCU, Heart Transplant. Has 5 years experience.

Don't call the ICU nurses on my unit. All of our pt's come to us with IV's already in or central lines. I put in an IV maybe once every month and a half, and it usually ends up with an order for a PICC line.

Floor nurses do the IVs on all shifts at my facility as well. If we get a tough stick and either don't have a lot of options or there have been multiple attempts from multiple people we might ask someone from ED to try. Usually with patients that bad, we start talking to the doctors right away about putting in a PICC or central if the patient will be with us for a while. I never call the ICU nurses, they have centrals and PICCs for most of their patients so I put IVs in more often than they do. The ones who do have peripheral IVs usually got them prior to going to the ICU (either on the floor or in the ED).

suanna

Specializes in Post Anesthesia. Has 30 years experience.

I am amazed that IV skills are no longer part of every nurses basic skill set. Sure, no one is good at them comming out of school, but that is true of many of out nursing skills. At my employer, every nurse starts thier own IVs. If it is a difficult stick, they can ask for a more experienced nurse to assist, but they are expected to participate in the process so thier skills improve. We need to be careful what skills we give up as basic bedside care providers. It is a path to having non-licenced care givers taking over our jobs if the more "skilled" proceedures are routed to a nurse as a specialist. What is left over can be done by a non-nurse. I see a day when a nurse covers the whole floor, or the whole hospital, with med techs, NAs, and various hospital certified bedside care providers doing the patient care.

GooeyRN, ASN, RN

Specializes in Psych, Med/Surg, LTC. Has 12 years experience.

Whoever the staff nurse assigned to the patient is. Take a few tries, then find another staff nurse. Do this with all staff nurses. Take a few tries, then call the ICU. If they miss a few times, try the ER nurse. If they can't get it in- well, it waits until the next day when anesthesia comes in.

biblepoet

Specializes in Correctional Nursing, Orthopediacs.

One word we do no IV start team here. I give myself two tries then I find an more experienced nurse and watch how she does it. Some of the people when the doctor is in will ask the doctor to do it. We have alot of IV drug users and they are a hard stick.

NoblePath

Specializes in Oncology, Hospice, Med-Surg. Has 4 years experience.

Well I've since found out that a floor nurse has to accompany IV therapy and successfully complete 10 iv's before you can start them on your own. Also I work on an oncology floor and our pt's usually have ports or piccs but the patients that come up that are not oncology are sickle cell or iv drug users so these are people that are frequent flyers and are notorious hard sticks (we get the same sickle cell pt's over and over). It's not uncommon for these people to have an iv in the foot or a finger. So I guess the thinking is that they don't want us to attempt an iv on someone who is a notorious hard stick if you rarely ever start them. They also did some patient satisfaction survey and found that patients especially remember when their iv was started and it's an indicator or high or low satisfaction so they want as little of attempts as possible. It's still frustrating though.