His name was George.
I worked night shift on a telemetry floor. Of course, all of our patients had to have IV access. It was standard policy and made sense should we need access in an emergency. Although the IVs were checked for patency every eight hours and changed every three days, it never failed that the IV would blow on night shift.
We were supposed to try twice to get access, but sometimes, the people we had on the unit were very sick. They had crap veins, and I would try, but I could never get them -- even with a 22 gauge.
I could always count on George, though.
When I heard the cart coming down my hallway, I'd peek around to see who the IV nurse was. Both of the IV nurses were good, but I knew that George could get anyone. I would smile when I saw him, walk him to the patient's room, and in ten minutes, he would come out. My patient would have access, and I was elated. Then we'd swap war stories of all the IVs we'd managed to get before.
I know I was straight up lucky to work in a facility with an IV team. Those nurses were always busy, pushing their carts through the units, getting access where everyone on the floor had failed, and basically saving our behinds when we just couldn't find a viable vein. Do IV teams make bedside nurses lazy? I don't think so, but I was always grateful when the team would come and help me out.
They were like magic in a code. I swear, those nurses could cannulate a vein in the middle of an F5 tornado. For some reason, the IVs we babied through the days and nights would inexplicably not work in emergency situations. I remember one IV nurse winding her way through the crowd, unphased by compressions, and getting access on one stick. That's what these professionals are about.
IV nurses don't just handle peripheral IVs, either. They are the masters of the PICC and central line. In my facility, IV nurses were trained and certified to start PICCs on their own. It was a fascinating procedure, almost like an operation, and I couldn't help but be impressed with their skill. Even when a PICC or central line clogged, they galloped to the rescue once again to get the ports open. Of course, they couldn't insert central lines, but they assisted with insertion and were responsible for their operation after the fact.
I remember one time when I was orienting in the ICU. We had a patient who needed bedside dialysis. It was the middle of the night -- what else? -- and we had to call in a very grumpy thoracic surgeon to insert the central line. The IV nurse came in and assisted him through the procedure, taking a great deal of stress off of me. I was so new that I wouldn't have known even how to begin assisting in a procedure like that.
Another time, we had the most difficult of scenarios. The patient was on dialysis and a breast cancer survivor. It only stands to reason that the blown fistula was in the right arm, and the breast cancer was on the left side. How else would it be? I admit that I immediately called the IV team. We talked to doctors and experts and anyone we could think of.
Eventually, it was decided to put the access in the breast cancer side, if I am remembering correctly. Obviously, these were extenuating circumstances, and the IV nurse quickly and easily found access in an arm that hadn't seen cannulation in years.
Also, when I was a new grad on orientation, I was trying to start an IV on my elderly patient. Not knowing any better, I started one on the inside of the wrist. I found a nice, strong vein there. The IV slid in, and for some reason, the blood kept pumping up into the port. I'd never seen that before, so I called my preceptor in. I asked her if it was possible that I cannulated an artery. Of course not, she told me. That's impossible. Call the IV team.
The IV nurse was really nice on the phone. She asked where the IV was. Uh-huh. And you see pulsing, right? Uh-huh. You just started an arterial line! Congratulations! My preceptor was floored. She'd never heard of someone starting an art line accidentally. So, I took it out, held pressure for ten minutes, and tried again in a different spot. I still didn't get it, and that nice IV nurse came up and got one in for me, no problem.
The point of this is that IV nurses are the unsung heroes of the nursing facility. Some hospitals don't have teams. PICCs and central lines are handled by doctors. However, inserting IVs is as much a specialty as anything else. It isn't about coddling the bedside nurse or even giving them the opportunity to lose their skills. IV nurses are vital to the treatment of the patient.
Think about it: would you like to be stuck twice by a nurse who has a hundred other things on their mind? Would you like them to take two chances and miss when an expert is on hand that could get it in one go? The need for IV teams may be controversial in some circles, but I know that I was always grateful when I heard them come down the hall. These nurses were some of my closest friends outside of the people on my floor, and I can't help but feel a tremendous amount of gratitude toward them for helping me and helping the patient.
PacoUSA, BSN, RN
3,450 Posts
I'd be one of those nurses who would gladly do IVs for you in exchange for trach care!!
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