Our team has been referred to as the PICC Team since its inception, and members as PICC nurses. We are VA-BC certified and in our facility are looked at as experts in our field. We are looking to build our team into a more collaborative service with a medical director and place centrally inserted central lines and art lines, among the many things we do now. Our facility is undergoing huge changes and our management has relayed that the timing is off for this request.
In the meantime we have asked our management to let us change our team name to Vascular Access Team, and members to Vascular Access Specialists. We requested a formal name change to help with this process and facilitate the culture change to really look at us as encompassing everything vascular access. They were hesitant and we were asked to provide a list of teams across the nation that refer to them as this vs. a "PICC team" and strong evidence to show why this is important despite our argument and efforts. We are currently placing adult and pediatric PICCs, midlines, UG PIVs, heavily involved with care and maintenance, policy development, education, and surveillance.
I am looking for as many teams that refer to themselves as Vascular Access Specialists, where they are, and any good references or information to provide our management............... Thank you in advance for your help!!
Sounds like your a Vascular Access Team now...why would the hospital be hesitant? PICC teams were the title giving to "picc and run" teams. Picc and run teams were very prevalent back in 1999 and the beginning of 2000. But as teams started expanding responsibilties with Central lines, Midlines, A-lines etc....the "PICC Team" moniker just didn't feel like it fit. So, I think, that's when Vascular Access Teams started. Which is a much more appropriate name. I'm not sure why the hospitals wouldn't want you to have that title? Is there a salary difference?
Jack
No salary increase. I agree that we are one now. They know we are very interested in expanding our services to central lines and a-lines, but again not good timing for our facility at this exact moment. That may be the hang-up and they would prefer to look at the change all at once.
I think it would really help our cause to give them a list of what teams are calling themselves, and what they are doing or placing in specific organizations across the nation. Not only for the name change now, but expanding our services in the future.
I work for 3 Vascular Access Teams in three hospitals and they are all under the name Vascular Access Team with one exception due to it's smaller size but it is coming in the near future as our expertise expands.
Christin Dillon BSN, RN VA-BC
I cringe at being called "PICC nurse". I also know how to insert foley catheters, does that make me a "Foley nurse"?
I call myself a "Vascular Access Specialist" and my job title in the hospital was "Vascular Access Coordinator"
There should not be any teams that only focus exclusively on insertion of PICCs. Your focus should be much broader than that. Consider the full scope of an infusion team. And I do NOT mean a team that gives IV medications. Those groups are usually in outpatient or alternative settings. My focus here is on acute care hospital.
In the style of Jeff Foxworthy, you might be an infusion team If your team supports the primary nursing staff when they have difficulties with peripheral insertion.
You might be an infusion team IF your team provides care and maintenance of all types of VADs during their dwell.
You might be an infusion team IF you are doing a complete patient assessment for the most appropriate type of VAD before you begin insertion.
You might be an infusion team IF your team is called to manage VAD or infusion related complications.
You might be an infusion team IF your team is involved with staff education about all aspects of VAD care and infusion therapy.
You might be an infusion team IF your team spearheads all product evaluations related to infusion therapy such as infusion pumps, and needleless connectors.
You might be an infusion team IF your team members serves on a variety of committees such as pharmacy and therapeuctics, infection prevention, practice or education councils, etc.
You might be an infusion team IF your team is involved with outcome monitoring and quality improvement initiatives regarding all aspects of VAD insertion, maintenance, medication errors, parenteral nutrition, or blood and blood components.
I could go on, but you get the idea. If your team focuses only on the insertion of CVADs, and is limited to that then you are a vascular access team. If your practice goes beyond insertion then you are an infusion team. We can try as hard as we might but the VAD and infusion therapy can not and should not be separated. Your team could have a certain number of people that focus only on CVAD insertion while other team members do the other aspects of team activites. There are many types of team structures and this is not a one size fits all world. Many think that the old concept of "IV teams" have totally disappeared. That is simply not the case. Many have survived the disbanding fervor because they focused on expanding their practice, tracked outcomes and could prove what contribution they made to safe patient care by the complications they prevented. They did not limit their focus to the number of procedures they performed.
Think this over very carefully to determine what your scope of practice should be for your facility! Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I read Lynn's definition and she makes a point about Infusion Therapy Teams. However, I think you have to decide, are you a Vascular Access Team?....meaning all things that are related to the Vascular Access. That could cover: Insertion of devices, care and maintenance of the device inserted, decisions on appropriate device given the clinical indication, advanced assessment to determine which device for which disease process, and early intervention, getting the right line in as soon as possible.
As an Infusion Therapist I would imagine you have to infuse something. So you may take the responsiblities as listed above, and in addition be an active participant in giving infusions. This is where you lose me. I believe, what makes us special is the inability for duplication of effort. As a Vascular Access expert, no other can do that job without the experience and expertise that took years to acheive. As an Infusion Nurse, every nurse on the floor can and does give the infusion. So, how does that differentiate you from the floor nurse or the ICU nurse or an ER nurse. Do you possess some special knowledge on infusions that the other nurses can't get?
I understand the broading of scope philosophy, but I believe in speciality more. I think that makes us stronger as nurses when we become highly specialized....that's why physicians have done it for decades.
Jack
ps. I wouldn't lose sleep over the term PICC NURSE, it actually is a term that launched us into a specialized group....show some respect. Remember, there were always IV Teams, until the money got tight...then there were no IV teams
"Do you possess some special knowledge on infusions that the other nurses can't get?" Absolutely! It's not that they can't get this knowledge, but it took me a lot of dedication and study to learn and if they care to do the same it is available. Otherwise, my CRNI wouldn't mean a darn thing. Specialization indeed.
Ok Jill, Fair enough but give me a little background. Do you give medications?...do you work on a floor And put in PICC's?...I'm not disagreeing with you. I'm just wondering how you are the Vascular Access expert in your hospital AND the Infusion expert on the floors?...just trying to figure out that role. Help me. Oh and I never said CRNI is not worth anything. It absolutely is like CEN, VA-BC,CCRN....
Jack
yes. As a matter of fact, just yesterday the pharmacist and I had a conversation about the best way to handle an infusion order. I am most definitely seen as the resource. My facility trusts me to investigate what I don't know. And yes, occasionally there is an infusion for the Vascular Access Coordinator to manage. Home Health also calls with questions and the outpatient infusion center, so absolutely a resounding yes.
Ok so your in the hospital placing PICC's, Midlines, Axillary's and IJ's to the in patient population, and the pharmacist is still calling you to advise on an infusion?...I don't what you make Jill, but it isn't enough I assure you. Fortunately my role of the Vascular Access Nurse is just the insertion of the right line. And by right line I mean all the lines I just mentioned. I do not, nor do I want to, be consulted on what should go into the TPN formula for a particular patient. I can't be an expert at everything so my team and I are the experts at inserting all those lines....and believe me that's enough!
This message is for Jack about his ill-informed comments on infuson teams. I hate to be the one to correct you but you could not be more wrong in your assessment of infusion teams vs vascular access teams. Your misconceptions are not infomred by current evidence about outcomes with infusion teams or the history of these teams. The name historically given to these teams is "IV teams" or "IV Therapy Teams." The first team was formed at Mass General Hospital in the late 1940's. Even as late as the middle 1960's several state laws prohibited any professonal other than an MD from inserting a peripheral IV device. Most states developed a Joint Practice statement between the boards of nursing and medicine extending this practice of IV insertion to only those nurses working on these specialized teams. So these emphasis has always been on insertion of the vascular access device. The practice was recognized as a speciality with the formation of the National Intravenous Therapy Association in 1973.This organization later changed the name to the Intravenous Nurses Society and then to the Infusion Nurses Society. The reason for this change was because infusion was then and is now NOT limited to only intravenous infusions but extends to epidural, intraspinal, subcutaneous, intraarterial, intraosseus, intraplural, and intraperitoneal. The very choice of VAD is totally dependend upon the type and length of therapy, numerous patient factors, and the venue of care. So the global approach is from the complete world of infusion therapy. I have worked on infusion team that did all medication administration and teams that focused on insertion and other care and maintenace without actually giving the medications. So the word "infusion" definitely does not indicate that these teams must do infusion of the medications. The eight core content areas in infusion nursing include fluid and electrolytes, pharmacology, antineoplastic and biological therapy, parentaral nutration, transfusion therapy, special populations (neonates, pediatrics, and older adults and pregnant wormen), infection prevention, and technology and clinical applications. This last one is critical because this contains the content related to all vascular access devices, their indications, insertion, care, maintanance, and complications. This list of content areas forms the scope of the CRNI examination fist offered in 1985. As you can see this is much broader than the VABC. Each person should choose what type of practice they want. I totally agree that insertion requires a high level of skill BUT that knowledge, skill, and critical thinking MUST include the therapy being infused. Infusion teams have not gone away as you suggested. Quite the contrary. I see strong evidence that teams that previously only focused on VAD insertion is realizing the need for expansion of their practice into the care after insertion. Those teams that ONLY perform insertions and then dump the rest of the patient's care onto oerburdened staff nurses are the problem, in my opinion. Jill's comments are totally accurate. She and I have been in siimilar clinical scenarios where we are inserting lines and managing these infusion related questions. In fact, several teams I have worked on where located in the pharmacy and several still are today. The 2016 Infusion Therapy Standards of Practice will include a new standard on infusion teams. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn,
Why are you always correcting someone. I'm not fighting with you about semantics of "Infusion Teams" and "Vascular Access Teams"......However, you are the resident expert on this site and obviously you have been around many years. Your grasp on Infusion Nursing history is impressive. How can anyone argue with what you just said. And you have alot of folks that I imagine want to follow in your footsteps, I can tell by all the comments.
But, you need to tell me ....what have you done recently. How many lines are you personally inserting?....It's one thing to teach, another to do. When was the last time you had to troubleshoot your way out of a difficult insertion. When was the last time you placed an axillary line at the bedside, making that decision that, that was the best line. I'm not on here telling ANYONE how they should practice their nursing. I bring only true to life examples of what's happening in the real world. You once said that it's good to have all that experience but you don't have the data after the insertion. Keith once said that he cares little about the experience and more about the evidence based studies.
I'll tell who says things like that Lynn. Nurses that don't do it. If you had 10,000 MST insertions with varying patient mixes, I think your advice would be different. It's great to have folks like yourself behind the scenes reading the latest material, but to be able to go to ANY bedside and assess ANY patient and expertly place ANY access....If I had to get a line?....I want that guy. So, I enjoy your advice and I will continue to read what you tell the nurses that ask for it. But, c'mon Lynn...I've been a nurse for 25 years 12 in Vascular Access, 5 in home infusion, 5 in ER medicine and 3 in management. Do you really think I don't know what I'm talking about?
Even if you don't agree with me....my aim here is true...I bring the practicum! It's amazing to me how nurses want to put all their faith in the readers and not the practitioners. But I guess that will never change.
Jack
I have not made a secret or tried to hide the fact that my practice now is education and consulting and not clinical practice. This career choice came after decades of clinical practice on numerous infusion teams. It takes both educators and clinical practice personnel. Evidence is more than a buzz word and it is a trend that is here to stay. Therefore we also need researchers. They are not in clinical practice either yet have much to contribute. The title of a team is sometimes a semantic issue and sometimes not. I am now, have always been, and always will be a strong advocate for the comprehensive infusion team and make no apology for that because I strongly believe it provides the best outcomes for the patient, the facility and the staff. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Fair enough. I just ask that you be kinder to us STILL on the floors putting in these lines and battling the real time problems . It's one thing (and an interesting thing) to read about a study that shows if you put a "Do not enter" sign on the door it could reduce the chance of infection by 6.3 %.....OK that's great but it doesn't mean every hospital system should change their policy. Look Lynn, the truth is we all do things differently...if there was ONE proper way then everyone would be doing it exactly the same way. But, that simply is not happening. So, it's the practice that determines what study you'll do next week. But in the end, I hope it's the practice that can come here and let us ALL know what they are doing without fear of criticism. Because as much as I use things you have said on this site, to support arguements for additional resources, it's ultimately up to the institution to allow us to spend.
But I will say that I feel that its invaluable what Hadawayassociates and PICC Excellence is doing because it's your work that gives the nurses entering into this field the basic knowledge they need to get started. And believe me, they need it. And I'm not just saying that so you won't hate me , I truly mean it.
Jack
Hello to the author,
I congratulate you on your desire to expand your role and incule placement of centrally placed central lines. We transitioned from PICc insertions to centrally placed central lines a few years ago and have enjoyed succes and growth of the service. What we did was first establish aministrativer approval to proceed with the program development and implemetation and then worried about a name change later. I wish you very good luck and please let me know if I can help in any way.
Tim
Tim Youngmann RN
Good job Tim,
Now I would like to ask a NON THREATENING QUESTION to the group.....Can you still be a Vascular Access Specialist if you do NOT place all the lines that fall within your scope. So, if you place PICC's, Midline's and PIV's...but do not place IJ's or Axillary lines...would you be considered the same as someone that does? And does one presume that being VA-BC shows you do place all access types?
Remember, Just asking...not looking to fight
Jack
The scope of your service is defined by your employer and your state board of nursing. Your certification has nothing to do with the scope of service that you provide. All certifications signfy that the individual has mastered a defined body of knowledge in that specialty. The CRNI certification is more comprehensive than the VA-BC but neither sets limits or extensions on the actual services that you are legally allowed to perform. That comes from your state board of nursing and your legal scope of practice. Many, including me, consider themselves to be specialist in infusion therapy and vascular access but my scope of services provided is focused on education after decades of clinical practice. So yes you are still a VA specialist or Infusion Nurse Sepcialist even if you do not place lines of a certain type. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
VA-BC is not a certification for inserters. It is a certification for all disciplines who work with vascular access in some capacity. It is true that many people with the certification do insert lines, but it is certainly not a requirement, nor is it in the Job Description. There are pharmacists with VA-BC, for instance. Is Interventional Radiology the experts on ports because they are the ones who place them? No. They are the experts on inserting ports, but I'd go to an experienced oncology nurse if I needed to troubleshoot it before I'd go to IR. Just saying that I think there is more to vascular access expertise than just inserting. As nurses we should embrace a more holistic approach to our care rather than reducing ourselves to tasks.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Certification is for verfication of a knowledge base. You may have a certificate that shows you can do a specific skill, but that is not certification. Google certification vs certificate, there are lots and lots of sites to clearly explain the difference.
I would be uneasy with a team that inserts lines and has little knowledge of the intended therapies. The two are inseparable. Vascular access is the highway upon which almost all healthcare is delivered. It really doesn't make sense to lay a road if you have no clue where it is supposed to go or what kind of vehicles are going to be using it. Know the patient, the medications, purpose, history, all of it. Knowing how to get a line in a human is great! Why is it there?
Jill, I love your road analogy!! You are so right about a true board certification and a certificate!! Thanks for posting this. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
So basically VA-BC means little. I don't agree, I think it is a certification like an ER certification (CEN). I know many managers that still carry a CEN but don't work in the ER. So certifications just show that you possess a body of knowledge in a particular area. It never trumps experience. I have to tell you I think this whole discussion hurts nursing. Everyone wants to be experts because you read all the EBP. But how do you know if all that EBP works, if you don't do it. And the problem is, if you find that a certain procedure or steps is not best for your particular patient mix, do you have to call for another study?...I think it's sad that this is the one area that we as nurses can direct into the future. Determine where the practice goes. And yet, as Keith stated, I'm more interested in the EBP than the experience. So, basically the Vascular Access Practicioner is just a technician. They learn from you guys, then they go insert. So, you set the precedence on practice, but you have no liability because you don't insert. You argue with an experienced inserter that disagrees with you on practice, yet you have no responsibility. I'm wrong or another author is wrong, because they are not strickly adhering to EBP, yet you have no idea what they are facing everyday. The one area, and we as nurses, can control and lead, and yet we continue to be led.
I always said, why I find Lynn's and Jill's and Keith's comments interesting and informative, I would love to hear from the bedside Vascular Access nurse. I will continue to read as much of the EBP as I can, But this is afterall, a minor surgical procedure. The folks performing this procedure are much more interesting to me. I hope there are not nurses out there reading this stuff but afraid to comment only to be scolded for NOT following EBP to the letter. Oh, and as I stated before , there are studies to support almost any arguement. So, your quick to list all your letters behind your name, and yet most of you don't touch patients. And Keith your a nurse Navigator!...not that there is anything wrong with that....but c'mon. Your advising on insertion problems?...Really?
None of you guys will answer because you never do. But just think about what I write here and understand there are alot of me out there trying everyday to do the best we can, getting better at the procedure, toubleshooting,making patients feel good about a difficult procedure so you guys can do what you do.
Jack
Ps. Jill, at least I'm driving down the road.
I’m not “advising on” anything. I come here to learn and share my opinions with others. We are bound to disagree on issues. That’s how we learn. I respect your years of experience. Thank you for your service. I was an inserter in the past; in fact, I helped stand up a Vascular Access Team at a major military hospital and setup and ran an outpatient PICC “clinic.” I also am appreciated for my oncology background as it pertains to vascular access, which I why I was invited to be a member of not only the Vascular Access Certification Corporation’s exam review committee, but also the Association for Vascular Access’ Standards of Practice Task Force. I was promoted to Oncology Nurse Navigator because of my varied background, which my employer felt would give our vets and service members the most comprehensive treatment experience. I try to do this every day, but I recognize my limitations and seek out the collegiality of discussion boards such as this one and the various oncology boards to which I also subscribe. I try not to limit my practice to one area, instead choosing to embrace multiple disciplines that touch on oncology so that I can be a resource for not only my patients and my co-workers, but also my hospital and regional VA healthcare system.
I should not have to defend my experience and credentials. Frankly they are irrelevant in a discussion board. There is no need to discredit me on your posts by questioning my interest in vascular access as a nurse navigator. Personal attacks are unprofessional and have no place in a neutral discussion board.
If you would like to know what I do as a Nurse Navigator and how it pertains to vascular access, I would be happy to share it with you. I love my job and I am proud of what I do. I miss inserting, but I wouldn’t trade my role as a patient advocate and educator for anything!
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
I would definitely like to know more about your role as nurse navigator! Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Hi Lynn,
I appreciate your interest in my role. Below I attached an article I recently wrote for the quarterly nursing journal for VA Northern CA Healthcare System. It gives a glimpse of some of the challenges that I was hired to overcome. Today I worked with a new breast cancer patient who is dealing with some delayed wound healing after her bilateral mastectomy. I welcomed her to our clinic, spent about an hour with her talking about her planned treatment, infection control, and side effect management. I assessed and then accessed her new port for baseline labs. I introduced her to the infusion nurses and to the social worker to set her up for a wig. I ensured all of her baseline radiographic studies were done. I coordinated with a local hospital in the area to schedule her for the American Cancer Society's "Look Good Feel Better" class. I got to know her and her husband and found out what challenges she might encounter during her treatment and beyond.
After I led her through the infusion room and introduced the facility to her, I took her to her oncologist and we talked together about her treatment plan. While walking back to my office, I once again passed through the infusion room and was stopped by literally ever single patient getting chemo so they could say Hi. They all remember their first meeting with me and they know they can always call me or grab me if they need anything. Then I get to go back to my office and read my discussion boards and write to the Nurse Practice Council and our new Nurse Residency Program coordinator to explain why "Accessing an Implanted Port" should not be the only learning objective for a one-day NRP rotation in oncology!
That's just a snapshot. I think I have the best job in the hospital. I can't tell anybody here that or else they'll ruin my gig!
Keith
“Turning Miles into Minutes”
Keith Gilchrist, BSN, RN, OCN
Joint VA/DoD Oncology Case Manager
Coordinating oncology care for the Veterans of NCHCS is challenging within a single hospital. Try doing it across two or more! The nurses, nurse practitioners, and staff at David Grant Medical Center (DGMC) in Fairfield and The Center for Extended Care and Rehabilitation (CREC) in Martinez do it every day! Add multiple computerized charting systems to the mix and you have one complex system.
As a result of the VA/Department of Defense Joint Venture, Veterans who require radiation therapy for the treatment of their cancer are often referred to DGMC. Veterans are admitted to the CREC if they live out of the local area and will require nursing services during their treatment. Potentially this distance and the different charting systems involved create a communication nightmare, but not for our staff!
Recently, nurses from DGMC’s Joint VA/DoD Hematology/Oncology and Radiation Oncology clinics and nurse practitioners from the CREC formed “The DGMC/CREC Nursing Collaborative.” This multidisciplinary workgroup brings together staff from both facilities and from many disciplines including nursing, medicine, nutritional medicine, speech/language pathology, and palliative care. The group meets every month in an effort to be proactive about the issues facing our unique arrangement. The focus of the Collaborative is on communication, patient safety, and systems improvement.
The success of our group has led to an early expansion to include nurse practitioners from the Sacramento VAMC representing oncology and palliative care. The group is thrilled to be able to meet and openly discuss issues facing our facilities and the unique challenges presented while caring for complex patients at facilities separated by many, long miles. VANTS lines shorten the distances between our facilities when members are unable to leave their respective sites. Minutes from each meeting are recorded and shared with members.
Currently, the team is working on improving communication of acute changes in patient status, isolation precautions, medication management and palliative care screening. The group credits the openness and willingness of all participants to think “outside the box” in order to effect changes in practice that benefit our veterans. Though we care for patients while working miles apart, we are only “minutes” away from making VANCHCS a better and safer place for our Veterans to receive their healthcare.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
A wonderful service! I know how difficult it is to navigate through our complex healthcare system due to the care of both of my parents. I often wonder what families do when they do not have a nurse in the family!! Sounds like your role fills that much needed gap. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you, Lynn! You are a superb role model and unwitting mentor! My older daughter is an 18 year cancer survivor who is also a paraplegic. We spend a lot of time in the hospital for various issues. The only reason I know what questions to ask are because of my job! I don't know how others do it.
Keith W. Gilchrist, MSN, RN, PHN, OCN, CRNI, VA-BC
Oncology Nurse Navigator, David Grant Medical Center
Travis AFB, CA
Well Keith it sounds like you do a wonderful job. The fact that you do it for Veterans and their families is a double kudos. I, being a Veteran myself, am inspired that someone is out there doing good work, especially in light of all the bad things that are said about VA Hospitals. So seriously, Thank you for your service.
Jack
Well, we are still basically called the IV Team by most people and that's what's on the sign outside our office !! We place most of the PICCs and midlines but also do all CVC dressings ( except in ICU & CCU ) access most ports , administer CathFlo and routinely place PIVs in all floors/areas/units of the hospital.Yes, we do monitors and surveillance and write new policy/procedures PRN and tweak the old ones occasionally. Teach an every other month IV Therapy class to mostly new nurses but open to anyone who needs a refresher. We are all CRNIs. We have an Infusion Clinic housed on an in-patient floor and the way they staff it is rotating about 5 of the nurses to cover those patients for their daily assignment. They are getting better, but we are called for "back-up" frequently. Funny story was -a couple of the nurses were going to take the CRNI Exam and 1 nurse told us we basically had an "IV Therapy certification" , they were taking a more in depth exam "Infusion Therapy". Is it administered by the INCC ? Why -yes. And endorsed by the INS ? Um, yes. Well, same CRNI I've had for almost 20 years - good luck !! ( 1 nurse passed and she left to work in another department ) . So, semantics what we are called. We just try to provide an excellent patient experience following INS Standards ( many grey areas -can't wait to see if new standards are more helpful ) and get through each shift with our sanity intact !
Good post IVEERN, that's the kind of stuff I like to read. The struggles and success of real life Vascular Access nurses. That is an interesting structure you have there.
Jack
The structure of an lV team described by ivern is the predominant structure for these teams. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
In my facility we are officially titled the 'IV Safety Team' and are known as 'Vascular Access Specialists'. We place PICC lines and short peripheral catheters utilizing ultrasound guidance. We are also responsible for teaching and providing competency assessment for port accesses and cathflo administration for all staff RNs. We will do line assessments as time allows or as needed per request of any staff member experiencing difficulties with any type of vascular access device. We have wanted to learn central lines insertion and place midlines recently, but as of yet have not received the approval needed. Regardless of the lines we place we are often called on to troubleshoot dialysis catheters, art lines, etc. Our team leader also maintains the IV Therapy policy within the hospital. We are not chemo certified. We will re-connect patient's to infusions once IV access has been established while we are in the room because we are nurses, but our main focus is access not infusion.
Danielle McClain RN, BSN
*
a.k.a. Vascular Access Specialist