I was wondering if any of you would be willing to help me by sharing your policies, procedures and/or thoughts on an issue. The SON affiliated with our hospital is requesting that we start allowing their students to push IV medications under the supervision of their nursing instructors. Our current policy does not allow this and actually does not even allow them to insert IVs, but they are permitted to hang IV piggy back medications, remove IV catheters, and hang and/ or adjust IV fluids. My issue with this is that the current cirriculum at this school does NOT include IV therapy or even blood draws. The argument is that students should be allowed to have this "experience" prior to graduation, and the clinical instructor would supervise the monitoring of the patient. My fear isn't necessarily with hemodynamic monitoring of these patient's. It is that without any knowledge of vascular access,  signs and symptoms of extravasation, infiltration, etc would go unnoticed.  Any feedback would be greatly appreciated.  THANK YOU!!
Christine Varner MSN, RN, CCRN, CEN
I think you have a valid concern if they are not given any education on the basic principles of infusion therapy, the risks, complications and how to properly assess a site before use. With this basic knowledge, they should be able to proceed under the supervision of an instructor provided that instructor has adequate skill and knowledge to identify and stop and risk from reaching the patient. I have long been extremely concerned about what student nurses are not getting in nursing school, but this must be done is a careful manner. If your students can not even insert a PIV, what knowledge and skills do they have to properly administer a medication through that PIV? What about CVCs? I agree that they need experience but it must be with the right approach - a hot button for me!! I was monitoring the responses you were getting on the staff development listserv and it is frightening what is actually happening with these students. Yet administrators expert these students to go to work as a new graduate fully prepared to assume all responsibilities and it is just not happening. I have been the expert on at least 2 legal cases involving new grads. One resulted in an air emboli to the cerebrum and one resulted in the patients death from sepsis from a PIV! Something has to be done!! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Robbin George RN VA-BC
I would use a blended learning teaching strategy. There is no possible way to be successful with only 2 hours. So I would create a self-directed learning process. This can either be paper-based or on computer, created by you or purchased from an education company. This self-paced process would focus on the knowledge acquisition and critical thinking skills. The 2 hour session would then be dedicated to the psychomotor skills lab with the anatomical. Then this would be followed by a period of supervised clinical practice precepted by a skillful nurse. No way that only 2 hours can be enough for anatomy and physiology of veins, infection prevention, catheter and supplies selection, vein selection, etc.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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