Another topic that we are trying to get changed in policy is placement of external jugular (EJ) and intraosseous (IO) lines by nursing. Currently, nurses cannot place or remove EJ's, and can only remove IO's. Placement of both can only be done by an APP or doctor. Our proposal would be to train ED and ICU nurses to place these. Push back from the care and practice council (our policy makers) is that an ED physician is "always available" and they don't see the need for nursing to start them. Our rebuttal being that an ED doc is not "always available" and we don't always have time to wait for one to become available.
Of note, we do not have an IV team here. Several ICU and ED RN's are trained in US guided midlines and PIV's. We also do not have 24/7 intensivist coverage, and our nocturnist is usually a family medicine doc that is not credentialed.
So on to my question - are any of you placing these at your facilities? If so, what does your policy, competency process, etc. look like? Also, if this is a new thing for our facility, was there anything that helped you to get the policy changed?