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Fri, 08/24/2007 - 14:25

cathie

ER assistance

Does anyone service their emergency departments?...we have being pulled into the ed because the MD has identified the patient as having long term needs.Â Â and orders piccs...of course now they want IV's, lab draws.....I don't believe we are necessary there, and of course, is overwhelmed by the needs on the floors...HELP!!

Sun, 09/16/2007 - 21:53

Deena

Our IV team is constantly

Our IV team is constantly being called to the ER during the course of a 12 hour shift.Many times the ER nurse has not even made even 1 attempt at starting the IV.There are many difficult and impossible sticks in the ER. I feel the nurses need to improve their skills instead of calling us all the time. They also have physician back up who can place central lines. Many times we can place an IV but when they go to the floor then we have problems with drawing blood and placing other IV lines. We place PICC's but we do not have a PICC team.

Mon, 09/17/2007 - 00:39

momdogz

I think sometimes it is

I think sometimes it is appropriate, and sometimes not. We do the peripheral IV starts that the ED can't get (probably 70% they could have gotten if they were more experienced/skilled - but that's the benefit of having a VAT). They're very appreciative of us, usually will listen to us when we recommend a pt. NOT receive a PICC (no matter how much they're begging us for one), and are very grateful when we do.

I do a good assessment, dialogue with the ED team, and plan from there - just like on the inpatient units. The most challenging part can be ensuring that the patient has good followup if they leave with a PICC, instead of being admitted. I think we all might be seeing more of this in the future - just as outpatient demands will continue to increase.

Mari Cordes, BS RN

Nurse Educator IV Therapy

Fletcher Allen Health Care

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

Mon, 09/17/2007 - 14:49

lynncrni

I come from the old school

I come from the old school of the full-service 24/7/365 IV team. So I have always provided services to the ED on a PRN basis, just like all other specialty depts such as critical care. We are the experts in infusion therapy and vascular access. Our services are provided to the general medical, surgical, orthopedic, etc nursing units a routine or regular basis and these specialty areas are on a PRN basis. I look at these units are customers of our services, not a hinderance to our other tasks. It is better patient care when the most appropriate device is placed by highly skilled infusion nurses in patients with difficult access. Clinical outcomes are better and financial outcomes are better for the facility. I firmly believe that the 9-5 services of PICC insertion only does not and can not ever meet the needs of the patients and the facility. It is time for us to realize that infusion therapy is needed in the entire facility at all hours of the day and night. We are the specialist that should step up and make ourselves indispensable to our facility by providing these services. Meeting these needs consistently and completely is good insurance against being disbanded as a team. I would not want to work in any other capacity, but I will get off my soapbox now. Thanks for reading my passionate ideas about this issue. 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

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