I am catching up on the listserve and would like to respond to two recent threads:
Re teaching IV starts in nursing schools. I taught med-surg nursing for 20 years at two different small (but excellent) programs. I was usually the one in charge of teaching IV skills. The main problem in teaching IV skills to nursing students is time. We always had a busy curriculum with lots to cover and not enough time to do it in. IV skills were taught in the junior year, and students had both theory and practice on both rubber arms and on each other. However, we never had time to do more than a couple sticks on real people in the lab. In the hospital we had opportunities to do them but never as much as we would like. The other problem is that in many programs a student might have psych nursing or public health nursing or leadership in the senior year which has few opportunities for practice. As a result it is probably unrealistic to expect that a new graduate will be anything other than a novice at IV starts. I know that some hospitals have new grads spend som! e time in pre-op or similar areas where they start lots of IVs in order to get more experience. Re Midlines: After reading some of the responses about midlines and CT contrast I am now convinced that using a midline for contrast is a bad idea and I will no longer do it. Two reasons are 'off label' use of a power picc cut in two, and the fact that infiltration/phlebitis is more difficult to detect with a midline. Actually I think midlines have only a limited role in the hospital; PICCs are usually a better choice. Rich Pearson RN MS CCRN Clinical Nurse Specialist Critical Care Alegent Health-Immanuel Medical Center Omaha, Ne 68025
