Any nurses coming into your hospital representing a manufacturer can
not touch your patients because they are employed by or contracted by
the manufacturer. The state license is important but who is paying
them is a critical issue in whether they touch patients or not.
Regarding your chances for a lawsuit, no one can answer that
question. That totally depends on you, your clinical decisions, and
the level of risk you take when making certain decisions. For
instance you could persist in making many venipunctures to access the
vein using US and cause nerve damage. So the factors that would be
considered by an expert would be the number of attempts you made, the
amount of times you passed the finder needle, your expertise in
identifying structures on the US, and your response when the patient
complained of pain - did you keep going and ignore the patient
complaints or did you abort the procedure? As long as you make wise
clinical decisions based on your assessment of your knowledge and
skill, you should lower your risk of a successful lawsuit
tremendously. Nurses get into trouble when they don't know or ignore
their own limitations and make clinical decisions based on a total
lack of knowledge or they ignore patient complaints.
Considering that it is reported to require about 50 attempts with US
to feel comfortable with it, there is no way that a manufacturer or
an employer could support all nurses through their entire process of
attaining competency - the cost would be too great. So we must try
without a preceptor on some of these.
Also, it is not the responsibility of those outside contractors to
state that you are or are not competent. This is the responsibility
of your employer. So document your attempts, learn from each one and
soon you will be proficient. Lynn
At 7:36 AM -0500 4/28/06, Alma Kooistra wrote:
The messages that passed through yesterday re ultrasound certification got
me to thinking........
I am crippling through the process of mastering PICC placement using
ultrasound. My training has consisted of having Boston Scientific send down
a couple of Ultrasound trained nurses who accompanied me for one day.
Neither were licensed in our state so couldn't touch anyone and just coached
at the bedside. They watched me during one insertion and a couple of our
other staff during one insertion as well. I had never seen a line placed
using ultrasound until the day I did it with them (and it wasn't
easy.........).
Since that day I have been out there struggling to get through the learning
curve on my own. I've read P/P for line insertion using ultrasound ad
nauseum. Beyond that I've had no other training.
How well protected am I in case of a lawsuit? I'm starting to get a little
nervous. I could hardly expect the staff who watched me though that one
first insertion to sign me off as competent......they would be crazy to do
that since I clearly was not competent. I have another trainer coming next
week. Is it possible that this amount of training would cover me if I have
a bad outcome? I don't know if there's anyone in our area (South Dakota,
Northwest IA) placing lines at the bedside using ultrasound so it's not easy
for me to get training. My managed chuckled when I asked about getting $$$
to go somewhere for training.
Alma Kooistra RN, CRNI
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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861
