Julie
DENISE GALLAGHER <[EMAIL PROTECTED]> wrote:
We are having a new cardiologist coming aboard and he is requesting 2
antecubital IVs be inserted prior to going for pacemaker insertion. Anyone
know the reason behind this practice? Thanks, Dee
>From: "Lynn Hadaway" <[EMAIL PROTECTED]>
>To: [EMAIL PROTECTED], [EMAIL PROTECTED]
>Subject: Re: [vascular] Ultrasound certification revisited
>Date: Tue, 2 May 2006 11:29:58 -0400
>
>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
>
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