PICC Line Administration Facts

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A variety of skills are brought to bear on a daily multiple patient regimen, but nurses may need some more than others at critical junctures in the patient’s care plan. The most valuable skill a nurse can get trained on is opening a pick line in a patient. This is often referred to as finding a vein, or setting up a PICC line. The necessity for keeping the “pick” line in for every patient is a requirement for institutionalized healthcare practices and sound care plan advice.

The tap-in should be clean and free from swelling, tension, stiffness,’and/or causing discomfort for the patient. Blood, water, liquid of any type collecting under the dressing should be examined at once. Once affixed, tapes should be annotated with the date of line-in for future reference. Finding peripheral lines in veins must accord with circulatory norms. Nurses cannot begin to rely on easy veins and many long-term patients will need the best pick line insertion techniques when their pick line sites will begin to dry up.

The PICC line is not an easy skill to master. Connecting with the Superior Vena Cava is essential, and thus not just “any” vein can be used. In long term patients the proper veins ”hide” or “become smarter”, evading nurse’s or a technician’s search. This the need for mechanized equipment to find the proper vein is often required. A sonogram machine can be used to generate a visualization of the vein location for technical insertion point.

Nurses categorically check the line on every patient they have in their care roster, whether they are on IV drugs or not. Infection can start if a pick line is left in for too long. This is due to the procedural adaptation in every patient’s medical status whereby IV drug therapy becomes necessary. Grooming a patient’s line and monitoring its condition must be done at all times. Re-insertion of the line must be performed at once if problems arise.

Yet time and again the need for a re-insertion of a patient’s line can shed light on just how few nurses on the ward, if any, can find a vein and insert the pick line in a manner which will be sustained over a number of days. Patients may pull the line out, loosen it, or even worse, injure themselves. Nurse should explain to patients why they need to be conscientious about their line and work towards not straining it or causing tears at the skin’s opening.

This is a serious problem and could cause further delays and inefficiencies in nursing care down the line. Hunting through various staff wards for a nurse who can insert a pick line without the assistance of a sonogram is a seriocomic statement of what training nurses are expected to have versus what the actually bring to the job each day. Nurses should note in their charts the condition if each pick line and notify patient services if additional assistance is required.

Of course the heplock can always be used but that required a clean set of tubes every 72 hours and a clean insertion site. Many patients do not have the skin integrity or the vein strength for this. For this reason the PICC line is favored. To avoid delay in adminitrating an ordered dosage or maintenance regimen of material, make sure the entire case history of the patients dermal integrity is reviewed before any perforation is commenced.

Handling Patient Visitors

Until you see the light in a patient’s eye, when their relatives come, how their face lights up, you just haven’t lived. The sum total of life is right there. The programmatic dynamic of parents raising children is reversed. The residents (parents) now received the care from visitors (children). It is a singular statement in every individual patient’s case what kind of care they get from family members. Just as people look the other way in a community when children are abused, a low-level nursing home gathers the neglected ones together. It takes a compassionate care nurse approach to make sure patients don’t feel neglected or overwhelmed.

Nurses in any pay range should report any examples of abuse to their nursing manager or as an anonymous complaint to the regional ombudsman. The County Health Facilities Director may also take an anonymous complaint alleging abuse. Nurses in acute care and skilled nursing should counseled to look out for signs and symptoms of abuse and should make an assessment in the chart accordingly. If patients should complain of missed medications, pain, unusual symptoms or worries concerning their care, the charge nurse should be notified.

The sliding scale of who and what family members come to visit is one nurses will become familiar with. Some visitors only show up once a year, on birthdays or anniversaries. Some people bring the whole family, and it can be overwhelming for a recovering patient or fragile resident. Sometimes visitors bring children or babies to encourage the older resident or family member to enjoy the family life absent in a skilled nursing facility or acute care hospital.

Nurses should make sure visitors should wash their hands before skin or physical contact with the patient, administer or deliver no medications or narcotics, and otherwise observe infection control best practices at all times in and around the patient‘s room and bathroom. Visitors and family, friends and relatives may not realize that resident of a skilled nursing facility or patients in acute care are extra vulnerable to viruses, colds, and other communicable diseases. Diabetic patients should be discouraged from overdoing it indulging on special “treats’ that can harm their health and change their blood sugar and cause a crisis.

Others come every weekend, and bring things or even help with the physical care and chores of a nursing home patient. usually, among nurses, this will reflect the status of a patient’s relationship to the visitor. Nurses should be vigilant if a patient shows a marked dejection after certain visitors come, or a tendency to depression after no visitors come. Such patients should be redirected to group activities or have the activities director contact relatives and suggest a family visit.

While financially the nurses know and differentiate between cash-pay residents and Medicaid or Medicare recipients, technically there should be no cognizance of the patient’s status when treating them or attending their bedside needs. health care should be available to everyone regardless of the ability to pay. By seeing the way the patients are treated, some nurses also differentiate between patients who receive visits and those who do not. This can be an unfair but persistent bias.

There is one simple rule for this: the family members and visitors of a nursing home patient will track neglect or have conversations with the patients where criticisms or reports might reach the ears of others. It is essential in some cases to keep frequent visitors’ parents (patients) well cared for, as the family member will appear at any time all day, or stay during significant parts of the day during one single shifts. That one family member will not see the effort the nurses put forth for the rest of the shift for the rest of the floor, but they can make enough noise t bother the managers and owners of the facility for months.

It is hard to watch a CNA or LVN favor a patient or set of patients whose relatives frequently visit, while the ones who need contact and pepping up most fall to the end of the range. One can watch a single nurse neglect a patient’s bed, person, or dignity outright, and hustle to the next room to cascade attention and caregiving on the least in need patient in the place. But this is what happens when nurse managers do not periodically refresh the training and motivation of nursing staff.

Any nursing home patient that has a visit from a relative or friend, social worker or investigator from the county health department, must have them sign in to the visitor’s register. there is usually a physician’s room or private area where an investigator can conduct I interviews or research charts. Additionally, medical records staff will make themselves available t assure any visitor they receive the most assistance possible.

Nursing for Sports Medicine

Nursing for sports medicine is a big movement in local and general practice health. The popularity of gyms, sports, and teenage and high school league sports, as well as childhood league sports can crowd a waiting room with single patient injuries or an entire team of them. The demands of the nursing challenge for these situations test nurses on their diagnostic skills, patient communication skills, and observational aptitude for patients who may not want their physical conditions commented upon or checked out.

The high school and college professional team sports system is rife with excesses that endanger student health. Education system nurses should brush up on sports medicine for concussions, artificial performance enhancements in teenager and young adults, and other wellness related issues for young athletes and sports participants of any age. Anorexia, alcohol abuse, drug abuse, and illegal substances may cloud behavior and vital signs.  Nurses should learn to read patients of all ages that might conceal or confuse physicians who may not factor in other elements in the patient diagnosis due to a lack of information.

Occupational sports medicine can have a broad range of employment opportunities. A television show where the contestants lose weight should have a physical wellness consultant to examine patients during extreme events and competitions. A recreational cruise should have a competent nurse to review case of passengers who have disabilities or health issue before they come on board.

Nurses should know about the ramification of high school sports and college sports, and recreational sports play and how much delivers patents in pain to the hospital on a regular basis. Sadly, people have a mind to ignore hat their doctor tells them and play anyway. Nurse should be rote in the conditions of sports related concussions, trauma, bruising, bone breaks and sprains, muscle tears and the incidence and symptoms for a diagnosis of concussion.

Nurses for sports medicine might branch off after years of general health practitioner employment or LVN work in the treatment of sports-related concussions and other sports injuries. In children and teenage athletes, there is the potential for serious long-term outcomes, such as brain damage, dementia and other risks such as substance abuse after the injury or trauma. Weekend athletes are prone to even more injury because they are likely out of condition or aging, not warmed up or not wearing suitable support equipment.

Emergency rooms can be filled with skateboard kids, bikers, roller skaters and surfers who refuse to wear proper headgear, pads, knee guards, etc. Participating in sports activities in the wrong time and place can also result in physicial injury. Sports concussions have a window of serious concern following immediate hospitalization where the patient must be scrutinized for brain damage, motor neuron fluctuations, synapse irregularity, or other disorders of the brain.

The competent sports medicine nurse will be able to diagnose and define sports-related concussions and the seriousness of the and the sports in which they are most often found. Family friends, and the patient (and coach) will want to know the immediate and long-term symptoms of bone breaks, fractures, and sports-related concussions. Nurses can take the opportunity in seminars and clinicals to discuss expert recommendations for preventing and managing sports-related concussions, to pass onto students and patients.

The Nurse’s First Day of Work

The first day of work as a nurse introduces a new student nurse or newly licensed nurse to the complex world of professional nursing. Occupational nursing, working for a living in the field of nursing and medical care, is a different challenge than merely answering test questions and performing nursing tasks for a limited number of patients and cases in a minute capsule of time. Putting on a show for a teacher or clinical preceptor is not as tiring as doing nursing tasks all day for inconsiderate or indifferent patients.

For new nurses, all too soon, after their first day, the workday becomes a repetitive chain of days that some new nurses find daunting. Nursing school wasn’t this much work!
Practical experience is what makes the most difference, in career nursing, because people are behaviorally trained to do what they have done before. Therefore, a nurse is best qualified who has done the same thing, medically speaking, for patients, over and over again.

Volunteer nursing experience and even intern duty at clinics can count. A nurse seeking work will want to demonstrate the most diverse and complete work history they can. The most complete medical knowledge level, and the most important skills are the accomplishments that nursing facilities and hospitals look for. A nursing home or hospital ward has enough of one thing, they are looking to fill a gap in skills, time schedule, or bedside manner.
A nurse coming into their first shift or first week of work, must understand that they are now the question “answerers” than the question-askers. people depend on them not only to do the right thing, but to say the right thing, and write the right thing in the chart. Nurses should get the knack early of writing vitals details of patients on little memo books or remembering case details all the way to the end of the shifts when it comes time to chart the patient responses. Keeping track of several different projects a day, even per patient, is a norm that new nurses must acclimatize themselves to. No nursing day on the job will be the same.

The new nurse should take in the data and treatment information they are given. Follow a single patient until you learn their medication schedule and care approaches. Nurses should use this time to observe all the things they can’t know from a patient’s medical chart, such as patient personality, manner, typical responses to questions.

The new nurse should show a minimum of argumentativeness, resistance to the process, or possession of too much superior work knowledge. The new nurse should understand that all the nurses she or he is working with have all gone through the process of getting to know the workplace and getting to know the patients and the staff procedures.

A new nurse should be watchful or ways they can improve on present nurse performers. The facility has hired new staff for a reason. Either they have worked the present staff to death, or you many nursing personnel have left. Local hiring pools give rise to dips and valleys in talent, and nurses may be working other jobs and not be available for all the shifts they are scheduled to work. The new nurse should make it look as attractive as possible for the facility to schedule them as much as possible.

The myth of a “nursing shortage” has come about for a reason. The fact is, nursing work weeks are set up to give nurses a break between long and arduous shifts. The anxiety and stamina that takes its toll on a nurse during the work week needs to fade away. A nurse needs time, sleep, and relaxation to unwind. The biggest advantage that a new nurse can bring to the table is their youth. The fact is, new nurses with strength and stamina to withstand long shifts of repetitive tasks and minute details are in demand. These nurses don’t come around every day. The best nurses get snapped up.

But the mistake most new and experienced nurses make is to try and fill all of their time with the most number of shifts. And nursing directors know that a nursing job candidate may not be as frank about their availability as they would want. The result is a kaleidoscope of co-workers instead of a reliable schedule of teammates.

A nurse should not assume another nurse will always be there to do a certain tasks or them or deal with a certain patient so they won’t have to. So, nurses cannot rely on a close set of friends on any nursing staff to function as a crutch. Social niceties like chatting, telling stories, or having lunch together should come second to attending call light systems and patient monitoring. A new nurse should be able to perform their duties no matter who is supervisor or charge nurse per shift. Long-term care can often be lonely and hard.

The hiring manager for a long term care facility or nursing home is trying to improve services to the public at all times. It is for them to review your skill set and decide how many nursing hours you can handle. Overworked nurses get sick, lose retention, and have mood swings. Often, nurses have second jobs whose work shifts do not complement well with the ‘primary” work assignment. For the respect of your nursing co-workers, try reporting your availability as honestly as possible. And don’t make a habit of coming late and missing the endorsement handoff.
The new nurse should treat the first day at work as the first day of the rest of their career. This is the last day their time is all their own. The patients now come first. The first time a new nurse punches in the time clock, all their focus and attention should be on patient directives and medical care objectives. From this beginning time onward, the nurse’s hands and mind are there to function for the good of the patient. This is the vocation of a career occupational nurse. Anything less of a commitment lacks the merit of a fully dedicated professional nurse.

Looking For a Nursing Job

Looking for a nursing job involves really evaluating your own personal job strengths. Applying at the same places as your friends or peers doesn’t always work. Working from newspaper ads only ads you into the mix with a huge bank of competitors. Occupational employment in nursing is an ongoing challenge for even the most senior and highly paid RN and LVN workers. Building  a lifetime network of people to consult and exchange information with about job opportunities and local trends starts now. A decade from now these will be peers working in places with new openings or new departments.

One strategy is to apply for weekend or part-time work at a long term acute care facility or long term care facility, to put some nursing hours and experience on your resume, without burning out from a heavy schedule and the stress of a full time work week. Limited interaction with key players can allow a new nurse to learn the job responsibilities without getting caught up in the vortex of a facility or nursing institution out of step with the nursing world at large. By limiting the scheduling availability, a nurse can allow for ongoing interviews during their off-hours in the full-time nursing employment space.

The first job of a nurse should be to absorb as many skills and workplace nursing abilities as possible. Making the transition from nursing student to nursing employee is not always as easy as the textbooks would suggest. The nurse candidate may interview with a Director of Nursing, or Human Resources Director, who has little or no idea what terms and in actual nursing job for an average shift is really like. The job description may not tell the whole story in a nursing position. Only the training preceptor can get a feel for what the new nurse is actually capable of doing.

Working part-time to start allows a nurse more time to evaluate if a new working environment is right for them. It takes time for a new nurse or new nursing school graduate to understand which parts of the working environment are fixed and which can be changed with experience and skill improvement. And the gradual build-up of skills and orientation will length the learning curve and leave a new nurse less likely to be overwhelmed. Thus a nurse can investigate what a facility or nursing department is like before committing to full-time availability.

A part- time schedule can allow you to burn in to a new place and absorb their rules and standard operating procedure, without trying to perform a full week of work at the same time. This kind of stress can affect how you learn all a facility’s rules and how you interact with all the staff. instead of burning bridges by becoming a moving target, start slow and begin to learn the ways of a new place slowly. interaction wit staff can remain minimal, so as not to get involved with any personality conflicts.

Part-time work generally begins with assignment of a preceptor. Today, nursing people call this “shadowing” a worker to learn their job. Nurses need to learn their preceptor’s ideas and functions before allowing a full time work schedule to break down the lessons and training. And sometimes a preceptor may not “fill in the blanks” as well as they should. But a part-time nurse can observe others at a nursing department and long term care facility and select whom they want to imitate in practice.

If a new part-time nurse blends in with the group and adheres to the institution’s policies and procedures, the director of nurses or nursing supervisors will schedule the candidate in for more hours and shifts. This is a good time to set limits for the availability. A nursing employer will not always respect the availability limits a nurse gives, and this is the best time to set the rules in stone. The ongoing battle for a nursing supervisor to staff the facility fully must co-exist with respect for a working staff of nurses and their need to rest and conduct their life in the off-hours.

The nursing job search includes a lot of phone calls, a lot of emails, and a lot of application forms. Job fairs and newspaper sections for jobs available aren’t always going to be the pathway to the best jobs. Many nursing homes and long term care facilities don’t have time to post individual job ads, and don’t have the staffing to vet the responses. If there is an area you want to work in, or a specific place you want to work, walk in and directly submit your application. By bringing your resume, three letters for character reference and your nursing school transcript , you will complete the application without the staffer having to do any work. The nursing supervisor or the director of nurses may decide to do an interview right then and there, and keep your application on file.

Newly minted nurses can’t always rely on the people at the other end of the line understanding nursing terms, medical courses, and departmental specialties. Many recruiting firms now do a lot of the screening for key posts. It’s best to get your dates and information about past work places straight, in the format of a general work application, because you’ll be filling them out almost constantly. Make sure your version of these events remains consistent, and be sure to have at least three character references from business and personal life at all times. If you feel that your contacts are being mined for marketing purposes, mark them “available upon request”.

If you feel your work experience is thin, write a cover letter describing your strengths on the job.  Talk about your individual abilities that make you unique to the nursing desk, hospital department, or long term care facility floor. Keep a list of the agencies, companies, nursing homes, and facilities you have applied to. You may want to look for older positions advertised or wait for another cycle or hiring to begin. Some larger companies wait and restart a cycle of interviews and training at the beginning of the first quarter and second , certainly not at year-end. if you are flexible to moving to begin a work assignment, say so on your voice mail message or the last sentence of your cover letter.

 

 

 

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