I am the only PICC nurse at a small 110 bed hospital. I work M-F ( 8 am until all the work is done :) doing all the PICC line insertions, dressing changes , cap changes, and trouble shooting. I am very busy and have just now had the need to have a designated Outpatient nurse help me on M, W,F ( maybe 2-4 hours) with teh cap changes and dressings so I can continue placing PICCS on these high volume days and not work 14 hours a day.
We are trying to figure our coverage for PICC insertions when I go on vacations or have family issues. When we first started doing PICCs there was another nurse who learned with me and we would cover for eachother. That nurse has not done PICCs in years , not familiar or competent with new technology and not interested or available to do them anymore. So it has been for years, when Gina is gone there are no PICC lines inserted. Drs were ok with it in past but now want to have coverage . We just purchased and are getting staff trained with teh Bard Pre Vue U.S unit for peripheral ivs so that will help in some instances but not for central lines. Our physicians want coverage in my abscence and I would like to do that in a way that is safe for our patients.
We were throwing around training another nurse at our hospital but...we all know that to excel at insertions you need to be doing them regularly and great improvment and trouble shooting skills come with experience . If they are only able to fill in that job in my abscence they would not be that skilled at it . We are not financially able to employ 2 full time PICC nurses with our volume, so having them doing PICCs consistenly isnt available . I know how troublesome it is to try to do one job , say full time PACU then in your "spare time" do PICC lines too ...so sharing 2 jobs doesnt work well either.
1st quarter 2013; 138 picc insertions 2nd quarter 155 insertions...now winter is coming in sunny florida so we are getting busier..in the last 3 days I have placed 17 lines. Just to give you a volume of iinsertions.
Other option is; are there contract or agency nurses to fill this type of job?
Any ideas or suggestion would be appreciated.
we are probably not supposed to advertise or promote on this board, but to answer your question, contact Stacy Pavish at PPR healthcare in Jacksonville Florida. tell her I sent ya! :)
Gina, consider a mobile service. I work for a mobile service, we cover weekends, holidays, sick call days and high volume days for several facilites along with our regular contract facilites. We have a 24/7 service. Most likely there is one in your area.
I've worked part time at various facilities, covering for days off on PICC teams. At one facility there was Saturday coverage. Another we do weekend on-call. At another there was 7 days/week coverage. Perhaps your facility can offer a weekend on-call option so Mondays and Fridays don't have to be so busy and your part-timer can get some hours in.
Part-time employement in the PICC industry can work out great for those with flexible schedules. Good luck!
Gina,
I am also a single person PICC team in a 143 bed facility. Would love to compare notes, can you email me at [email protected]?
OH MY GOSH ! I feel for you! Administration should not put such a burden on you. It doesn't make sense to pay you overtime ( 14 hour days ? and then you have to come back the next day and maybe do it again ? ) For one thing, staff has to be responsible to take over the dressing & cap changes. A mobile unit sounds great or hiring a part-timer on a regular basis, say every Wed. or Friday on a high volume day,so she/he would be doing several each week to maintain skill. There might be someone who just wants one Xtra day. We have just started our U/S guided PICC program and will soon learn Vasanova for tip placement. Administration is letting us have a two person team for right now since we are still not "proficient" but are hesitant to let us have on-call to cover the pager , so while we are doing PICC's, all our PIV starts and dressing changes or troubleshooting go unanswered. It's a dilemma, but at least we have eachother to support. Good Luck !
Our VAT Team assess/maintain all PICCs inserted by our team as well as Interventional radiology- We are proactive in the recommendation of CDC -"Central line bundle"- this includes daily assessment of line necessity and removal if not needed. This is inconsistent since other central lines placed by MDs (subclavian/IJ placement) are assessed and maintained by bedside nurses. Care and Maintenance plays an important part of patient outcome (positive or negative).
What is your team's role (to include education) in the care and maintenance of all central lines in your facility.
Do you partner with your Infection Prevention and Control? Do you know what your infection rate (CLA-BSI) in your facility?