I am a member of a vascular access team (PICC team) and am wondering which type of MD is your medical director? Did you have the oppurtunity to choose the MD or were they "assigned"? Thanks in advance for your input!
I am a member of a vascular access team (PICC team) and am wondering which type of MD is your medical director? Did you have the oppurtunity to choose the MD or were they "assigned"? Thanks in advance for your input!
I have never worked on a team that had such a person. Somehow, the term "medical director" seems a great deal strange to me. Most physicians have far less knowledge and experience with infusion/vascular access than a nurse focusing on this area. Most view CVAD insertion as a low level, low reimbursement task. With nurses everywhere expanding practice to include all CVAD insertion, nurses definitely need medical collaboration as equal decision makers. Radiolgist are often in this position. Epidemiologist also. Maybe surgeons with this interest. This is loosely based on the specialty of physicians involved with AVA and WoCoVA. The issue might be that the radiologist knows nothing about infection prevention practices and epidemiologist are lacking in high level details of insertion practice and technology. Thus the need for nursing to take a strong lead in the collaborative practice. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
We have always had a medical director, usually asked to be the director by the team - we need to have a physician sign off on our standing orders for PICCs, so that was the initial need. We also found it helpful in addressing physician issues. Having a doctor talk to another doctor, instead of a nurse, is unfortunately sometimes needed. Yes, we are the experts so our directors have always backed us up. We started with a nephrologist, then a pulmonologist/intensivist, and now an interventional radiologist. We continue to work to develop and promote respect for the PICC Team and their knowledge base, but it is not always an easy road.
If you can choose your director, look for a physician who consistently supports your evidence-based decisions and is willing and able to go to bat for you, someone who orders a lot of PICCs in his/her practice and is knowledgable about them.
Wendy Erickson RN
Eau Claire WI
Hi Lynn
I agree with you. I feel Vascular Access nurses should be the lead discision makers especially ones that come with a wealth of experience and are board certified. I hope we can get to that point. I think the problem is with nursing itself. Our "leaders" are usually nurses that have been in systems for many years and have the mentality of rank and file. They are very reluctant to give away power to anyone they deem as under them. I don't know, but that's usually what I see.
Jack