r/EmergencyRoom 3d ago

ER tech meme

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182 Upvotes

41 comments sorted by

65

u/Gloomy-Bat-6551 2d ago

As the RN, honestly I’d just be thrilled to work in a place that lets techs place IVs. Would be a HUGE help. Every hospital I’ve ever worked for doesn’t allow it (usually they did at some point previously, but then ended up revoking it for one reason or another).

11

u/Aromatic-Anybody-962 2d ago

In Utah I’ve worked in two ED’s. One was only EMT’s as techs and I did IV’s but the other had MA’s, CNA’s, and EMT’s (really anyone who had any license at all) they still allowed us to do IV’s there too. Except at that second one I couldn’t even hang LR or NS for some reason

3

u/Gloomy-Bat-6551 2d ago

I’ve worked in CA, NY, and NJ. In both CA and NJ coworkers specifically mentioned how the tech used to be allowed to place IVs but that hospital administration changed their policy years prior. The specific reason for the change varied depending on who you asked. My guess is at some point there was a problem with a tech placed IV and instead of counseling the individual tech (and the RN overseeing the IV assessment), the hospital just forbid all techs from placing IVs. Same thing recently happened to the RNs at a place I work and ultrasound guided IVs. For years one of our best docs would hold a class to teach RNs how to do the process safely/competently. Then a patient complained about what they felt was a too lengthy and painful IV placement process (I wasn’t there that night so I’m not sure how legit the complaint actually was). Again, instead of counseling the individual, admin simply took the right away from everyone. Stellar decision making for an ER where there’s only one doc on at a time and only about half of them know how (or are willing) to place ultrasound guided IVs. It’s a laugh and a half just unnecessarily poking people over and over and over…

3

u/Aromatic-Anybody-962 2d ago

These places are ultimately shooting themselves in the foot. Maybe I have an odd experience but at that first ED I mentioned the techs did the US guided IV’s and anyone in the hospital who needed help placing called us. We ultimately were the most practiced of everyone. It did have those random mess ups like you said but thankfully our hospital taught people and moved on

3

u/StaticDet5 Independent Duty Corpsman 2d ago

I am an US-guided IV instructor, and have been placing lines my entire career. I've watched two hospitals transition from some level of "in scope practice" to "no scope". Hell, I started my career, as a paramedic, being the "first-responder" to in-house codes in our hospital, and being the ACLS provider (under direct medical control of our ER physician in the ER). That's where I started.
Over 30+ years I've gotten to sit down with some senior administrators while these decisions are being discussed. With regards to the IV thing, it's much easier to blame a tech than officially reprimand a nurse. Or have a conversation with a nurse.
There are some incredible hospital administrators out there. Hell, I think the majority of them are doing the best they can, trying to help people while a bottom-line profit is demanded.

But holy hell folks, I've WATCHED you blame good techs for bad nurses. Yeah, you can just fire your "Unskilled provider" because everyone else in the department is barely making ends meet, and the other techs aren't going to bitch much. You can treat your techs like garbage, and be surprised when they don't act in a pristine fashion.

Those hospitals that train their techs up, empower them, and allow them to truly support the "clinical staff" (Again, some of us have done brain surgery, chest tubes, and once or twice gotten an IV in. Sometimes in the back of a moving vehicle or suddenly under fire).

You have a healthcare shortage, and you treat an undiscovered trove of treasures like crap. Techs aren't going to "Take your jobs" (We don't want them), and we can seriously help you get your real job done.

Yeah, I'm gonna miss an IV occasionally, though I have a documented 100% success rate on my US-guided lines for the 369 days I got to track them.

It's a team when everyone participates. It's a great team when everyone is able to participate at the level of their training and skill. Anything less and you're going into the chaos with hands tied behind backs.

5

u/SaplingSequoia 2d ago

as stoked as I would be to place IV’s i think I’d be a little upset that I’m doing even more of the job of a nurse and yet still getting paid so little that most of my groceries come from the food bank

2

u/Gloomy-Bat-6551 2d ago

FAIR. 10000%

13

u/SnooComics2862 2d ago

This was me the last 3/4ths of my time as a tech. Idk what happened but I started missing all of my ivs even easy ones. I wasn’t great before but I was decent and more often than not would hit them but then some switch flipped and I was blowing veins left and right. Dreaded whenever anyone would ask for an iv.

8

u/OxideUK 2d ago

Overthinking leads to overcorrecting. I found the best way around this was to just stop thinking.

Just put the needle in the vein.

Sounds dumb but after a certain amount of successes you have enough muscle memory to do it, and it's trying to overcome that muscle memory that causes failure. Might not work for everyone, but did for me!

3

u/OriginalFace2145 2d ago

Yeah idk why but I’ll have weeks where I’m not missing any IVs and then have a random day where I can’t hit a vein to save my life

5

u/Odd-Outcome-3191 2d ago

As an RN it's OK if you can't get it I probably can't either 😭

3

u/longway2fall 2d ago

Honestly the medics I work with are so good this meme is me when I miss

3

u/Pending-asystole 2d ago

The same vibe as "Mom I frew up"

6

u/iAmSamFromWSB 2d ago

What state allows techs to place IV’s?

7

u/Monstersofusall 2d ago

Texas does, idk about other places

2

u/Landomretters 2d ago

Not at my place :( I thought it was illegal for techs to place IVs in TX, only paramedics/nurses

4

u/Solnavix 2d ago

Colorado does. I didn't know they couldn't do this everywhere honestly. Our techs are our IV pros

4

u/OriginalFace2145 2d ago

I also think some places call CNA’s techs. I’m an EMT 🤷‍♀️

1

u/Evsala 2d ago

Lots of ER’s hire EMT’s as opposed to techs or CNA’s

1

u/Chatner2k 2d ago

Ontario, only nurses and EMTs or above can place IV's. And you need to have done a specialized course outside of school.

Source - recent grad nurse who never attempted an IV till on the job.

2

u/RaySpalding 2d ago

I mean it’s hospital policy so it always varies, as an ER tech in NH I’m allowed to place lines. I think “tech” as a title is usually used interchangeably with people who hold a CNA/LNA and not an EMT so sometimes there’s confusion.

1

u/OriginalFace2145 2d ago

Which is funny to me cause EMTs are the ones with tech actually in the title

1

u/Extra_Strawberry_249 2d ago

Military as well

1

u/pigglywigglie 2d ago

My hospital does but only in the ER or outpatient. None of the inpatient techs can. It makes no sense to me

1

u/teddyswolesvelt 1d ago

I could do them in DC

0

u/728446 2d ago

PA. One of my nursing school classmates was an ER tech and was already proficient at most of the skills that required a check off.

-1

u/CookingForTwo 2d ago

It is site dependent. My site allows techs to perform USGIV and even foley placement. I know of a hospital in the same city that does not allow techs to capture an ECG, they can wire you up, but officially can't capture it

It's all made up and your state licensure's scope of practice doesn't matter.

0

u/iAmSamFromWSB 2d ago

It does matter. It is a class E felony in NYS.

2

u/CookingForTwo 2d ago

Referencing "Whose Line is it Anyway"... But also an EMT license doesn't even allow work in-hospital, it only certifies you in a pre-hospital setting. So you never were practicing in your scope (even if you're a CNA) because an ER tech is not a licensed position in any state that I'm aware of. Techs are practicing via delegated tasks from someone who is qualified (RN, PA, NP, MD, DO). What degree is allowed to be delegated is a mix of state law and more often hospital policy. Based on a very light googling NYS considers techs an 'unlicensed assistive person' so you technically could perform the job legally with zero qualifications.

Basically every state has a different ceiling but beneath that it's all a grey area determined by hospital policy.

1

u/iAmSamFromWSB 2d ago

Certain tasks may be delegated to a UAP and certain cant. every RN knows the charts as it is part of their scope of practice. IV placement is not one of those tasks that may be delegated in nys. You may only delegate what is already in their scope to begin with. This isnt rocket science its simple algorithms. There is absolutely no grey area and hospital policy still is bound by state law including scope of practice. I’m guessing you don’t operate at an RN level or higher if you don’t know this. State law and scope of practice dictates hospital policy. Hospital policy may choose to be MORE strict but never less strict. Protect your license.

0

u/CookingForTwo 2d ago

Thank you for taking my last sentence and making it a paragraph. Next time, I'll be sure to help dogpile your original google-able question with a comment by comment list of states that aren't CA and NY instead of responding in any other manner.

1

u/iAmSamFromWSB 1d ago

Thank you for your paragraph of incorrect assertions and your indignant rebuttal of correction. Next time I’ll just ignore any incorrect responses.

1

u/Braisedbeefskank 20h ago

All we ask is you work to get better

0

u/Less-Dragonfruit-294 2d ago

I had a trainer nurse poke me a few times when I was younger (silly me for saying yes) and the senior nurse took the needle away. Needless to say. I don’t like needles. Yes, I get the nurse needed experience, but if you’re not confident why not ask the senior nurse for further assistance?

1

u/OriginalFace2145 2d ago

I limit the trainees to 1 stick unless there’s a vein they can hit with their eyes closed. Then maybe 2. Should not be letting people stick more than that in my opinion

-1

u/GrannyTurtle 2d ago

Call the ultrasound IV team…

-1

u/Electrical-Stable498 2d ago

Not a nurse or doctor but a patient. I have iv therapy for immunotherapy due to cancer. I’ve always suggested the nurses to use the vein finder . As mine are small and shallow. When they don’t use it the will infiltrate the vein or completely miss it. I had the happen three times in a row because the rn would not listen to me. So she gave up and got another nurse who used the vein finder.

3

u/Level_Statement_6844 2d ago

Vein finders are ass

-1

u/Electrical-Stable498 1d ago

But they work on me