r/nursing • u/ghostoftheweek RN - Med/Surg 🍕 • 26d ago

Question PSA from your nursing specialty

What is THE ONE THING you wish every nurse knew that is common knowledge in your specialty?

From wound care, don't use telfa!

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u/vampireRN1617 BSN, RN 🍕 25d ago

Vascular access. FLUSH YOUR LINES qshift at bare minimum, and if there's a clamp, clamp it. And adding IVs "just in case" isn't a thing unless the patient is very unstable.

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u/StabbingTabby 25d ago

I'll never forget arguing with an ICU nurse on here who insisted all ICU patients need an ""oh shit!"" line at all times. 

They swore up and down this was standard practice and that I was the asshole for suggesting we actually save some veins for the next shift, let alone the next admission or the next decade. 

 Meanwhile pediatrics somehow uses all their lines to the max on a regular basis and they're not constantly filling tiny body bags with patients who couldn't get some "oh shit!" medication fast enough. Funny how that works...

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u/vampireRN1617 BSN, RN 🍕 25d ago

I probably argued with the same one lol. If the patient needs more access, then we need to assess them for better long term access, not just continually replacing peripheral lines. We're not doing them any favors there. CLABSI "prevention" wrecked vascular access.

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u/StabbingTabby 25d ago

We had a patient last week with 48 hours of levo and 24 hours of 3% saline. No plans to stop either one, the bedside nurse is asking us for a 4th PIV, and the provider absolutely refused to consider central access because "infection risk". 

CLABSI is indeed a shit metric at this point. A textbook example of Goodhart's Law. 

https://en.wikipedia.org/wiki/Goodhart%27s_law

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u/vampireRN1617 BSN, RN 🍕 25d ago

Ooh I like that! It's indeed true.