Question

The nurse witnessed a more senior nurse make six unsuccessful attempts at starting an intravenous (IV) line on a client.

The senior nurse persisted, stating, "I refuse to admit defeat." This resulted in unnecessary pain for the client. How
should the first nurse best respond to this colleague's incompetent practice?
A) Report the nurse's practice and have the nurse manager address the matter.
B) Encourage the nurse to attend an in-service on IV starts.
C) Reassure the nurse that this is a difficult skill and give her feedback on her performance.
D) Document an unmet outcome in the client's plan of care.

Answer 1

To best address the issue with the senior nurse's multiple IV attempts, the first nurse should report the practice for patient safety and provide supportive feedback, and consider the establishment of a checklist to improve procedure consistency.

Step-by-step explanation:

The first nurse should address the senior nurse's practice regarding the intravenous (IV) line attempts in a professional and constructive manner. The best response might be a combination of options A and C: to report the nurse's practice as it relates to patient safety and provide supportive feedback. Reporting the incident would help ensure proper protocols are followed in the future while providing feedback could offer immediate assistance and improvement. Moreover, implementing a checklist approach, as suggested by Dr. Pronovost for ICU doctors, could serve to improve consistency in performing procedures like starting an IV line. Nurses, similar to the ICU scenario, should feel empowered to speak up if they observe a colleague deviating from established protocols or best practices.