Infusion (IV) nurses form a crucial part of every healthcare team. IV Nurses Day is celebrated every January 25 to recognize the work IV nurses do each day and also to thank them for their advocacy and devotion to the lifelong learning that is so crucial in their specialty.
The Infusion Nurses Society (INS) is celebrating its 50th year as the professional organization devoted to nurses in this specialty. As an international nonprofit, INS helps nurses across the globe who want to learn more about infusion nursing, advocate for nurses in the field, and find ways to improve and share their skills and knowledge.
IV nurses perform at a fast-paced level providing the infusion work that many patients require as they undergo tests, procedures, or therapies requiring any kind of infusion through intravenous access. IV nurses are a primary resource for the start-to-finish process of administering medications and transfusions through an IV line or port. They follow meticulous procedures to prevent infections and also help their patients understand the importance of caring for the area, particularly if a line remains in place.
IV nurses work with patients of all ages and may choose to focus their eventual work with one particular age group. They may choose to work in a children’s hospital, for example, or primarily with older populations in nursing homes. Depending on the work environment, IV nurses may see different patients throughout the day or they may begin to form lasting relationships with patients they see for long-term care or for routine care of chronic illnesses and conditions. Nurses in this specialty can work in their choice of settings including medical offices, infusion centers, patient homes, hospitals, and mobile centers. This opportunity for variety or stability means that nurses are able to focus their career on the path that most suits their goals, aspirations, and lifestyle.
Patience is a particular skill of infusion nurses. They are often working quickly and sometimes with patients who are fearful or upset by the IV process (children and adults alike). As they are working, they also must be reassuring and calm to help patients manage the process. IV nurses are exceptionally accomplished at finding access quickly and with as little discomfort to the patients as possible. They need to be able to reinsert lines that have come out and to monitor the medications, fluids, or products that are being used in the infusion process.
IV nurses will continue to provide the best care possible by obtaining a certified registered nurse infusion (CRNI) credential. With certification, nurses gain additional knowledge and skills needed to provide high-quality, evidence-based care in an industry that continues to see rapid changes in technology.
Certification also signals to patients, peers, and industry leaders that nurses are committed to the best IV care and to obtaining current information. As an IV nurse, being linked into professional organizations, such as INS, builds connections with nurses who are equally committed to the career path. It’s a great way to be inspired by the work of peers and to inspire others with your own work.
In honor of today’s IV Nurse Day, Minority Nurse spoke with IV nurse Julio Santiago, DNP, RN, CCRN, VA-BC who is owner and COO of Priority PICC Solutions, an outsourcing vascular access company that provides PICC services to hospitals and nursing healthcare facilities in the greater Chicagoland area. A longtime advocate of diversity, equity, and inclusion in nursing, Santiago has experience in many areas of nursing including ICU, neuro/neuro ICU, behavioral health, director of nursing role, home health, and as a nursing faculty member.
How did your career path lead you to becoming an infusion nurse?
I’ve been a nurse for over 31 years, and my wife has been a nurse for over 34 years and a vascular access nurse for over 25 years. About 15 years ago my wife and I discussed the need for hospitals and nursing facilities to have trained nurses to provide access at the point of care for patients that require infusion therapy. We felt that if we created a company that would help support hospitals and nursing facilities with the appropriate vascular access for patients that needed infusions, the company would do very well in the Chicagoland area. That was the start of how I became involved.
What do you like most about your career choice as an IV nurse?
That I get to help patients when they are in the most need. I get to provide the appropriate access to patient when they need it most. I also get to support nurses and make it easier for them to their job when it comes to infusion therapy.
What kinds of educational and professional decisions helped you get to where you are now?
I believe education and good mentorship are the keys to being the best nurse that you can be in your specialty. Whether it’s getting specialty certifications that validate your knowledge in a particular field or formal education to improve your professional knowledge, it’s important that nurses find ways to keep up with the latest standards of practice in their specialty.
A good mentor will also help to provide the needed support and encouragement needed as a professional nurse. Healthcare providers are being stressed to the limit during this pandemic, having a mentor or a peer group to talk with helps to decrease the stress and cope better with the stressors. I’ve been fortunate to have mentors and peers that are very supportive and provide the needed encouragement when situations get difficult.
What was your biggest struggle along the way?
Lack of knowledge from the perspective of hospital and healthcare administrators about vascular access and infusion therapy. The first part of providing patients with infusion therapy is to be able to provide the most appropriate access. Too often facilities decide about access based on convenience and not what is best for the patient. For example – facilities will use a PIV (peripheral intravenous)/midline instead of a central line because central lines infections are reportable, but midlines and PIVs infections are not reportable.
Working with facilities to make sure that established standards of practice are followed can be challenging at times. My standard of practice is based on a simple idea – If my grandmother needed to have an infusion, what would be the best course of action? Would you try starting six or seven unsuccessful PIV (peripheral intravenous) without the use of ultrasound, and then insert a midline using ultrasound (because that’s the best option for the care)? Would you be happy if that was done to your loved one? Do you have trained nurses in the facility that can provide care around the clock, or do you only have specialty trained nurses during business hours Monday through Friday? Are those the only times patients will need infusions in hospitals? I believe many decisions would be done differently based on that simple idea and following the standards of practice.
Infusion nurses’ clinics and hospitals are very specialized areas of practice that can be done on a schedule. What I’m referring to is the fact that these treatments are started while the patients are in an inpatient setting under acute care situations.
As an IV nurse, what skills do you rely on most for your technical tasks and for your more hands-on nursing tasks?
Making sure that you have the right mentor/preceptor to help you learn the skills is very important. I would say that learning the rationales for the treatment, indications, contraindications, potential complications, and things to avoid are important clinical reasoning skills that every nurse should feel confident performing.
Do you belong to any professional organizations?
The guidelines established by the Infusion Nurses Society (INS) are the standards of care that we follow to provide care to all our patients. These standards have been created to provide Excellence, Integrity, Inclusiveness, and Innovation to healthcare patients (INS, 2022).
I’ve been part of the INS Diversity, Equity, and Inclusion task force for over a year. The purpose of the task force is to ensure that INS is supporting and promoting diversity and inclusion within the infusion community. As a male Hispanic nurse, it’s important to me that the nursing profession addresses issues of inequality and inclusion in healthcare. Phillips & Malone (2019) reported that “ensuring workforce diversity and leadership development opportunities for racial/ethnic minority nurses must remain a high priority if we are to realize the goal of eliminating health disparities, and, ultimately, achieving health equity.” INS is taking the steps to ensure that infusion nurses provide care that is fair and just to achieve the best outcome for all people (INS, 2021).
On January 25, IV nurses around the country will once again be recognized with a day in their honor. Since 1980, the Infusion Nurses Society has sponsored IV Nurse Day has called attention to the nurses who specialize in infusion nursing.
This year’s theme “It’s About Us. It’s About Infusion.” highlights IV nurses’ dedication to their professional careers and their commitment to their patients’ health and safety.
Infusion nurses are drawn to the specialty for various reasons. Many enjoy the direct patient care and their essential place in a medical team. They are able to offer patient and family education for those who are seen in offices and centers and to those who require infusions out of a clinic or hospital setting. And they are also able to remain current on innovative practices and medication management.
IV nurses must know how to properly place infusion equipment to reduce pain, increase accurate placement, and prevent infection. They need to understand what medications (antibiotics to chemotherapy) and fluids (blood to saline) they are administering and keep tabs so they know which medications might interact. Infusion nurses keep track of infusion sites for any signs of infection, poor placement, or discomfort.
According to Salary.com, infusions nurses make anywhere from $78,550 to $94,136 annually. IV nurses who want to remain at the cutting-edge of the industry and who want to provide the best possible patient care should become certified as a CRNI (Certified Registered Nurse Infusion). Certification requires extra training and a deeper dive into the details of this specialty. Obtaining certification means you have the latest tools to help your patients.
While infusion nurses are masters at the task of establishing a line or a catheter with minimal discomfort and excellent placement, they are also doing it all while talking with and often comforting a patient and any present loved ones. They are able to distract with words and actions, to establish a trust and connection with their mannerisms, and reassure with their knowledge. All of this direct patient care is what makes an IV nurse’s job different every day.
Take the time today to thank the IV nurses in your life!
The celebration of IV Nurse Day every January 25 recognizes the work infusion nurses do with and for their patients. Infusion nurses are an essential part of the care team, acting to properly care for infusion needs and collaborating with other members of the health care team.
“Challenges in our ever-changing healthcare system combined with new, developing technologies and complex infusion therapies, afford the opportunity for the infusion nurse to use his/her expertise in infusion therapy to provide holistic patient care,” says Marlene Steinheiser, MSN, RN, CRNI®, director of nursing education of the Infusion Nurses Society (INS), Infusion Nurses Certification Corporation.
Of the primary responsibilities of an IV nurse, acting with the patient’s health and welfare in mind is primary. Celebrated since 1980, IV Nurse Day focuses attention on this essential care. “The infusion nurse acts as an advocate for patients receiving infusion therapy, ensuring that safe, quality infusion care is delivered,” says Steinheiser. “Patient assessment, with particular attention to the patient’s vasculature and prescribed therapy, is important so that the appropriate vascular access device (VAD) is selected to accommodate the treatment plan.”
Steinheiser also says that many infusion nurses also take on leadership roles where they provide education and guidance to other nurses while also continually monitoring for complications and setting in motion effective interventions when needed.
Student nurses interested in the career will find infusion nurses are not limited to specific settings. “Infusion nurses’ roles may vary depending upon the practice setting,” Steinheiser says. “Infusion nurses work in many settings, agencies, and organizations including, but not limited to, hospitals, nursing homes, ambulatory infusion clinicals, physician offices, and patient homes.”
According to Steinheiser, expert infusion nurses can help reduce complications by sharing their knowledge and educating patients, family members, and other healthcare team members and always assessing the patient. “Skilled VAD insertion, prevention of complications and early identification coupled with implementation of interventions, minimizes further damage that can result from infusion-related complications,” she says.
Like any nursing career, this branch of nursing requires continual education to stay current with best evidence-based practices that help prevent, reduce, and treat any complications or challenges. “Due to the invasive nature of infusion therapy, infusion nurses can encounter possible adverse events with any infusion, such as extravasation, catheter malposition, nerve damage, or infection,” Steinheiser says. “The infusion nurse is prepared with advanced knowledge and continuing education to promptly address these situations.”
The INS is an excellent resource for current and future infusion nurses. The organization offers free educational podcasts (available to members and nonmembers) where nurses can learn about and refresh their skills for safe infusion practices. And the learning center provides both virtual education and recorded educational sessions from prior conferences and webinars, and what Steinheiser calls a key resource for infusion nurses, the Infusion Therapy Standards of Practice.
As with other nursing practices, nurses with the desire to specialize in infusion therapy may study and take the certification exam offered twice a year, says Steinheiser. “To assist the nurse in preparing for this exam, INS has study material which covers the eight core components of infusion nursing,” she says. “Once nurses pass this exam, they are considered infusion nurse specialists and can begin using the credential CRNI®. The CRNI® is capable of an expanded role in directing evidence-based clinical practice, research, and quality improvement activities.”
Infusion nurses care for all patients, providing care that helps many other healthcare processes go more smoothly. “Infusion nurses provide for all patient populations, from the neonate to the elderly patient, and follow them along the continuum of care,” says Steinheiser. “Infusion nurses use their critical thinking skills, perform advanced procedures using state-of-the-art technology, and ensure safe infusion care.”
On January 25, IV Nurse Day celebrates the infusion nurses who complete the high-tech and exceedingly patient-sensitive process of infusion care.
The 2017 theme, “IV Nurses: Outstanding Skills. Outstanding Care.” gives acknowledgment to the specific skills IV nurses bring to a care team. Sponsored by the Infusion Nurses Society, this day has been an annual international event since 1980, says Mary Alexander, MA, RN, CRNI, CAE, FAAN, and chief executive officer of the society and of the Infusion Nurses Certification Corporation.
The IV Nurses Society has 7,000 members across the globe in more than 40 countries and territories outside the US. Approximately 3,500 of the members are certified as well. And they work in many settings—about half of infusion nurses work in hospitals and the other half work in alternate sites like infusion centers, physicians’ offices, or in home care settings.
“The care we provide is something all patients can relate to,” says Alexander. “Patients go into a hospital and almost everyone gets an IV.”
While IV certified nurses are not the only ones who can place an IV, the additional training gives the nurse the skills and the experience to do it well, she says. To place an IV properly, nurses must asses the patient, determine the appropriate device, and the proper management of care once the IV is in place.
As some patients can have an IV for a few short hours or in extraordinary circumstances for the rest of their lives, proper placement and care is paramount to patient comfort and safety, says Alexander. Infusion nurses are also then responsible for patient or caregiver education upon discharge. They need to convey accurate information about how to care for an IV and why it’s important for the patient to have it.
“It’s vitally important that clinicians are experienced and know what they are doing,” says Alexander. Because the lines bring solutions directly into a patient’s bloodstream, any complications can be life or death.
Patient safety is every nurse’s top concern, but infusion nurses also have a direct impact on patient satisfaction. Alexander says when patients are asked about their hospital stays, some surveys indicate the quality of food and the experience a patient had with an IV as the top influences of their overall satisfaction with the hospital.
IV Nurse Day recognizes all the work infusion nurses do, says Alexander. “We are all over the place,” she says, “You won’t find us in one specific place. We are an important part of the health care team when we are looking at the overall care of the patient.”
As part of the team, IV nurses can educate others on the team as well. Having an IV nurse on the team means the other team members are able to focus on their own tasks. Because of their experience, IV nurses save costs and labor because they generally get an IV placed correctly on the first attempt. That improves cost, reduces the risk of complications, and makes for a much happier patient.
If newer nurses are interested in this certification, Alexander strongly suggests getting some overall clinical experience prior to fulfilling the IV nurse certification process. And for nurses who are not yet certified, but interested, the Infusion Therapy Standards of Practice outlines some of the common guidelines for this specialty.
“The more you do it, the better at it you get,” says Alexander. “It’s good to recognize infusion nurses do a fabulous job and patients appreciate what we have to offer.”
Alexander notes that while some might expect IVs to eventually be replaced by a different process, she doesn’t see that happening in the very near future. And IV nurses also bring an extra component that’s hard to quantify. “To me, it’s high-touch, hands-on caring as well as high tech,” she says. “That’s extremely important.”
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