IV Nurse Julio Santiago Dedicated to Patient Care

IV Nurse Julio Santiago Dedicated to Patient Care

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.

Santiago uses his experience and voice to make change for student nurses and the wider nursing industry. He is cofounder and president of the American Association of Men in Nursing Joliet Junior College Nursing Program Chapter and is active in several professional organizations including the Infusion Nurses Society, National Association of Hispanic Nurses, American Nurses Association (ANA) Illinois Legislative Committee.

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).

National IV Nurse Day: Crystal Miller Discusses DEI

National IV Nurse Day: Crystal Miller Discusses DEI

Today’s observation of National IV Nurse Day marks a year filled with change, upheaval, and continuous learning like few other years.

Minority Nurse spoke with Crystal Miller RN, past president of the Infusion Nurses Society (INS) and current co-chair of its Diversity, Equity, and Inclusion (DEI) Task Force, to hear how the COVID-19 pandemic and the social upheaval around race has shaped the way INS is defining a path around DEI.

Above all else, the role of an infusion nurse (also known as a vascular access nurse) is one that focuses on the patient. “The pandemic has challenged us to look at the way we deliver infusion and vascular access care in our patients as never before,” says Miller.

IV nurses work in roles where taking care of immediate needs is essential, but, she says, they must constantly look at the bigger picture. “We have to look down the road so our patients get what they need from the outset,” she says. “We need to look long and hard at the best device to treat patients, especially those who are impacted by COVID-19.” A device or approach that might have worked when a patient was admitted to a facility may no longer be effective as the patient’s condition changes.

Miller is unequivocally proud of her specialty and of being part of the INS. “We are more than the equipment we use,” she says. And with vascular access as a global issue, Miller says INS decided to take a fresh look at what a global approach means to their nurses and patients.

“We’ve always been proactive in how we deliver the care we give,” she says. “We make sure the people who are at the table represent those in their areas.” Doing so makes sure INS is present and aware of diversity, equity, and inclusion issues and how they impact healthcare delivery and outcomes. “We want to make sure people have a voice,” says Miller. “And we want to make sure as an organization that every patient we see has a voice and is represented.”

DEI work is not a one-and-done deal, says Miller. “Whatever we develop and put forth, we need to make sure it’s ongoing work.” That means looking at how diversity is represented including different genders and identities, sexual preference and orientation, practice settings, and culture and race. “To the best of the abilities of our organization, we want to make sure we don’t put forth something that doesn’t consider how people feel,” she says. “We challenge others to listen with empathy and care.”

One of the best ways to learn about and to improve on DEI work is to talk with people, says Miller. Learning about what is important to people, how they do things, and how they see the world imparts the kind of detailed knowledge that can make all the difference to a patient.  Once you are informed, you can always do things a little better and that gets noticed. “When you prove your credibility, there are no limits,” she says. “When you recognize things are outdated, you change them up.”

With a focus on diversity, equity, and inclusion, a new interaction with patients opens up, especially with those from underrepresented populations. “Patients are grateful for the advocacy,” says Miller, “because there is someone in their corner, who is advocating for them and listening to them.”

The pandemic has shifted DEI efforts in ways that no one could have predicted. Of all the different healthcare practices or interactions patients may or may not be comfortable with, the need to separate people and keep them isolated has created an enormous burden for families and healthcare staff. “There are no family members present who can speak to a patient’s preferences,” says Miller. Vascular access nurses have shifted into finding innovative techniques to overcome this barrier.

On this year’s IV Nurses Day, Miller says although the typical celebrations aren’t possible, it’s still important to honor the work infusion and vascular access nurses do. “For me personally, I think there’s so much uncertainty in work and in healthcare now—it’s good to know we get to recognize our specialty,” says Miller. “We are the best resources where vascular access is concerned and we take that very seriously.”