Things have been blessedly uneventful in the NICU lately. The census was down to 10 last weekend and the babies are all doing well. I could tell old NICU stories, but instead, I think I'll share a few of my IV therapy moments.
A long time ago, in a hospital not so very far from my home, I took a PRN position as an IV therapy nurse. That means whenever they had a need and I had a few spare hours, I'd go do some stick-and-runs, change a few central line dressings, assist with central line placements, and generally lighten the load on the regular staff so they could do things like teach people how to care for their implanted venous access devices (Ports and Hickmans, mostly) once they got to go home with them.
As you doubtless know, patients have the right to refuse pretty much any intervention - provided they're competent to make that decision.
The patient's IV had infiltrated and the staff was waiting for me to restart it. I soon found out why they hadn't tried themselves. I didn't even get a chance to introduce myself when the man announced, "If you try to stick me with needles, I'm going to hit you!" As a rule, I'd just document the refusal and go on to the next patient, but I wasn't entirely certain that this patient was competent to make that decision. I was in no mood to find out if he meant what he said about hitting so I quickly made a U-turn and found his nurse. She assured me that he had been evaluated by the psych folks, that I could legally restart the IV without his consent if necessary, and that she'd find me some help to restrain him.
The help didn't look substantial enough to keep me from getting hit - and I really prefer the cooperation of the patient in any case. When I re-entered the room, I explained that Dr. "X" really felt that he needed his IV and that I didn't care to be hit. I suggested that instead of hitting, he could share his feelings about the procedure - in whatever vocabulary suited him.
He was quite cooperative after that. He spent the next 5 minutes telling me in very colorful language exactly what he thought of the hospital and of the nurses who'd been caring for him -- and Dr. X. He didn't swing at me, though. In fact, he held his arm quite still and even thanked me before I left.