#Kelpforesrdwellers

[sweetdreamspootypie]

hey, saw your tags on my iStop notice and had to say something. if you're a nurse you really gotta take the can't leave port accessed thing super seriously. I think it may apply to all IVs but I have a port so that's what I know.

I don't think I was explicit about it: the reason it is so highly illegal has nothing to do with infection. it is specifically to prevent people from having IV access for illegal drug use.

so imagine how I feel about the port being left in now that I know what they think I wanted from the hospital.

@kelpforestdwellers

(idk how tumblr does notifications for asks so figured I'd tag you)

Yeah that makes sense as the reasoning

But still

Plenty of people have central lines out in the community - people on chemo, long term antibiotics, dyalisis, gastroparesis patients who are TPN / IV hydration / IV antiemetic dependant. And those are just the ones I have met going through y particular ward which is general medical, not specialized.

I know you have been / are going through a very long and frustrating process around getting it added to your official care plan and being properly facilitated to access your port at home.

But I have assumed that's just bureaucratic paperwork nonsense about like. Which doctor wants to put their signature to it that they've done due diligence about risk management with you. And stuff about who's job it was to organise it for you.

As opposed to being issues with just having an accessed port at home itself.

It is obviously a huge fuckup to have an /accidentally/ accessed port - but that's still to my mind mostly about infection control.

If they did actually think you were at risk of unsafe IV drug use then yes that is also a major beach of duty of care.

I just had a quick scroll through your blog and you haven't said anything about the process of discharge besides the fact that there was back and forth about when it would be. So tbh I'm confused how you also didn't know it was still accessed, as it's a whole process to de-access it unless you were expecting procedures to be done while you are unconscious. But there was so much other things you were chasing for a safe discharge that I guess it just got forgotten for you.

It sounds like that ward were not confident with the port - you mentioned them getting snotty about doing a blood draw - which is wild to me, because central lines are amazing for that. It's so easy to do a blood draw, we love it. Especially ports! Way easier than PICCs. The only issue is that a phlebotomist will not do patients with central lines, so the nurse has to do it. So it's not a 'patient refused' it's a 'not done on pleb round - awaiting nurse to do it's

So the fact that that happened implies a high percentage of nurses there aren't familiar with central lines, which almost certainly contributed to it not being on their mental checklist for when you left.

Which is a silly situation but also kinda familiar. One of our gastroparesis patients has a standing plan that if she ever needs to go to hospital, she will access her port herself and draw her own blood samples at home before she goes, because it's not worth dealing with ER staff where nobody is confident to initially access a port.

Anyway yeah

I can see the reasoning about it being bad to have an unplanned IV access for drug abuse concerns

But I still would absolutely not blink an eye about a patient coming in from home or going home with central line access. But it should be part of a clearly documented plan for discharge.

I'm in aotearoa though, so different laws obviously. If there is something similar here, I wonder if it's one of those things where they tell you as part of putting the port in in the first place, but. For anyone else it's not relevent.

I hope things start moving for you for being able to access it safely at home.

[sweetdreamspootypie]

[Reblogging to add what was said in DMs as per request]

I'm so so sorry - my engagement and comments were intended to be in the context of 'the US drug laws make no sense' and commiseration for the fact that then bs laws are not medically necessary and are contributing to everything happening with you, and the lack of CVC competence on a ward. You're right I should have put that at the start - it hadn't occured to me that you might engage with it in a way of trying to help me understand laws that might apply to me. Thank you, but also I apologise, that's really not a task you needed now or ever.

I hope you get to have some good rest now you're home, without extra sources of stress.

hey, saw your tags on my iStop notice and had to say something. if you're a nurse you really gotta take the can't leave port accessed thing super seriously. I think it may apply to all IVs but I have a port so that's what I know.

I don't think I was explicit about it: the reason it is so highly illegal has nothing to do with infection. it is specifically to prevent people from having IV access for illegal drug use.

so imagine how I feel about the port being left in now that I know what they think I wanted from the hospital.

@kelpforestdwellers

(idk how tumblr does notifications for asks so figured I'd tag you)

Yeah that makes sense as the reasoning

But still

Plenty of people have central lines out in the community - people on chemo, long term antibiotics, dyalisis, gastroparesis patients who are TPN / IV hydration / IV antiemetic dependant. And those are just the ones I have met going through y particular ward which is general medical, not specialized.

I know you have been / are going through a very long and frustrating process around getting it added to your official care plan and being properly facilitated to access your port at home.

But I have assumed that's just bureaucratic paperwork nonsense about like. Which doctor wants to put their signature to it that they've done due diligence about risk management with you. And stuff about who's job it was to organise it for you.

As opposed to being issues with just having an accessed port at home itself.

It is obviously a huge fuckup to have an /accidentally/ accessed port - but that's still to my mind mostly about infection control.

If they did actually think you were at risk of unsafe IV drug use then yes that is also a major beach of duty of care.

I just had a quick scroll through your blog and you haven't said anything about the process of discharge besides the fact that there was back and forth about when it would be. So tbh I'm confused how you also didn't know it was still accessed, as it's a whole process to de-access it unless you were expecting procedures to be done while you are unconscious. But there was so much other things you were chasing for a safe discharge that I guess it just got forgotten for you.

It sounds like that ward were not confident with the port - you mentioned them getting snotty about doing a blood draw - which is wild to me, because central lines are amazing for that. It's so easy to do a blood draw, we love it. Especially ports! Way easier than PICCs. The only issue is that a phlebotomist will not do patients with central lines, so the nurse has to do it. So it's not a 'patient refused' it's a 'not done on pleb round - awaiting nurse to do it's

So the fact that that happened implies a high percentage of nurses there aren't familiar with central lines, which almost certainly contributed to it not being on their mental checklist for when you left.

Which is a silly situation but also kinda familiar. One of our gastroparesis patients has a standing plan that if she ever needs to go to hospital, she will access her port herself and draw her own blood samples at home before she goes, because it's not worth dealing with ER staff where nobody is confident to initially access a port.

Anyway yeah

I can see the reasoning about it being bad to have an unplanned IV access for drug abuse concerns

But I still would absolutely not blink an eye about a patient coming in from home or going home with central line access. But it should be part of a clearly documented plan for discharge.

I'm in aotearoa though, so different laws obviously. If there is something similar here, I wonder if it's one of those things where they tell you as part of putting the port in in the first place, but. For anyone else it's not relevent.

I hope things start moving for you for being able to access it safely at home.