Whilst intravenous cannulation is a basic skill for a nurse, expertise in this area along with other technical, non-technical and leadership skills can allow you to specialise and advance in your nursing career.
I am Raymund Daquiz, Lead Nurse for the Vascular Access Team at the Conquest Hospital of the East Sussex Healthcare NHS Trust. As my role title suggests, it means I am dealing with "veins" and "venous devices" all day. However, it is not limited to just finding vascular access to patients, I believe that we’re making a difference by ensuring patients can get their intravenous treatment in a timely manner as well as providing effective leadership to my team. I make sure that each of us provides quality patient care and in turn increase patient satisfaction.
I was chosen to learn the insertion of Peripherally Inserted Central Catheter (PICC) from St George’s Hospital in Tooting, London due to my top notch skills in cannulation and venepuncture more than a decade ago. I came from an Onco-Haematology background where I was able to enhance my skills when dealing with needles, which was noticed by my previous matron at the time. In my current Trust, I was the first person at Conquest Hospital to do the procedure independently and proficiently under ultrasound guidance.
I applied for the Team Lead role when the previous Team Lead left, and I was given this role. I have been doing this since 2011 to present, and I enjoy every single day at work. The Vascular Access Specialist Nurse Role was approved through the Trust’s then Director of Nursing in 2007, giving their support for the extended role of a Vascular Access Specialist Nurse in performing procedures related to the post (ie. PICC insertion, Midline insertion, Implantable port procedure, Ultrasound cannulation and venepuncture, etc.). Consequently, companies supplying vascular access devices deliver the training either as a national training workshop, or visiting local Trust sites for the training.
My typical day includes ward rounds to check on our patients with PICC lines, to consent patients referred to our service, do the central line referrals, and troubleshoot misbehaving central lines within the hospital.
As a vascular access nurse, it is important to have good hand-eye coordination. In most procedures, you are looking into an ultrasound screen for what you are doing on the patient. You should also possess good human interaction skills as you need to inform the patient as best as you can regarding what you need to do to them. Obtaining an informed consent is also essential prior to starting the procedure. It is important that the patient knows about the benefits and risks involved in order to make an informed decision about his/her treatment.
As a team leader, I am responsible for the daily operational management of the Vascular Access Team service. I am responsible for clinical procedures and educational delivery alike. My team delivers various study days such as Cannulation, Venepuncture, management, maintenance and troubleshooting of Vascular Access Devices, Blood culture training, Port needle-access training, and IV study day for newly qualified nurses via the Trust Learning and Development department electronic booking system.
I have also spearheaded a business case to acquire machines that will facilitate PICC line insertion. I presented it to the Trust Board and have been approved thereafter. My innovations within ESHT include the following:
1. Use of Nautilus ECG machine, (Tip placement locator for PICC tip positioning using intracavitary ECG)
2. Use of Taurolock Antimicrobial locks for prevention and part treatment of CRBSI (Catheter Related Blood Stream Infection)
3. Use of VPS (Vascular Positioning System), an even better tip locator system with tip tracking technology. (Uses intracavitary ECG plus real-time tip tracking).
I find this job very rewarding because I enjoy what I’m doing. Just like with any role, it also has its challenges. Every person has a different vascular structure. Some call for a more intricate procedure than others. But that makes it more exciting too.
My specialty is very fulfilling and technical. Those newly qualified nurses thinking of a career path can look into Vascular Access as their field of specialty to eye for. It is not for everyone like any other specialty field, but those who love "veins" and high tech devices to enable you to enhance patient experience can surely try and become successful in Vascular Access.
About the author:
Mr. Raymund Daquiz is a UST BSN alumnus batch '98. He finally arrived in the UK in 2005 and marked the start of his successful nursing journey to date. He started as a Chemo staff nurse in the McCartney Unit of East Sussex Hospitals NHS Trust (old name of our trust) and began to train in PICC insertion in August 2007. He became the PICC placer in Onco/Haematology until end of 2008 and immediately promoted to a vascular nurse specialist a year after. He is currently the team lead for the Vascular Access Team which he applied for in 2011.