Thinking about the patient journey as a picc line placing radiographer

Things are not always as they first appear, a lesson learned from a radiographer who appears to be a small part of a much larger journey for a patient….

During the start of my training of PICC line placing Radiographer I met a patient who became extremely distressed about having the PICC line and upon being informed that I was training to insert them during her consent, this upset her more. Initially, I was shocked at her distress as her arms were severely bruised from where ward staff had performed numerous attempts at cannulation and I had explained how a PICC line would mean this would stop. However, on further discussions I discovered that this lady had undergone major abdominal surgery and had several lines inserted previously that had become infected and also failed. This patient had been in hospital for several weeks, and she was concerned that she would encounter more complications.

Meeting this patient made me realise how vital it is as an operator of line insertion to understand where the insertion of lines comes within the patient journey. I was guilty of concentrating solely on my role of inserting the line, and not considering the procedures that the patient may have experienced previously. However, this incident enabled me to gain an understanding of that although the line insertion may appear as a quick procedure to myself, for the patient it could be deemed as yet another complex procedure or it could be occurring after the patient may have received bad news, for example the diagnosis of cancer, and the line is required for treatment purposes. After this incident I have since ensured that I read the patient’s medical notes in order to establish a thorough history, which may help me gain more of an insight into the patient’s journey aiding my empathy for the patient.

Becoming familiar with the patient and their experiences, I am dealing with my patients with a patient centred approach. Using a patient centred approach has been deemed as effective patient care and government initiatives such as the NHS Plan and NHS career framework advocate this practice. My practice prior to this incident was of the traditional approach in which radiographers are trained and that is to use a medical model of care. I was focussed on why the patient needed the line, the procedure itself and how I was going to successfully insert the line for the patient, which at the time seemed the most important achievement, especially as I was still training.

This patient also highlighted the issue of being a returning patient for line insertion. Complications such as infection and thrombosis are associated at point of insertion with PICC’s. However, despite trying to prevent these issues as an operator by using an aseptic technique and working within a sterile environment, line displacement, thrombosis and infection can still occur post procedure.

Reflective practice has helped my development of becoming an advanced practitioner. In the next blog I shall discuss how this patient’s journey has enabled me to help reduce returning patients for line insertions.

 

Kay Hackett LinkedIn Profile

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