On Thursday, Jan. 25, we celebrate and highlight our North Puget Sound IV nurses. There are sixteen on staff at Providence Everett and four at Swedish Edmonds. They’re responsible for managing most peripherally inserted central catheters (PICCs) and ports throughout the hospital – including lab draws, dressing changes and site checks. They insert peripheral IVs for patients needing better access and midline catheters for patients with challenging veins.
We sat down with two of our intravenous nurses to find out how this specialized team serves patients across Providence Swedish.
Meet Rowena Nicolas, Providence Regional Medical Center Everett
Rowena Nicolas has worked at Providence for 18 years – 8 in renal medical telemetry and the past 10 in IV therapy. As she describes it, “IV therapy involves highly specialized tasks, such as placement of peripheral intravenous lines on patients with challenging vasculature like sickle cell disease, IV drug use disorder, peripheral vascular disease and chronic renal failure. IV nurses conduct a thorough assessment of veins, decide the appropriate IV catheter based on the complexity of IV medications needed by our patients.
“We also handle placement of ultrasound-guided IV starts, and midline and peripherally inserted central catheters (PICCs). Other tasks include central line care, troubleshooting, de-clotting, accessing and de-accessing implantable ports and management of infiltration/extravasation of vesicant medications [medications that can cause damage when accidentally infused into the tissue surrounding a vein] and recommended antidotes, if any.”
As part of the IV team, Rowena is “an advocate for vein preservation”, provides education to nurses on hospital units, helps ensure safe delivery of IV medications and manages complications. Critical thinking skills and the ability to prioritize patients with complex IV needs are crucial parts of the job, as well.
Rowena says the greatest challenges the IV therapy team faces are the inevitable complications related to peripheral/central venous access devices – despite their efforts to eliminate them.
Rowena, a native of the Philippines, earned her BSN from Lyceum Northwestern University. She’s married and has a daughter in high school. In her free time, she loves to cook and enjoys watching movies and TV shows.
Meet Rachelle Bottenberg, Swedish Edmonds
Rachelle Bottenberg, RN VA-BC, a PICC nurse at Swedish Edmonds, has worked for Swedish nearly 18 years – but her history in health care goes back much further. She grew up in Pedricktown, New Jersey, and worked as a nursing assistant before becoming an LPN at age 19. She moved to Washington in the 1990s and finished her RN education at Everett Community College in 2005.
Rachelle joined Swedish on Valentine’s Day, 2006. She spent her first 10 years in critical care and picked up shifts in the ED, PACU and cath lab. Since joining the PICC team, she also takes shifts in outpatient infusion and minor procedures.
“PICC/IV nurses at Swedish Edmonds support all patient care areas within the hospital,” Rachelle says. “As the IV nurse, I place PICC and midlines for inpatients and outpatients. Our duties also include monitoring all central lines within the hospital, changing dressings on central lines, placing difficult peripheral IVs, patient and staff teaching. We also support outpatient radiology services, assisting with port access and difficult IVs.”
“A typical day is very busy,” she continues, “constantly adapting our schedule as patient issues arise.”
Rachelle’s favorite thing about working at Swedish Edmonds is “the wonderful people I work with.” Her greatest challenge is knowing multiple patients need her at the same time.
“Our PICC nurses do so much in a day and are a vital resource to nurses and clinicians to provide the excellent care Providence Swedish is known for,” said Trisha Ross, who leads the team.
Rachelle and her husband, Jace, have two sons: Hayden, 12, and Tanner, 11. In her spare time, she enjoys paddle boarding, kayaking, Pilates and yoga.
Thanks to all the North Puget Sound IV nurses for their expertise and commitment to the health and safety of our patients.
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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.