Key Responsibilities and Required Skills for IV Nurse

🎯 Role Definition

An IV Nurse (Infusion Nurse) is a registered nurse specialized in intravenous therapy and infusion management who assesses patients, establishes and maintains vascular access (peripheral IV, PICC, midline, tunneled central lines), safely administers IV medications and infusions (antibiotics, chemotherapy, biologics, TPN), monitors infusion reactions and complications, documents care in the EHR, and collaborates with the interdisciplinary team to deliver high-quality, patient-centered infusion services across outpatient infusion centers, hospitals, home infusion, and specialty clinics.

This role emphasizes mastery of sterile technique, venipuncture and catheter insertion, infusion pump programming, medication safety, emergency response for anaphylaxis and extravasation, and clear patient and caregiver education to ensure adherence, optimal outcomes and regulatory compliance.

📈 Career Progression

Typical Career Path

Entry Point From:

Staff Registered Nurse (medical-surgical, telemetry, oncology)
Home Health or Hospice RN transitioning into infusion services
Emergency Department or ICU RN with IV/vascular access experience

Advancement To:

Charge Nurse / Lead Infusion Nurse
Infusion Clinic Manager / Clinical Supervisor
Nurse Educator / Vascular Access Specialist
Clinical Nurse Specialist or Nurse Practitioner with a focus on infusion therapy

Lateral Moves:

Home Infusion Clinician
Oncology or Hematology RN
Vascular Access Team Member / PICC Team RN

Core Responsibilities

Primary Functions

Assess, triage and prioritize incoming infusion referrals and walk-in patients, performing comprehensive vascular access assessments (vein mapping, prior access history, assessment of central lines/PICC sites) and documenting findings and plan of care in the electronic health record (EHR) to ensure safe, timely infusion delivery.
Independently establish and maintain peripheral IV access, insert and troubleshoot midline catheters and PICC lines (or assist with PICC insertion), and manage tunneled central venous catheters, using evidence-based sterile technique and ultrasound guidance when indicated to reduce complications and improve first-stick success.
Prepare, mix and reconstitute IV medications and biologic agents per institutional policy and manufacturer guidelines, including cytotoxic chemotherapy, monoclonal antibodies, IVIG, antibiotics, antivirals and parenteral nutrition (TPN), while following safe handling, compounding and hazardous drug procedures.
Program, start and monitor infusion pumps, elastomeric devices and syringe pumps; calculate and verify infusion rates and volumes, perform medication verification with a second RN or pharmacist when required, and adjust therapy per protocol or physician orders.
Perform continuous and interval assessment of patients during infusions for signs of adverse drug reactions, infusion-related hypersensitivity, extravasation, phlebitis, infection or fluid overload; initiate emergency interventions including stopping infusions, medication administration (epinephrine, antihistamines, steroids), airway and hemodynamic support and escalation per ACLS/BLS protocols.
Provide comprehensive patient and caregiver education before, during and after infusions — instruct on catheter care, signs/symptoms of complications, post-infusion self-care, infusion pump operation, and when to contact the clinical team or seek emergency care — and document education provided.
Collaborate with physicians, pharmacists, case managers and home infusion providers to develop individualized infusion plans, coordinate transitions of care, arrange home delivery or clinic follow-up, and ensure continuity and adherence across settings.
Conduct pre-infusion assessments including allergy history, baseline vital signs, lab review (electrolytes, renal/liver function, drug levels), pregnancy status when relevant, and medication reconciliation to confirm appropriateness and safety of IV therapy.
Execute and document safe vascular access dressing changes, catheter maintenance (flushing, locking, dressing integrity), and specimen collection from central lines following institutional and CDC guidelines to minimize catheter-related bloodstream infections.
Triage and manage infusion-related complications such as extravasation by initiating local measures, administering antidotes per protocol, coordinating surgical or specialty consults and documenting the event and follow-up plan to ensure patient safety and regulatory reporting.
Ensure accurate, timely and compliant EHR documentation for every patient encounter, infusion start/stop times, medication lot numbers and expiration, patient responses and adverse events, and complete required incident reports and quality documentation.
Administer weight-based, time-sensitive and high-alert IV medications safely by performing independent dose calculations, double-checks for high-risk drugs, using barcode scanning and following institutional high-alert medication protocols.
Maintain and calibrate infusion equipment, pumps and supplies — perform daily checks, report malfunctions, and collaborate with biomedical engineering and supply chain to ensure adequate stock and readiness of infusion supplies and emergency equipment.
Participate in multidisciplinary rounds and clinical huddles to review complex patients, infusion plans and discharge needs, providing nursing input on vascular access choices and ongoing monitoring priorities.
Lead and participate in quality improvement initiatives focused on reducing catheter-related infections, improving first-attempt IV success rates, decreasing extravasation events and optimizing infusion throughput and patient satisfaction in the infusion clinic or unit.
Train, mentor and precept new nurses and support staff in IV techniques, vascular access best practices, infusion pump programming, emergency response and clinic workflow to build team competency and standardized care.
Maintain strict compliance with environmental and occupational safety regulations for hazardous drug handling, biohazard disposal, sharps safety and infection prevention, and participate in routine audits and competency validation.
Coordinate care and scheduling for complex infusion regimens including multi-day antibiotics, chemotherapy cycles and biologic therapies; verify insurance authorization, obtain informed consent as required, and provide clear scheduling and follow-up instructions to patients and families.
Participate in clinical research and registry activities when the clinic is involved in trials, including administration of study-related infusions, adherence to protocol-specific documentation, and timely reporting of adverse events.
Provide compassionate, patient-centered care focused on pain management during vascular access procedures, anxiety reduction techniques, and culturally competent communication to improve patient experience and clinical outcomes.
Engage in emergency preparedness and response for the infusion setting by maintaining BLS/ACLS certification, participating in mock codes and ensuring ease of access to emergency medications, oxygen and resuscitation equipment.
Support billing and coding accuracy for infusion services by documenting services rendered, supplies used, and time-based infusion details needed for appropriate reimbursement and compliance with payer requirements.
Maintain professional development through attending infusion-related continuing education, certifications (IV therapy, Vascular Access Specialist credentials), and staying current with evolving guidelines for infusion therapy, sterile compounding and safety standards.

Secondary Functions

Contribute to policy review and development for infusion nursing standards, catheter maintenance protocols and hazardous drug handling to reflect best practices and regulatory changes.
Assist the nurse manager and operations team with staffing forecasts, clinic throughput optimization and patient scheduling to support operational efficiency.
Participate in community outreach and patient education events to raise awareness about infusion therapies, home infusion options and vascular access care.
Support supply chain coordination by tracking inventory usage patterns, suggesting standardization of consumables and ordering high-use items to prevent treatment delays.
Collect and analyze basic quality metrics (infection rates, first-stick success, treatment delays) and present findings to leadership to support data-driven improvements.
Act as a clinical resource for telephone triage related to infusion side effects, catheter concerns and medication questions, providing evidence-based advice and escalation when needed.
Engage in interdisciplinary education by presenting infusion-related topics to physicians, pharmacists and allied health staff to promote cohesive patient care practices.
Serve as a point-person for new device evaluations and pilot programs related to vascular access technology and infusion pumps.

Required Skills & Competencies

Hard Skills (Technical)

Peripheral IV insertion and maintenance with high first-attempt success; skilled in ultrasound-assisted IV access and vein visualization technologies.
PICC and midline catheter care and dressing changes; familiarity with PICC team workflows and dressing/securement best practices.
Central venous catheter (tunneled/non-tunneled) assessment, dressing changes and blood draw technique from central lines.
Infusion pump programming, troubleshooting and verification (smart pumps, syringe pumps, elastomeric devices).
Safe handling, reconstitution and administration of cytotoxic and hazardous IV medications (chemotherapy, biologics) including use of PPE and compounding/transfer protocols.
Total parenteral nutrition (TPN) administration and monitoring; understanding of electrolyte adjustments and central-line associated monitoring.
IV medication dose calculations, weight-based dosing, rate adjustments and high-alert medication double-check procedures.
Phlebotomy and blood specimen collection from peripheral and central access with correct labeling and chain-of-custody procedures.
Electronic Health Record (EHR) proficiency for infusion documentation (Epic, Cerner, Meditech or similar); barcode medication administration experience.
BLS required; ACLS and/or PALS preferred depending on setting; IV therapy certification (where applicable) and vascular access specialty certifications (VA-BC, CRNI, or local equivalents) are highly desirable.
Knowledge of infection prevention standards, catheter-related bloodstream infection prevention bundles and CDC guidelines.
Familiarity with payer authorization, infusion billing codes and documentation requirements for outpatient infusion reimbursement.

Soft Skills

Excellent verbal and written communication skills for educating patients, coordinating with interdisciplinary teams and documenting clear clinical notes.
Strong critical thinking and clinical judgment to rapidly assess infusion reactions, complications or changes in patient status and initiate appropriate interventions.
Empathy and patient-centered bedside manner to comfort patients undergoing vascular access procedures and long-term infusion regimens.
Time management and multi-tasking ability in a fast-paced infusion clinic or inpatient setting while maintaining attention to safety and detail.
Team collaboration and leadership presence to precept new staff, lead huddles and contribute to continuous improvement projects.
Adaptability and resilience when managing unexpected clinical events, schedule changes or high-volume infusion days.
Problem-solving orientation with a focus on operational improvements, supply issues and patient flow optimization.
Cultural competence and sensitivity to diverse patient populations and complex social determinants that affect infusion adherence.
Accountability and ethical practice with a focus on patient confidentiality, medication safety and professional standards.
Instructional skills for delivering clear, actionable patient and caregiver education and for conducting staff in-service training.

Education & Experience

Educational Background

Minimum Education:

Associate Degree in Nursing (ADN) or Diploma in Nursing; active Registered Nurse (RN) license in the practicing state required.

Preferred Education:

Bachelor of Science in Nursing (BSN) preferred, particularly for leadership or education-track roles.

Relevant Fields of Study:

Nursing (ADN/BSN)
Clinical/Acute Care Nursing
Oncology Nursing (preferred for chemotherapy infusion roles)
Critical Care or Emergency Nursing background (valuable for high-acuity infusion settings)

Experience Requirements

Typical Experience Range: 1–5 years as a Registered Nurse, with at least 1–2 years of experience in IV therapy, infusion nursing, oncology, home infusion, ED or ICU preferred.

Preferred:

2+ years of direct infusion or vascular access experience, demonstrated competency in peripheral IV insertion, central line maintenance and infusion pump management.
Prior experience with outpatient infusion centers, oncology/hematology infusion clinics, home infusion services or hospital-based infusion programs.
Certifications such as BLS (required), ACLS (preferred), IV therapy certification, CRNI or vascular access specialist credentials are highly regarded.

If you need this tailored to a specific setting (oncology infusion clinic, home infusion, hospital infusion unit) or adjusted for regional certification and salary ranges, I can adapt the document accordingly.