Do you ever miss?

[Brenna's Dad]

So, here is a question for all you CRNAs/SRNAs/MDAs out there.

Now, I am pretty decent with IVs. Obtaining about a 90-95% proficiency in dealing with old, septic, shutdown ICU types.

But, I can't help wondering what will happen after I start my clinincals. I mean, as a nurse perhaps the, "wow, I can't believe I misssed!" comment might be accepted. But as a CRNA/SRNA/Anesthesiologist, how does the patient react when you miss. Their confidence level in you must hit rock bottom.

So, how do you all deal with this. Do they teach you some magic method in school for obtaining 100% accuracy? Do you simply get so proficient that you never miss or maybe 1/1000? Are your patients just so generally healthy that you can't help but hit? In difficult pts do you just forget it and go for the jugular? What excuse do you use when you do miss" "Sorry Miss Jones, it looks like the needle is defective"?

Thank you for your honesty.

[Tenesma]

l. rae... you are absolutely right - it is a purely technical skill - the more often it is practiced the better it gets... when i was an intern i always used to cringe when the families would ask for the dr. to start the IV... in the beginning I would end up fishing around for veins, while the RNs sat back and grinned :)

personally i am still amazed at how some people are just born talents at getting IVs into neonates and small peds...

[Brenna's Dad]

Hey L rae,

I was joking. It wasn't my intention to be putting down nursing. And of course, nurses are among the most proficient IV initiaters. I am also well aware that most physcians (anesthesiologists excluded) suck at the skill.

However, my comment surrounding missed IV attempts and pt confidence, stems from my belief that most people are nervous when going under anesthetic. Having their anesthesia provider miss an IV start might result in a lowered confidence level; something, I strive not to have happen when I care for my patients, regardless of the situation.

[g8rlimey]

Peds and neonates are an exclusive talent...I have watched some amazing sticks on some tiny babies, but never had the desire to make it a skill of my own.

[l.rae]

Originally posted by Brenna's Dad

Hey L rae,

I was joking. It wasn't my intention to be putting down nursing. And of course, nurses are among the most proficient IV initiaters. I am also well aware that most physcians (anesthesiologists excluded) suck at the skill.

However, my comment surrounding missed IV attempts and pt confidence, stems from my belief that most people are nervous when going under anesthetic. Having their anesthesia provider miss an IV start might result in a lowered confidence level; something, I strive not to have happen when I care for my patients, regardless of the situation.

Bu frankly, I think you took my post the wrong way and ended up sounding spiteful regardless. I have been a "nurse" for ten years and will continue to be a "nurse" after becoming a CRNA.

It wasn't my intention to sound spiteful just as it was not your intention to put nursing down....sometimes it is hard to know where a poster is coming from because of the format.....lets just say..."l missed this one"...LOL...and truly don't intend to offend, just to clarify your post...and thanks for doing that......LR

[l.rae]

Originally posted by g8rlimey

Peds and neonates are an exclusive talent...I have watched some amazing sticks on some tiny babies, but never had the desire to make it a skill of my own.

DITTO and AMEN!

[Brenna's Dad]

apparently edits don't go through immediately. LOL.

I edited that last part, because upon reflection, I think it sounded a little argumentative.

[fence]

I know that some days I rock starting IV's. Other days...well, I may attempt a couple but after a few misses, if its one of those days I just ask one of my teamates before I even try.