Hey there firemedic7 -
You are not alone in the "IV" problem. Others have been there - remember it is a technical skill - one that can be learned. I am a bit confused that you admit 15 years experience and you are still having a problem.
I was in serious danger of "failing" out of my degreed medic program some 14 years ago, because my IV skills just kinda sucked. I mean I'd get maybe 1 out of 5. My FD medic preceptors just held my feet to the fire (not literally) but, you bet, by golly I got pretty good - failure was not an option. For me it was reviewing the technique and getting in the numbers.
Day surgery is an excellent "training ground". Lots of IV's - most patients pretty healthy (or else they would not be OP surgery candidates). I do not go on sight alone, I go by feel (and the alcohol prep to "wet" the area does enhance it for some). Sometimes I see, nor feel - but those are desperate times. Never go the no glove route for a stick - just not worth the risk!
Practice feeling around on everyone. Feel the hand, forearm, upper arm. As for assistance with your "technique". For me-
1. Find site.
2. Prep site.
3. Traction skin at site.
4. Stick to flash, advance 1/4 inch, off thread cath with other hand.
5. Apply pressure above site (to reduce free flow blood out cath - BIG MESS)
6. Collect samples, secure lock or line.
7. Secure site.
This is a numbers game. More attempts is the only thing that will make you better - after correcting any "errors" in your technique.
Honestly, I found that after a few hundred I was pretty good. I've placed probably thousands at this point in my career. I tend to avoid the hand (bad place for infusions). I chose the forearm or non-dominate wrist most of the time. I'll go for a clean AC in a desperate case or a good EJ in an even more desperate case. But I have placed femoral lines without any problems as well.
CONFIDENCE can be the key!
Get the numbers up and GOOD LUCK! You can do it!