Vent: "I should warn you, I'm a tough stick..."

Specialties Emergency

Published

Seriously? If I had a dollar for every time I heard this and got it on the first stick, I'd be retired.:smokin:

Our IV team likes us to put the EMLA on before they come down. If I KNOW that the kid has NOTHING, I'll ask them to come pick their spot (since it's likely to be mid-forearm or someplace else weird), otherwise, I smear EVERYWHERE. They need to make EMLA onesies for all ages. :)

And honestly, you don't even need to tell me whether you're a hard stick. I can tell by looking. I have done this just a few times.

HAHAHA so true!! :)

Specializes in Emergency, Haematology/Oncology.

I couldn't help but put a comment on this thread because I too, could retire if I had even 20c for every patient that has told me they are difficult. I counted how many IV lines I put in the other day, 28. That's all my pts and all the hard ones no-one else could get it's one of my (sadly) few talents. When the "they had 6 tries last time" comment comes, I look them dead in the eye and say, "I won't". If the patient knows you are confident, it's half the battle. Have never used local or emla, a butterfly or anything smaller than a 20g. I truly believe it is an artform and like anything, repetition and practise makes perfect. Having said that, the only time I do miss, will be the 20 year old guy with garden hoses on offer!

Specializes in ER, ICU.

I too have a rare talent in my ED with IV sticks. I work nights and am a go-to person for those who have a tough time with their sticks. I am happy to help too, as it just gives me more practice with different veins.

Like others gave said, I actually enjoy the challenge! If I get it first try, the patient us super happy and they think I'm awesome (lol, win-win). If I can't, well that's what they were expecting so it's not a letdown...

I rarely have to stick more than once, but depending on the situation and acuity, I have no problem sticking more than twice or just going for the EJ. One hospital I work at makes you have 3yrs before bring allowed to stick an EJ, the other allows it if you're an RN, no time requirement.

For whatever reason, the nurses in our hospitals are allowed to do a manual IO but only midlevels and MDs are allowed to use the drill...

Specializes in ER.

I seriously don't understand this mentality that people have when someone else has a difference of opinion. It's like their can only be one right way and everyone must agree. It's absurd. Everyone has their preferences they all have their Pet Peeves.

As far as a difference of opinion, I'm perfectly OK with being wrong. I'm sticking by my AC sites because they are what works for me, and since I'm the one sticking the patient I get to decide. If the floor nurse wants it done differently I'll give her absolutely no trouble when she puts in her own preferred site.

Specializes in pediatrics, ED.

I hate the people who say they are a hard stick and than point out only 2 veins your "permitted" to stick. The other one is you start to swab them with Chlorprep and they start screaming and pulling away or FREAK about the tourniquet. I have had people freak so hard on the tourniquet that they hyperventilate. It is tight, and not pleasant but really I don't like to leave it on your arm for extended periods of time.

As far as the "I'm a hard stick" IT frustrates me its' like your either 1. REALLY a hard stick or 2. You generally freak so you clamp down causing your veins to constrict and make it impossible to pass a catheter.

As far as the Butterfly comment. I have sat MANY a patient down and state "Butterfly's are a style of needle, they come in a variety of sizes" They usually look at me like I'm crazy but than I show them and they go "OH!"

I think most of the issue with IV starts are lack of education.

"I must warn you, my veins roll". *****!! who the hell made this line up anyways? Don't tell your patients that their veins roll. Hold that vein down, and use a smaller needle that you might be able to handle.

Specializes in EMERG.

Unless its an IV drug user telling you "I am a tough stick"....I don't believe it!LOL

Specializes in GICU, PICU, CSICU, SICU.

I know the feeling. I had to stick a girl the other day that was doing IV drug abuse in my opinion and the mother complained it took a second stick to get a functioning line...

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I always ask the addict....Where's your best vein. Trust me they know:rolleyes:

1 Votes

Every time someone tells me that I grin REALLY big and say "Oh, I just LOVE a challenge! Woot!" and dig in. I did that once to a young man "hard stick" and afterwards getting an 18g on the first try, I stood up, held out a flush straight ahead of me, and dropped it on the bed next to him like "you've been served" and he just busted out laughing. Doesn't bother me. Some people really ARE hard sticks, and sometimes the info they give me, like rolling veins, fragile skin, collapsing veins, lots of valves, etc. really is helpful to me. I'm blessed with big, juicy veins that you could hit with a garden hose.

Specializes in Trauma, Teaching.

The other night I had an adult pt in who has had a lot of procedures, according to her and her mom. Mom sits there with a disapproving face on before I even sit down, tells me she has "shallow veins" and everyone "always goes too deep, and how it always takes a lot of sticks before anyone succeeds.

I already had the tournequet on by then, veins are just fine. I looked up and said, "well, I really busy tonight, do you mind if I just do it on the first one?". Proceded to not only to place one but to draw labs at the same time. Since the tubes do take a few minutes to fill, mom who isn't even in line of sight decides I must still be digging around and says "she went too deep didn't she?".

I just finished taping, held it all up and said, we're done, I'll be back with your meds in a minute. Mom later said what a good bedside manner I had.

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