Worried: have to spend 5 hours doing IV sticks tomorrow.

Nurses New Nurse

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Specializes in Ortho, Neuro, Detox, Tele.

So, as part of my orientation, I have to spend 5 hours doing IV sticks in the outpatient surgery center tomorrow. I'm worried, cause I'm not really that good at doing IVs...any tips? the only plus is that most of em should be pretty good large veins hopefully....I need some advice on how to start a good IV....

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Specializes in NICU, PICU, PCVICU and peds oncology.

They're sending you there so you can get good at it! Most people who have day surgery are generally in decent health and have lots of good veins to try. Start distally and work proximally. Hands are easiest to secure, but antecubitals are easiest to hit. However, antecubes won't make you popular with the other nurses. Have all your tapes and dressing material ready before you open the catheter and have your line primed and ready to go. Don't tie the tourniquet too tight, stabilize the vein by putting a little traction on the skin, puncture below and slightly to one side of the spot on the vein you're shooting for and don't forget to breathe. When you get the catheter into the vein, put a little pressure on the vein past the point where the tip of the catheter should be so that when you take out the stylet you don't get blood all over the place... and don't forget to breathe.

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I did my stint in the day surgery center today. It was one of the best experiences!

I have been on the floor for 6 weeks and have been about 50/50 on my IVs. I was doing pretty well at first, but then went through a slump where I wasn't getting any. I really didn't want to go to day surgery today, but now I'm glad I went.

The nurse I worked with was sooooo patient and had lots of good advice to give. I had a rough start and didn't get probably the first 4 that I tried. We have butterflies as well as stylets on my floor, and most people use butterflies, so that is what I have been using. But, in the surgery center they use the sylets, so it was a bit of a learning curve just getting the right feel for it. But, I just kept trying. I made some stupid mistakes and felt embarrassed at times, but I didn't give up. Even a couple of the ones I missed, the nurse I was working with also missed. They do IV's all day long, so it made me feel a little better.

As the other poster said, get all your supplies ready before you start. Raise the bed to a comfortable height, sit in a chair if you need to. The biggest thing I learned was to GO SLOW. I thought that by penetrating the skin quickly, it would hurt less for the patient. But, I just didn't have the control I needed.

You will be fine. The nurses know that you are there because you need the practice. Honestly, I was so thankful for the experience. It was the first time I felt that someone really was looking at what I was doing, and giving me tips to improve, and encouragement to keep trying.

Let us know how it goes. Good luck!

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Specializes in L&D.

I am not even remotely good at IVs but a few tricks I've learned:

sit down. Especially in an outpatient surgery setting, you have time to sit down, get comfortable, get all your supplies arranged, and talk yourself down (if you are like me and could benefit from that kind of thing).

Dangle the patient's hand down below their body if needed, to help the veins plump up.

Look at the hands first. If there's a vein that splits into a Y, go right in the middle of the Y. It is almost impossible to miss those, I am awful with IVs and I have never missed one of those (although I now am sure I will next time).

Pick a landmark - a freckle, scar, etc. Use your fingernail to make an indentation in the pt's skin (gently) above the vein if there is nothing else. Make it a half inch or so from where you plan to insert the needle, so you have something to aim for.

Bevel up, loosen the catheter from the needle before you start, and keep your supplies handy.

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Specializes in Med Surg, Ortho.

I almost always have to cut the tip of the finger out of my left hand glove. This helps me feel the vein. I go strictly by feel when doing my IVs. Just be careful after you've found the vein and use your middle finger and thumb to disconnect the needle.....or have a new glove nearby.

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Specializes in Staff nurse.

I like to use a warm blanket wrapped around the arm and hand to coax the vein closer to the surface. Usually works, even on the hard to sticks...

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Specializes in ICU/CCU, Home Health/Hospice, Cath Lab,.

Lots of good advice here - i'll just throw in my 2 cents!

Look at both arms and decide which vein you want to go for. Then tie your tourniquet around that arm.

Next, get comfortable. Pull up a chair and lay out your supplies. I almost always use a 20 gauge unless the vein is very small or I really need the big bore.

Twist the cannula a bit to loosen from the needle. Place the bevel face up. LOCK down the vein (this is the biggest mistake people make - they don't lock the vein and it moves on them). I usually stick just a bit to the side of the vein.

When you get the flash of blood, drop the needle down almost flat and advance it just a bit further (makes sure you are in the vein). Then with your finger advance the cannula into the vein. If you are not drawing blood release the tourniquet and retract the needle and attach your tubing. If you are drawing blood leave the tourniquet on, retract the needle attach your syringe and draw blood (you can also draw through a J-tube (small extension tubing) and flush it afterwards.

During all this find what helps you relax - I tell jokes, others sing in their head, whatever. Now smile because you just started the perfect IV.

Hope this helps

Pat

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Specializes in Ortho, Neuro, Detox, Tele.

Yeah, it kinda worked today...I got 1 out of 12 sticks today. I know it just comes with practice.....but it still sucks to have sticked a bunch of people and not get that many in....it happens, I know what I need to work on though, got lots of great tips from the surgery nurses...

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

I would LOVE a chance to do something like that! I'm about 50/50 on getting them first try and there are always the teeny little old people with veins the must crawl clear back into their bones that I am not comfortable even attempting yet, it's something that comes with time and practice, but we don't always get to practice on the floor

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I also wish I had the chance to go to something like that! I just started in the ED and all my training is on the job, also I came from a nursing school that does not teach IV insertion. :( My preceptor had me sticking people my very first day and I was so nervous.

I got 2 out of 5 sticks, it's so hard for me to even feel the vein. If I can manage to find one I feel, I have no clue how to approach it. How much of an angle do you go in with? How do you know if it's a deep vein or a shallow vein? How do you know if it will even be a good vein to use?

For the 3 that I missed, one was a really large guy and I couldn't feel ANYTHING. One was an older lady and I got the vein but then blew it. The other was a perfectly healthy woman that I really should have gotten, I just couldn't do it. Ugh, it's so discouraging.

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Couple of other hints: I always use the sleve of the gown to cushion the tourniquet. You can make it tighter without hurting the patient. TAKE YOUR TIME. Put a tourniquet on a friend or coworker that has good veins and memorize where they are. Then apply that knowlege to your pt. Don't just look, FEEL. If you can see it but can't feel it, it's not worth bothering with. Don't worry so much about angles, I usually go in at a very flat angle, unless the vein is very deep. TAKE YOUR TIME. If someone has lousy veins or they are not well hydrated, it may take awhile for them to pop up. If you have somone who hasn't eaten in 5 days and has vomiting and diarhea, that MAY not be the best person to practice on.

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