[dreamrider_212]

I am an RN who has just started working in and Arthritis infusion clinic and I have a few (really basic) questions that I hope someone can help me with.

1. When drawing up saline & any IV med they recap & reuse the same needles throughout the shift. Is this general practice or just the clinic trying to save money? I have stuck myself 3 times so far trying to recap!!!

2. I am having trouble stopping the blood flow after accessing the vein before I can get my flush or Solu cortef in there. I do put pressure behind the cath tip but my patients still bleed and look like something from the chainsaw massacre.

3. Any tips for reducing my nerves prior to sticking.......sometimes I am so nervous my hands shake.

4. Any suggestions as to really good, stable veins to use????

Any info/comments would be gratefully received.

Thanks

[iluvivt]

needles should only be used once and then the safety mechanism should be activated and then it should be discarded in an appropriate sharps container. In the event you do not have an engineered safety sharp or needle you should recap passively and then dicard. To recap passively the cap is set down on a stable surface and then you slide the needle into the cap....) do not get you fingers near the tip of the needle)...then lock it. The second ? I think you are starting an IV right with a catheter over needle device...if this is the case have your saline flush ready with whatever cap you are using already attached to the saline. Start you IV and then occlude it with several fingers where the tip should lie not at the insertion site. So if you inserted a 1 inch catheter place several fingers one inch above the insertion site Of course remember to pop your tourniquet.
To decrease your nerves the best thing to do is to be confidant. Seek the help of more experienced nurses. Stay calm because the pts can sense it when you are uncertain and they tense up and then the whole thing is then difficult. Did this answer your questions or clarify for me and i will respond

[accessqueen]

There are a couple of hints that might be helpful. First make sure you have a nice tight tourniquet. Put it over the pt sleeve, less pain for patient, you can make it tighter. then, TAKE YOUR TIME. It takes time for veins to engorge. Feeling is better than seeing. If you see big juicy vein, go for it. But some really good veins can't be seen easily but can be felt very well by palpating. Look at someone with good veins and memorize where they are, then feel in those areas on your pt. If you can't feel a nice palpable bouncy vein, don't go for it. Then don't worry so much about angle of approach, usu. your angle should be as low as possible so you don't go through the vein. Also strecth the skin taut below the insertion site to stabilize the vein so it doesn't roll. If the vein rolls, it's poor technique.

[Tolos]

1. When drawing up saline & any IV med they recap & reuse the same needles throughout the shift. Is this general practice or just the clinic trying to save money? I have stuck myself 3 times so far trying to recap!!!

I draw up my saline flushes through a vial access device, the syringes already have a needle for a stopper, I take the needle off to draw flushes. I never recap or reuse any needle of syringes. I think it is nurse and patient abuse to reuse and recap a syringe.

2. I am having trouble stopping the blood flow after accessing the vein before I can get my flush or Solu cortef in there. I do put pressure behind the cath tip but my patients still bleed and look like something from the chainsaw massacre.

Just like nurse Iluvivt suggests above, place several fingers on the intact skin of the patient where the tip of the little catheter is, to stop the blood from flowing through it to the outside. Attach flush to the extension set and stabilize catheter at the site with tegaderm. You would have removed the toniquet once you have blood return.

3. Any tips for reducing my nerves prior to sticking.......sometimes I am so nervous my hands shake.

The more you gain success at this, you will be more confident and your nerves will be calm, so continue to practice and practice.


4. Any suggestions as to really good, stable veins to use????

Any info/comments would be gratefully received.