[anne74]

How long did it take you to become proficient with placing IV's? I just started a new job in pre-op, and I'm sucking royally at getting these placed. So far I've had one successful attempt within about 10 tries. My preceptor is very sweet and patient, and tells me it takes repetition and practice. But right now I can't see myself EVER being good at this.

Has anyone gone from being terrible with placing IV's, and then somehow gotten really good? Or, do you know of anyone who never got the hang of it, no matter how much practice?

[bosnanurse]

HI!
I know somebody can say oh it will come ,it is not hard but you have to first go through your mind where this needle will finish and how you will pull it back. In beggining I was so BAD that I would always call girls form CCU to come and do it and then I started to observe how they are doing . Next time I looked veins, palpated( didn't find anything under the skin for a long time ) but I was looking for something and was exploring it >NOw I can find it in very "hard sticks" and I have my whole set up how I am doing it: Chair close to pt , legs spread , arm down , head of pt on other side, talk about weather, sing a song arange everything in same order (to calm down, to observe, to make pt confident and me of course!) and I am IN! Then I say, "OK , I am in so just do not move it is a few seconds to finish and you did wonderfull!" Again whole procedure to clean up and I am getting out from a room with a smile.

[mamason]

Yes, it takes practice. Plus, the pt's you are working with have probably been NPO for their procedure. Which could make finding a good vein hard. My preceptor usually picked out the pt's that had good veins and would encourage me to try with them first. The pt's that were a more difficult stick, I would stand back and observe how my preceptor inserted th IV. I would watch her and ask a lot of questions. Once I got used to the "easy" sticks,my preceptor encouraged me to try the more difficult ones. I eventually got it. Just takes practice and confidence in yourself. You'll get it.

[RGN1]

Good advice here. Confidence & practice in virtually equal measure. Don't beat yourself over the head about it!!

Even a seasoned nurse like me can worry about it too. I used to do an average 5 IV sticks per shift now I only do about 1 per month, if that. I'm worried that I'll lose my ability so when I come over to the USA to nurse next year I'll be useless!! Also I'm much better when I'm not being watched & that might also play a part in your problems!

Keep your chin up & be positive, think about the theory of how you insert the needle & the anatomy involved. I'm sure you'll soon find it 2nd nature!!

Good luck xx

[P_RN]

I found that once we went to the protect-iv sets I suddenly got good at it. I think it's that little extra bit of plastic to hold onto. Another trick is to look and then feel your own veins. They have a certain "feel" and you need to be able to identify the feeling. If your husband, fiance, roommate is agreeable ask them to let you palpate their veins. Soon you will find yourself looking at people on the elevator and evaluating their veins. I even notice athletes on tv. Believe it or not those big ropey veins may not be all that easy to stick. Remember on older folks you might not even need a tourniquet. YOu can use a BP cuff inflated to above the systolic and then deflated and closed just above the diastolic. It feels better to the patient also.

Good luck. You'll be an IV wizard in no time.

[mamason]

Originally Posted by P_RN

I found that once we went to the protect-iv sets I suddenly got good at it. I think it's that little extra bit of plastic to hold onto. Another trick is to look and then feel your own veins. They have a certain "feel" and you need to be able to identify the feeling. If your husband, fiance, roommate is agreeable ask them to let you palpate their veins. Soon you will find yourself looking at people on the elevator and evaluating their veins. I even notice athletes on tv. Believe it or not those big ropey veins may not be all that easy to stick. Remember on older folks you might not even need a tourniquet. YOu can use a BP cuff inflated to above the systolic and then deflated and closed just above the diastolic. It feels better to the patient also.

Good luck. You'll be an IV wizard in no time.

Yes...I did that too. Drove my husband nuts! And the big ropey veins tend to move a lot.

[suzy253]

I'm getting better and better and will always seek out IV starts where I'm working. Getting more confidence is a big thing too. At my hospital, there is a very large elderly population so their veins are not the best to say the least. I've heard nurses say that if you can start IV's where I work, you'll be able to start them anywhere. I limit myself to two sticks...then I'm out and will seek out someone else to try. Often they can't get them going either.

[OBSFlightRN]

I agree with the others that it has a lot to do with confidence. Even now that I'm experienced, I'll occassionally get on a "bad run" where I miss a bunch. The more you miss, the more your confidence drops and you start to missbecause you think you will. It's important to relax, take your time, and pick a vein that you're sure you are happy with before you stick anything. I most often use the cephalic vein. It's the one that goes up the inside of the wrist and up the inside of the forearm. In most people it's big, straight, and easy to palpate.

Good luck. Relax, keep practicing and one of these days it will just kind of click for you.

[AB_Normal]

What they said. With 5 years as a Medic I could hit an A/C with my eyes closed. But AC is not the best of places in a lot of cases. LOL! So I ended up going back to the drawing board. And yes! I suck royally at times. But after watching people, looking at vascular anatomy charts, closing my eyes and palpating for veins...I've somewhat mastered hand and wrist veins.

And you know what I've been told? There are things you will be good at in nursing others will not be so good and they will be good at things you aren't so good at. I know that at times I believe in the ideal world vice real world...but I still believe in teamwork and positive thinking! And when I started IV's? I was about your initial ratio as well and never thought I would get better. But you will. And when you're a seasoned nurse and that new nurse comes on the floor and gets frustrated because she has a hard time 'sticking' the side of a hay barn? You will take your time, show her, give her positive thoughts, praise, and tell her the same thing. We've all been there.

[anne74]

Thanks so much for your words of confidence guys!

Do any of you guys use "blebs"? We first adminster a solution of saline and alcohol intradermally to numb the site. A wheal is created, much like TB shots. Then we're supposed to aim in the middle of the wheal - but is further masks the vein, and I'm having trouble sensing the depth I need to go in, since the wheal is essentially a bump in the skin - right over the vein I'm going for.

I guess this bleb thing is evidenced-based, and the patients seem to really like it. It's less painful and probably has an even bigger psychological/placebo effect. But I don't know how good it is when I can't get it in and have to try again. (Or someone else tries - I only try once.) I guess I'll get used to it?