All in my head?

[JVoEDrn]

So,

I've only posted a few times earlier, and it was mainly to lend an insight to my journey of studying and passing the NCLEX (THANK GOD thats over).

I passed on Nov, 28 2012 and By December 12 I had 2 jobs. I work FT as an IV nurse for an alternative medicine clinic and Per diem as an urgent care pediatric nurse. The first couple of weeks were nerve wrecking, wondering if I had what I took to be an RN, without a clinical instructor peering over my shoulder telling me I was doing something wrong...or even right! I cried during my orientation, which was only a week at my IV job, and 2 shifts at my pediatric urgent care job....talk about being thrown into the wolves den! But nonetheless, I survived and am proud of the nurse I am becoming and already am.

My issue, is not really an issue, more of observation of myself. I've gotten quite good at IVs, I've always been good at them, even during clinicals, but with me starting 5-10 IVS a day, not including, non-iv sticks but blood draws, I'd say I've gotten pretty good, had some embarrassing moments and have had people tell me "WOW! You're the best person to have ever stuck me!" ^_^

I've gotten REALLY hard sticks, and have found new and inventive ways to feel and find veins, still learning tons, but happy with where I am at in terms of PIVs and BD. HERE is my problem, there is a man, who in general makes me uncomfortable...but he is a sweet man, and has done nothing that would make me feel uneasy, its just a vibe I get.... I have seen far worse sticks, and have succeeded, then this man, but for the life of me I cannot get him started. He gets an IV push every Tuesday. I/we use 23g butterflys on him bc the push is only over 20 minutes.

THESE are my favorite, next to blooddraws, no angiocath, nothing, just needle insertion, blood return boom IV. WELL, out of 10 times that I have tried him (NOT INCLUDING the times I've RETRIED) I have only gotten a successful attempt maybe 3 times. I always blow it. ALWAYS literally and figuritively. I got him the first time, and then from there it was downhill. Its mortifying when he comes in, all patient as can be, and yet....I end up mostly grabbing the iv certified ND to come and gloat and get him with no problem. UNACCEPTABLE. H.is veins do roll, but nothing I've not dealt with. His veins are deep in some areas, again, something I am not new too

I have people who beg me to draw them and schedule appts just to be sure I am there for the IV start.

This is so crushing to the ego. I know its mental, but why and how do I get over this? I find myself onhis appt days dreading it on my way to work....and he won't even be in until late in the afternoon.

It makes me feel incompetent. Just some words of wisome and advice from fellow nurses.

I always get blood return and then the vein blows.

UGH!!!!!! Hes coming in at 230 and im already dreading it.

Thanks so much.

Jenny

[chrisrn24]

Maybe he needs a PICC or something?

[Esme12, ASN, BSN, RN]

His veins may be fragile and the butterfly is lacerating the vein as you infuse/inject/secure. Any shift at all can lacerate the veins. Do you have any 24/26g angio caths?

[morte, LPN, LVN]

can you try without a tourniquet ?

[PalmHarborMom]

I am just a student but if he needs IV's that often for a long period of time. Is there a reason that he does not have a PICC line or a port? That has to be torture on his veins. It seems to reason that his sticks may become more difficult as time passes.

[Serlait]

WOW! You're doing a lot of sticks for an alternative medicine clinic. Can't help wondering what the heck all your patients are having infused. Especially those coming in weekly. Is the fact that it is an alternative medicine clinic precluding patients receiving PICC lines to avoid such frequent sticks? Don't get me wrong, I think there is definitely a place for alternative medicine, but I'd be more worried about what I'm infusing so frequently than my ability to stick someone.

[amoLucia]

Maybe he needs a PICC or something?

I was thinking an Infuse-a-port or Port-a-cath or whatever its name be.

[chrisrn24]

I was thinking an Infuse-a-port or Port-a-cath or whatever its name be.

That too!

[Roseyposey]

If you have no problems with any sticks besides this one, let someone else start his i.v. and get over it. Accept that you are not perfect and quit wasting so much of your mental energy worrying about your imperfection. Why can't you start this one i.v.? Does it really matter?

[Mulan]

[quote=HERE is my problem, there is a man, who in general makes me uncomfortable...but he is a sweet man, and has done nothing that would make me feel uneasy, its just a vibe I get.... quote

What's that all about? Maybe being uncomfortable is affecting your performance.

[SwansonRN]

If I had a dollar for every patient I couldn't get blood or start an IV on...I probably wouldn't need to be a nurse it's frustrating, but it shouldn't be something you dwell on! It sounds like you're very good, I would want you as my nurse.

[tamadrummer]

Is it possible to get the company to purchase a small cheaper ultrasound? It's not a sure hit every time but you know when you are in before you even see the flash.

[jadelpn, LPN, EMT-B]

I love to start IV's. Favorite part of my job. I have been doing it a long time, and am really, really good at the most difficult sticks. Tons of practice. ANYWAYS....Using a butterfly that is not a catheter but a needle is near impossible to thread into a vein without the needle going through the vein. That is why they are used for blood draws...they don't bode well for the extent that is needed for infusions. Truly, I have never gotten the gist of why one does this when you could just put a 22 gauge peripherial IV catheter in. Another issue is that if the patient moves their arm/hand--wherever you put the butterfly, it could then go through the vein and the IV infiltraite. OF COURSE always follow the policy of your facility, however, in my opinion, not great practice and maybe something to look at to change that policy. Especially with all the various regs about safety needles.