In my first job as a nurse, I worked an oncology unit at a massive medical center in DC. Our patients, frequent flyers for treatment and follow-up therapy, almost exclusively had PICCs, ports, Hickmans--a quasi-permanent-type central catheter of some kind that allowed for quick, easy access into the venous supply. If you somehow managed to sneak onto our floor without one, you were soon given one, whether to ease the difficulty with PIV starts in oncology patients or to lessen the chances of extravasation when IV vesicants were used.
Now a clinic nurse who works in two areas that require PIVs, I've struggled since early this year to get the hang of starting them. My close coworker, Amelia*, a nurse who is quickly approaching retirement, is my teacher and avid supporter. Amelia could start an IV blindfolded on a rock with both hands tied behind her back.
For months and months on end, the technique has eluded me. I've watched, tried, failed, and tried again. The quiet anxiety of knowing that I'll have to go into work the next day and start and IV has lingered over my shoulder this whole time, but the deep desire to master this unique skill--to be "that nurse" who can get IVs into even the most elusive, evasive veins--has driven me beyond the anxiety and just. keep. trying. Amelia promised me that's the only way I'd figure it out.
Two weeks ago, I got one--first try, on a patient I had known as a friend, and after vacation, no less. Buoyed by the success and with Amelia out of town on vacation herself, I started a second on a new patient. Third. Fourth. Fifth. This week my record broke, and another coworker had a try at a patient who has been getting IV therapy for over 10 years and whose veins, fragile from constant abuse, I could simply not convince to hold a catheter.
But that's not the focus here. The focus is that I seem to be developing that confidence, that unspoken technique that I've seen older nurses exhibit when they start IV lines. Unflappable, unstoppable and undeterred by failure, I've watched coworkers land lines in the most difficult of patients and wondered...how do I get there?
For everyone who has ever asked that question, I bring you good news from the other side of the problem.
For the pre-nursing students who worry about this issue, for the new nurses who are wondering the same, and for nurses like me, who struggle with a certain skill, the answer is the one we all dread: practice.
Perform that skill every chance you can with as much confidence as you can muster, and accept advice and assistance from more experienced coworkers. You may be the nurse who can't quite figure it out now, but you could become the nurse who someday teaches others if you just keep trying!
