I agre with everyone above, especially the pull up a chair part and confidence. One thing I did early one was to evaluate all the veins, because some days there are no veins you can visualize- you gotta go on feel- on that note, Julie, about the angle. It really depends on what I want to hit. If I am doing a cath in the hadna dn the vein is sort of "shallow"- visible, etc, I go at a pretty low angle, but when I move up into the brachial area (I know a bad spot, but on my paralyzed/sedated patients, it is a good spot comfared to the foot). The veins may be a little "deeper" and so I do go in at maybe a 45 degree angle, pierce the skin, and sort of dip back down to a 30-35 angle, at least thats what it seemed like to me.
Use the warm towel to soften up the skin.
And I will admit to this, and then "dont try it at home. If I have a really rolly vein, I will sometimes pull the skin down with my thumb on my left hand and put my left index finger up alongside the vein, using my right hand on the other side to place the catheter...in effect squeezing the roller between the two. This is risky in that if the pt moves, you could potentially jab yourself with a very contaminated hollow bore needle, so while thats what I do, it is surely pretty stupid when I think on it! Now, the ng tube? WHy is it that everyone else can pop them in and mine just crul right up? and why is it when I put in the nasal trumpet I feel as if I am cramminghte thing into the pt's brain (it always goes in, but....
Thanks everyone, these tips are great.