I am terrible at IV's!! - page 2

by momthenRN

4,677 Unique Views | 17 Comments

Starting IV's has never been an easy skill for me. I took off for 5 years to raise my family and am now working again. I am finding everything else fairly easy but starting IV's are such a challenge for me still. I have not... Read More


  1. 0
    Quote from RealNurseWitch
    Why is that? That you shouldn't use the AC on someone with serious health problems or renal disease? Is it just because the AC may need to be used for multiple lab draws, or in an emergency situation?
    I will use the AC on a renal patient if that is all they have (and after trying a different site distal to the AC). You want to "save" the veins that these patients have left. Same goes for patients with other chronic illnesses, such as sickle cell, cystic fibrosis, or patients receiving chemo. (For example, I had a sickle cell patient in the ED who needed an IV. She was a very hard IV start - she said that at her last hospital stay they poked her 8 times! If that wasn't bad enough, she also said that the IV site blew 3 times during her admit stay. I took a long time assessing what sites I could use and I placed a 24g CIV in her wrist/forearm, saving her from multiple pokes. It delivered the pain meds she needed and worked fine for administering fluids).

    However, using the AC totally varies by patient condition. If I have a septic dialysis patient who has a blood pressure in the toilet, I'd go AC if there wasn't an obvious site in the hand/forearm. But if I had a dialysis patient who had nausea and all they needed was zofran and fluids, I'd put a small gauge in the finger long before I'd go AC.

    Basically, don't go AC if the patient has good veins in the forearm/hand. But if the patient is crashing, go for the AC (which is why we should save the AC - so it can be accessed when there is an emergency). Also, the AC is fine for a normally "healthy" patient (those patients who have had few, if any, IV's in the past).
  2. 0
    Just make the ER nurse do it before the pt comes up, or call one if it infiltrates. That appears to be the unwritten practice in my hospital.
  3. 0
    Quote from mikeybsn
    just make the er nurse do it before the pt comes up, or call one if it infiltrates. that appears to be the unwritten practice in my hospital.
    are you serious? shame on you!

    how convenient of you to make the ed nurses start your iv's; i sure wish i could tell the ambulances to go around the block a couple of times because i need to start an iv on the floor since the patient's nurse either lacks the skill, knowledge, or common courtesy to start a line. you are delaying patient care (pain meds, fluids...).

    apparently iv starts are our business and i'll gladly start them, but the tradeoff is you getting our code browns.
  4. 0
    Quote from kmoonshine
    Are you serious? Shame on you!

    How convenient of you to make the ED nurses start your IV's; I sure wish I could tell the ambulances to go around the block a couple of times because I need to start an IV on the floor since the patient's nurse either lacks the skill, knowledge, or common courtesy to start a line. You are delaying patient care (pain meds, fluids...).

    Apparently IV starts are our business and I'll gladly start them, but the tradeoff is you getting our code browns.
    I'm an ER nurse, this was sort of a vent.
  5. 0
    Quote from MikeyBSN
    I'm an ER nurse, this was sort of a vent.
    Sorry Mikey, I didn't know that you were being sarcastic, nor did I know that you worked ED. My apologies.
  6. 0
    Quote from kmoonshine
    Are you serious? Shame on you!

    How convenient of you to make the ED nurses start your IV's; I sure wish I could tell the ambulances to go around the block a couple of times because I need to start an IV on the floor since the patient's nurse either lacks the skill, knowledge, or common courtesy to start a line. You are delaying patient care (pain meds, fluids...).

    Apparently IV starts are our business and I'll gladly start them, but the tradeoff is you getting our code browns.
    When I worked on the floor as a secretary, it was common practice to call the ICU nurses if the floor couldn't get an IV after 2 sticks (yes, there were exceptions and there were a few nurses who were really good at IVs...one of whom posts here every now and then). Once I got my EMT cert, they even asked ME to start IVs a few times (I didn't - I wasn't practicing as an EMT at the time and thus not covered under the hospital's malpractice insurance). It was frustrating for the ICU nurses and irritating for me to observe. Learn how to start IVs - it's a necessary skill if you're a nurse, no matter what area you're working in.
    Last edit by paccookie on Jan 16, '08
  7. 1
    I had a LOT of trouble with iv starts until.....1.I slowed down and 2. I SAT down. Sitting helps you relax and changes the angle. Try it!
    CaLLaCoDe likes this.
  8. 0
    I thought I would never be able to start an IV. Practice definately does help. Try to start all that you can on people with reasonably good veins. I'm sure your co-workers won't mind when you offer to start or re-start their IV's. I did so many that now I'm referred to as the IV geru and I love starting them now.


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