I have been starting IV's for about 6 months, some days I'm good some days I can't hit anything! Esp with older people, I usually can start on younger folks with no problem, my question is what are some tips and tricks so I can become better with IV starts? I ask my fellow nurses and all they say is " u will get better in time" I just hate having to call our NOW nurses( we have nurses who come and help you if you get backed up or need IV started) makes me feel stupid esp when she comes and hits the vein her 1st try and I tried twice! lol My main problem is when I put the cath in I get blood return but when I try to flush it, it won't flush, and sometimes my cath gets bent! Any tips will be greatly appreciated!
Hey there, practicing, often, really does make a difference. No matter how good you get, you won't get all of them, and then the ones you miss are not always the hardest looking all the time. What looks like a sure thing can turn into mission impossible. Some days you are the one who finally gets lucky on that hard to start patient.
I always wiggle/spin the cath loose before inserting because sometimes they seem stubborn once inserted.
I pull up a chair and position my self so I am as comfortable as possible.
I avoid using a tourniquet if possible, especially in older patients. If I have to use one, I remove it as soon as possible, always before flushing.
Be gentle when you flush the vein, some nurses bury the plunger and blow an otherwise good IV start.
If the vein suddenly disappears on you, make sure you haven't accidently blocked the vein with your fingers and cut off the blood supply. Seems obvious but it can happen by accident and is one of my personal stupid tricks to pull when starting an IV. Just move your offending hand and the vein should reappear.
If you are easing the cath in and it stops, sometimes gently twisting it while trying to advance it will help. This will sometimes help if you are running into a valve.
Sometimes you can find large veins close to the surface on a person's upper arm.
Good luck, and remember that no one is successful all the time.
* OH yeah, Sometimes you see little "bumps" or slightly enlarged spots on a vein, those are valves. Sometimes you can see them, sometimes you can't. Try to avoid placing an IV where you can see that the cath would pass through a valve. Sometimes you can't see them to avoid them.
Last edit by BlueBug on Jan 5, '09
: Reason: forgot something!