I am a nursing student currently going to Kent State University (Kent, OH). I am in an extern program right now finishing up 410 hours of clinical experience on a surgical floor. I have a problem starting IVs. The first couple I tried went in beautifully and it seems like lately I can't hit the broad side of a barn, the vein rolls, or I just blow it. I was wandering if anyone had any secrets that they use that they would like to share. I know it takes practice and a lot of it can be mental as well. I don't feel its the mental part, b/c I feel confident going into it and I know I haven't had much practice, but I just thought maybe some of you would have some helpful hints!!! Thanks!!
Jul 15, '03
IV's are something that just take a lot of practice! Every chance you get to start one - go for it!
Before my current position, I worked pre-op in Day Surgery - lots of experience there. I have found one helpful technique when using the IV catheters that all hospitals by now are probably using (the type that lock the needle back in to help prevent needlesticks - can't remember the name brand right now). Because of the way they are designed and the fact that advancing the sheath is usually done with only one hand because of the lock mechanism - they can be a little tricky for some - especially if you are used to the old kind that many would use with both hands. Many complain that there is less room for error with these. Look at the tip of the catheter and you will see how the needle protrudes a good bit past the end of the sheath. If the problem you have is that you get flash-back, but can't seem to advance into the vein, your problem might be that when you start to advance the sheath over the needle, you aren't far enough in the vein. The result is that the IV won't advance and the vein blows. The solution I found is that once I see flash back, I advance just a "bit" more which helps to insure that the whole thing (sheath AND needle) are IN the vein - (not just the tip of the needle IN the vein and the sheath still on the outside). Then advance the sheath the rest of the way in (with the forefinger of your dominant hand) and you should have good results.
Don't get discouraged. It wasn't until I had worked in Day Surgery and did this full-time 5 days a week 8 hours a day that I felt really good about it. It is a skill that takes practice - and I see Doc's on the floor all the time that want to "give it a try" and miss, only to have a nurse get it right in. Must be the reason they don't volunteer to try too often - unless they are an anesthesiolgist!!
Good luck and let us know how it goes!
Jul 15, '03
Another clue is palpate your own veins, hubys veins, admire elevator riders veins you're with (silently). Get a feel for what a good vein feels like. I still look at hands and arms and I don't think I'll ever outgrow it
Jul 16, '03
There are going to be days you can stick a 16 gauge in the hand veins of a very dehydrated 99 year old diabetic, dialysis, chemo patient and days you can't stick a 24 gauge into a balloon...LOL. Don't lose faith in yourself, practice when you can, see if you can hang out in out patient surgery, etc for a shift or two...you can do it!
Jul 16, '03
Just keep at it. I got the first IV I ever started and then proceeded to miss the next 100 patients, it was very discouraging. Now my coworkers call me to stick the patients that they miss. Somedays like cotjockey says I can hit the hardest of patients and then miss someone with ropes for veins.
Don't be discouraged, just keep trying and trying and trying.
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