Unsuccessful IV stick.

SouthernLPN2RN, MSN, RN, APRN, NP · Sep 16, 2005

I tried my first IV stick this week and I didn't get it in. I actually went under and to the side. I didn't even feel comfortable with the site but the instructor insisted that I pick between the antecubital and the cephalic vein above the wrist. I wanted to choose the metacarpal vein that I had picked out but the instructor thought it might be too small. The thing is, I could see it and feel it, so I felt better about it. I couldn't feel the cephalic vein, and I couldn't see the antecubital, so how was I to pick? I chose the cephalic vein because at least I could see it. I got really nervous and just wasn't sure I could make it in but I tried anyways, and I didn't make it. It has knocked my confidence level down quite a bit. I had 2 other opportunities to get an IV in during the day but once I saw the veins, I didn't think I could do it. I am really discouraged right now. I just need a bit of encouragement, I guess. Everyone else who tried had a successful stick and I'm feeling a bit like a loser right now. My instructor says I get first dibs at IV's next week. I am working myself into a fret over it. I certainly don't want to keep putting holes into people that go nowhere and serve no purpose!

It has happened to all of us at some point or another and you'll get the hang of it! Sometimes even the most beautiful veins won't cooperate. My advice is to take every opportunity that you get to help you increase your skill and even though it may sound stupid, positive self-talk is always helpful for me. I just keep it in my mind that I *will* get it no matter what and I usually do better with that attitude than I normally would. Good luck!!

Katnip, RN · Sep 16, 2005

Given a choice by feel or sight, go by feel. The ones you see can be very deceiving sometimes.

And heck, you can be a nurse for 30 years and still have days when you can't hit the side of a barn. Don't sweat it. Practice will make you better, but nobody is perfect.

stidget99 · Sep 16, 2005

I went to the ER 1 1/2 weeks ago. Had a nurse (with at least 21 years ER experience) who stuck me. You can still see the bruise. It's not as purple anymore but it's still there. She REALLY nailed me hard. My point in sharing this is that we all miss. But give yourself a break. You will get them w/ time and experience. Good luck to you.

Tweety, BSN, RN · Sep 16, 2005

I understand. I actually got the first IV I tried, and then proceeded to miss the next dozen or so.

Just don't be afraid to try and to miss. It's a skill you just have to do over and over and over again. There are a few "gifted" ones that start 100% of their IVs from nursing school and beyond. I'm not one of those, but I'm proud to say when people miss on the unit they come to me for help. :) I still have my days when I can't hit a vein the size of a rope.

It's normal to be nervous, just keep trying and trying and trying. You'll get a feel for it soon. Good luck!

Demonsthenes · Sep 16, 2005

When doing IV's and/or dressing changes and/or any other medical procedure in which attention to physical detail (like checking pupils for equality), I suggest using reading (magnifying glasses). The same will give you, in the case of IV's significantly more detail about the position and placement of veins and the needle in relationship to the same.

I know that MD's sometimes wear a sort of magnifying glass, ( a sort of reading glasses) with a flash light attached to the same to give them better visual ascertainment of medical procedures. Nurses might want to do the sme when doing IV's. :)

needs help · Sep 16, 2005

Dearest Lisamc1, Please don't be too hard on your self. as others have said, it happens to us all. When I was in my preceptorship for RN I was doing good with IV's until the day my instructor wanted to watch. Well that day one of my patients was an elderly dehydrated lady. Her veins looked SPECTACULAR, so I figured I wouldn't have a problem even with the case of nerves I got every time the instructor was watching. Well the instructor chose the vein, like yours did, and sure enough I missed big time. The instructor chose another vein and had me try again, same thing vein blew this time as well. I felt like balling my eyes out. The only reason that didn't happen was the instructor then tried and she missed twice. A 40 yr veteran RN MSN :rotfl: The next one to try was the charge nurse, she was a 30yr veteran med/surg & ICU RN BSN. well she also missed twice. I felt so much better knowing that it does in fact happen to EVERYONE at some time or another. Keep your head up. There is nothing to be

worried or upset about we all do it. Your most definately NOT a loser. you will get it. Try not to worry. Please don't hesitate to let me know if I can be of any help. Rhonda :) :balloons:

mediatix8 · Sep 16, 2005

I'm a new graduate and sometimes I get them, and sometimes I don't. But the good thing is that when you get a job, all you have to do is try twice and if you don't get it you ask the charge nurse. I thought I would have bad attitudes about asking them for help but I don't... and if no ne can get it we are supposed to call ICU and then those nurses try. Either way, someone has to do it. It'll get done either way.

KatieBell · Sep 16, 2005

Really, it isn't a big deal. I never even started an IV on anyone before I graduated. In school, there is sometimes a lot of focus on doing the skills. Remember that almost all of those skills can be performed by people with less training than you will have. Your value as a nurse is not determined by how many IVs you get in, BUT, in how well you can critically think about what is going on with your patient. I can teach anyone to start an IV...but to get someone to think carefully about where to put the IV (which arm, which site for what procedure CT or surgery?, what size cannula is going to meet the patient needs, etc) Is actually a bit harder. The technical side will come, but remember it isn't just the putting it in, its the thought that also counts....SO cheer up, you and about a millions of us here have missed an IV stick, one step closer to becoming a nurse....

Mommy2Katiebaby · Sep 17, 2005

LOL, I'm sorry you missed, but you can't be a nurse if you're not willing to make a few extra holes in folks. I've been practicing for fifteen years and I still threaten my mom / baby patients with "Don't you dare hemorrhage, because you do NOT want me trying to restart your IV..." When it has REALLY sucked has been when I'm the only RN on the floor. I use proper technique, I've taken multiple IV classes, and I still take three tries or so to get most of them. I think I just don't have a lot of sensitivity in my fingertips - can't feel the buggers as well as I need to.

Don't worry, you'll get the hang of it - and EMLA cream is great stuff.

allnurses Guide · Sep 17, 2005

Lisa - I was like Tweety . .got in my first try and then not alot of luck after. My first was a lucky find in the ER though . .. 18 year old female with large juicy veins. I got right in - I honestly don't remember the instructor picking out the vein. It was all so long ago (7 years) :rotfl:

Don't be discouraged. You'll get it. A friend of mine works in a surgery center and sometimes starts 25 or so IV's a day. She is really good. And always uses Lidocaine. I rarely use it. Most of the time the patients don't want to be stuck twice. BUT if I have a pt who is actually afraid - I will use Lidocaine.

(or find another nice nurse to try) :)

steph

fab4fan · Sep 17, 2005

I'm one of those annoying people who just has a knack for starting IVs; I'm not sure what it is or why it happens, it just does.

One thing I have noticed is that new nurses or nurses who have trouble starting IVs don't take their time...they tend to go for the first thing they see. I'll often put on the tourniquet and then take some time to just look, tap around on a few areas, etc. Also, if I don't get an immediate flash, I don't pull the cathlon out right away; sometimes just taking a minute and repositioning is all it takes.

But I would say the one thing that has really helped is to just take your time. It doesn't take any longer to look around for a bit than it does to just stick the first thing you see and then have to stick the pt. again...and at least in my case, I often save my pts another IV start.