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This is a discussion on Need help with IV skills for old nurse in Infusion Nursing / Intravenous Nursing, part of Nursing Specialties ... I have been a hospital nurses for over 35 years but have had very little experience and very little...by jabwrn Oct 10, '12I have been a hospital nurses for over 35 years but have had very little experience and very little success with IV starts.(always worked in an area where I didn't have to do it or could get help from more experienced staff). Now I am afraid to look for a new job due to my poor IV skills. If I miss a vein the patient thinks I am an idiot or writes a poor customer service survey. What can I do to improve?
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- Oct 10, '12 by EJMI would do what nursing students do: practice on other nurses and your hubby.
- Oct 12, '12 by iluvivtLook for a community IV therapy class that you actually get practice sticks on a dummy arm or a live person many of these are linked to LVN certification for this skill That way you will learn the theory and basics from the experts. I can not tell you how many nurses I have trained that told me..I never knew that and if I would have done this from the start it would have saved me an lot of heartache. Are you in a position that you can go with an IV nurse for at least 2 days of training? If so this would be great and again save you from a lot of trouble The certification will also serve you well in seeking employment.
- Oct 12, '12 by rn/writerCheck your local community college if they have a nursing program or train EMTs or paramedics. The training is usually offerred at a low cost and may be directed at folks in your exact situation.
- Dec 19, '12 by somenurseYes, practicing helps! Following various IV nurses, can help too. Each one can give you tips and pointers. A course is great idea, too.
Some things i do, to start IVs on hard to get patients, include,
if vein is just invisible, sometimes it helps to wrap arm in warm warm wet towels, and surround that with a "chuck" (plastic bed liner thingie) and give it about 5 to 10 minutes. Sometimes makes previously unseen veins bulge up easier to see or feel.
Have patient open and close fist, over and over, if that is possible.
another thing that drives me batty, is seeing anyone slapping around on a patients arm to raise their veins. It can redden the skin, and worse, it is unnecessary useless pain, and it hurts and it makes the patients tense. don't do it.
I rub rub rub the vein i am about to stick, in downward manner,
for quite a while prior to sticking it. This helps fill the vein, and also increases my chances of spotting any knots, curves, hardened valves, etc, so i can avoid those spots.
Rub it, don't slap it.
Also, be aware, the smaller the bore of needle you are using, the slower the flashback will be. Your chance of going through the vein, is higher, cuz your flashback is so slow in tinier needles.
Of course, have everything ready to hook up once you are in vein, and i almost always place either a chuck or a towel under my site. Murphy's rule, if i don't, that vein will gush while i am hooking up the IV line, and stain the sheet...
TALK to the patient, the whole time. I do, anyway. I get the patient talking, about whatever, while i insert the IVs. It helps distract them. Mostly, all you have to do, is ask the occasional question, or give feedback, seem interested, "Wow, that musta been something! When did you finally find your dog again, then?" or whatever.
Whatever they are interested in, i get them to talk about that. Reduces the tension surrounding the IV insertion, for both of you, if you can engage pt in conversation. I've had so so many ppl state, "wow, that didn't even hurt!" and i think,
it's cuz they've been busy reliving when their last vacation or whatever, the whole time/not thinking about what is going on.
Re: getting written up negatively by the patient, if you do miss--
The patient will be more likely to "like" you, even you miss, if he felt you were interested in HIM, as a person. Most ppl do like to talk about themselves, ha ha!
silently sticking needles into people, makes it hurt more, imo.Last edit by somenurse on Dec 19, '12
- Dec 19, '12 by jabwrnThank you so much for taking the time to send such helpful advice!