Starting IVs

Specialties Med-Surg

Published

I actually don't mind the craziness of the floor I work on. But, there is one thing that brings me so much terror and it is starting IVs. I only started 3 so far and I have almost worked as a new nurse for a year. Two of those IV starts were under the supervision of another nurse. I only successfully started one last week on my own and it was the smallest gauge possible (24!). Though, she was a hard stick.

We never practiced starting IVs in nursing school. I am the type of person who needs to practice, practice, practice my clinical skills.

Does anyone have any tips or pointers? Any basic tip would be helpful! A number of times I was able to get some blood return but then it was infiltrated.

Specializes in Adult M/S.

Starting PIVs is so hit and miss! I was on a dry run for weeks. 0/6 different Pts even with young guys whose veins I could see across the room. Now I've been 4/4 and I'm not doing anything differently. You just have to practice, practice, practice and know that you will miss some. Fee bad for causing pain and discomfort but that's part of the learning. Don't feel bad when you try and miss 2 starts and then have the ED/ICU nurse come in to try and they hit one right off the bat w/o a problem. The most difficult part is finding a good vein. Put on the tourniquet not too tightly, have the Pt dangle their arm, put on warm packs, wrap the arm in a warm blanket, anything to get the veins to pop up. Feel around for a vein some of the best veins you won't even see but will feel. Go for it! have everything set up. And realize that even plump fat veins will disapear once you put in the cath. keep feeling for it. Today I hit one where the vein was right there but didn't want to be punctured but I didn't stop until I got it. There was that satisfying pop when I found the vein and cannulated it. Felt good. Still haven't gotten the knack for not letting lot's of blood run out after withdrawing the needle but that too will come. Also, I've been a nurse for 9 yrs 4 on med/surge and still miss lots of starts but will alway try. Knowledge come with experience.

Specializes in ICU / PCU / Telemetry / Oncology.
Still haven't gotten the knack for not letting lot's of blood run out after withdrawing the needle but that too will come.

I'm pretty good at not spilling blood out of the angiocath once the needle springs back. I'm right handed, so I just press down on the vein above the insertion site with the pinky of my left hand and grab the flushed extension set with my right hand, then use the left pointer and thumb to hold the angio while I screw in the extension with the right, then let the pinky go. It takes practice of course. Although some on anticoags tend to fail me by dripping through regardless lol. 18G are kinda tough to keep from leaking. I use a chux pad everytime underneath the arm but most times it ends up clean.

My former hospital was gonna get those angios that lock blood in a chamber after the needle is withdrawn, so no need to hold the vein. After the inservice I was excited but then they nixed the deal. I was mad so I quit (LOL, jk ... I left for better reasons, but poor administration was clearly one of them).

Sent from my iPad using allnurses

+ Add a Comment