Re: Humiliating IV questions

I love starting IVs Practice is what you need, though. You have to jump in with confidence and learn from that...here are my pointers:

1. I hate those Insytes...it's hard to have to hold onto the needle while you are advancing. I prefer the Protect caths.

2. Always try to see where your vein is going. Is it straight? Is there a biforcation? Does it disapear? This is important to know when you are advancing. If you don't know where the vein is headed, chances are you will thread right through it.

3. Always advance the tiniest bit forward after getting a blood return to ensure the entire tip of the cath is in the vein. If not, blood could leak around it and blow.... or at least make you think that. It will cause a bruise for sure. Once you get the return, STOP!

4. Advancing... sometimes they just slip right in. Pull the needle out enough that the tip is inside the catheter and always advance slowly. You need a feel for it... if it glides in, glide it in. If not, you have to figure out why it wont. Sometimes in that case, I will take the needle out completely and then try to advance, because it's hard to hold onto both.
- You might be against a valve if you feel like you are hitting something. DONT continue to poke at it! Insert your needle back into the cath and gently insert the cath a little farther. The needle tip will go through the valve. Then try to advance. This is when knowing where your vein goes comes in handy. You need to know where to advance
-Sometimes veins are just small or a pain in the butt! If so... just very carefully thread the cath into the vein, while visualizing it. This is especially so for micros.

It's definately something you have to learn for yourselves. You have to realize that these veins are very fragile. If you thread the cath too quickly, you could tear the vein and blow it. I see people ruin perfectly good veins that way and for no reason!

I hope this helps! Good luck!!!

Re: Humiliating IV questions

Those are great tips. I'm getting better at IV's, but I've still got a long way to go!!

Re: Humiliating IV questions

[quote=lvnurs9;3118609] Insert your needle back into the cath and gently insert the cath a little farther. The needle tip will go through the valve. Then try to advance. This is when knowing where your vein goes comes in handy. You need to know where to advance quote]

ummm, you are not suppose to reinsert a need through an IV catheter as you could shear the catheter off and into the patient. I know many people still do this anyway, but I would not reecomment it especially on small gauge.


sweetooth

Re: Humiliating IV questions

Ya I know.... that is why I hate the Insyte caths. They always do that. The Protectives slide very easily in and out of the caths, and since they are a closed system, it stays sterile. So yes, it is a risk, but of the cath gets punctured, you'll know right away cause it won't thread right. I would never not re-thread if I though I could save the vein.

Re: Humiliating IV questions

I'm opposite, lol! I can usually start an IV but my luck is not as good when doing venous sticks with a butterfly. In fact, if it's a kid I just *know* I'll have a problem with, I'll stick for labs with the angiocath, withdraw the needle and drip the blood into the microtainer (or suck it out of the hub with a sterile syringe/blunt tip needle for a blood culture.) I think it's just one of those things that becomes easier with practice. I was in NICU for almost a year before I even attempted starting an IV without backup standing by to help me hold or flush etc. - I was just so awkward with it I'd get it in but then blow the vein or pull out the catheter when trying to advance or flush. Practices makes it better! Volunteer to start IV's for other nurses. A new admit (non-volume depleted!) with "fresh" veins can be a real confidence booster! My one "real tip" - try loosening the hub before sticking, it makes it easier to advance!

psychomotor

My instructor in nursing school told me I had "psychomotor deficiency", so I know how you feel. The only answer is to keep practicing and also to observe other people who do it well often. But all of us have good days and bad ones when it comes to skills. After several years, you'll just have more good days than bad!

Re: Humiliating IV questions

Originally Posted by Kimbalou

Don't worry, I've been in NICU for almost 18 years and IV's are not my thing. i can do an art stick fairly easily for labs, but i have trouble with coordinating IVs with advancing, etc. too. If I look at a baby and can tell i couldn't get the IV, I will get the "Expert" nurse to do it...I've had nurses be shocked that I won't do an IV if I KNOW I won't get it...why hurt the baby more than is necessary? It doesn't help when the IV caths are changed frequently on the unit...always a new one to get used to! I always have another nurse helping me, or I help the other nurse because IMO it is not a one-person job.
Some nurses use the vein viewers to help with starting the IV.
I don't have much advice, but to just keep trying and get advice from the "experts" in your unit.

I agree with you.

I have been in my new NICU for only three months and I attemped one IV and it blew.

I was very concerned about this but my manager said we are getting much better at getting PICC lines in, earlier, therefore, negating the need for a bunch of IV's unless that kid is going to need blood or frequent ABG's.