IVs

You have given me great advice in the past so now it is my turn to return the favor.
I have done around 10,000 IVs in my life and i can tell you first hand that i still miss some. I cannot come from the CRNA ave but from the experienced IV ave keep going each one will get you that much closer. Also i assume you are sticking some of your critically ill patients, right? well they are the hardest people to get a line on so rest assured this minor detail will be up to par by then or will be their by the time its needed. Hope it helps.

If you can, get in touch with someone in your ER department, tell them what you're doing, and ask them if you can float there and stick IVs in the triage patients for a few days. Use angiocaths.

There are always opportunities throughout the hospital to gain experience in starting IV's. When nurses on the floor can't get the IV, they call the house supervisor. Talk to your House supervisor and tell them if anyone needs an IV to can call you.

Don't stress about it too much. I started anesthesia clinicals with very little IV experience, for the same reason you mentioned (all my ICU patients already had tons of access). When we first started clinicals, a lot of my classmates and I would complain "I suck at IVs." You'll get plenty of opportunities to start IVs in anesthesia school, and in my experience most preceptors are understanding and are pretty cool about giving you tips. I've only encountered one CRNA who made a comment that SRNAs should be proficient in IV starts when they start clinicals, but this CRNA is a pretty nasty and judgmental person.

So, get some practice if/when you can, but don't stress about it too much. An article I found very helpful when learning how to do IV starts was from the journal Nursing2005. The title of the article is On the road to successful IV starts. I tried to upload the PDF here but didn't succeed.

Good luck!

Hi guys:

it is very reassuring to read all your comments. i have limited IV's experience and I will be starting nurse anesthesia school next January. Thanks.

I have the same worries. I start in August and I would consider myself below average at IV starts. However, during the powerpoint presentation at my interview in Pittsburgh, they specifically addressed this concern and stated that we will be starting MANY IV's every day and will quickly gain skill.

Hi,

I had the same problem 1 1/2yrs ago when I joined a neo/peds crit.care flight team.......I sucked at IV starts---I mean REALLY sucked. And that is an "expectation" of my job description......

So, I went to the OR....and was able to jump from room to room and bang a few in. But really, time & repetition is the answer.

I can give one meaningful peice of advice specifically for Peds/Neo populations.........DONT RUSH. I see other RNs do this all the time (even my own teammates). Really be methodical when picking a site on a kid or baby, because there may not be many spots if you blow your first attempt. Also make sure you have plenty of people available to restraint the pt. and hold your limb properly (if the pt is awake....which mine usually are). On pt < 2yrs I prefer a 24g .54 length......I hate long angiocaths.

Lastly, With really fragile vessels, after your initial flashback try "floating" the catheter in with your saline flush instead of advancing with the needle. This has saved me many times. Slow it down, really slow it down.

Good luck,
c.

I think the best way to get experience in IV starts is to go to a first day surgery preop holding area or a GI clinic. If you dont have a lot of experience, you dont want to be going around trying to start IVs on patients that are already too difficult for the ICU and floor nurses...that comes with time. It's a skill. Practice on some healthy people to start out, you'll get better each time.

Hi,
IVs are a skill like intubations etc. Some of my classmates have limited IV experience. Be confident, engage the patients, and distract them while you start their IVs.