As a patient, is it okay to suggest a vein for IV?

Published

Hey guys this is my first post so bear with me! So my question is this... Is it offensive to ask the nurse starting my IV as a patient in the hospital to stick a certain vein? Long story short, I was recently admitted to a hospital I used to work at 3 days post lap chole with a fever of 103 (another story altogether). I was there a total of 4 days and had 5 IVs with about 14 sticks altogether. The 5th time they had to restart my IV I asked my nurse for a warm blanket and a tourniquet so that I could find the good veins I knew I had. She was very cool about it and let me do it and said she was going to get another nurse to start it because she wasn't that good. I am an RN and most of the nurses there knew me. I am also the nurse on my unit that the others come to for tough IV sticks, so I know a bit about this topic. Anyway the nurse came in to start the line and I, very politely of course, asked if she wouldn't mind considering the vein I had found. She said "no no let mgr look at both your arms" and telling me how long she's been doing this and how she was extremely good at hard sticks. Then she proceeded to stick this teensy little vein in my hand and couldn't even get a flash. I understand there are days you just can't get an IV, I've been there and it frustrates the hell out of me, but I feel like she should have at least considered my opinion considering all the previous sticks. The next nurse came in, took my advice and got it. It was the the last IV they had to start on me during that admission. I'm just wondering if my feelings are valid and would you do the same thing? How would/did you feel if/when this happened to you? Thanks in advance for the input and I'm sorry if this is really a silly question!

Specializes in ED, Informatics, Clinical Analyst.

Sometimes I actually ask patients where the best place is. I just hate the people who say you HAVE TO start it HERE when there are better places to stick. I had a lady actually pull her IV out because it wasn't where she told us to put it...

Up Vote Up Vote ×
Specializes in Acute Care Cardiac, Education, Prof Practice.

I have been telling my husband to start picking out his favorite veins for Remicaide. Lately they have been putting them in his hand or wrist, which sets off the pump non-stop as he tries to work on his laptop during his sessions. The man has ropes of blue up his forearms but they always seem to avoid them for some reason.

Up Vote Up Vote ×
Specializes in CEN, CPEN, RN-BC.

1st question to my patients: Have you ever had an IV before?

If yes, where's the best place to put one?

They'll tell you, believe me.

And then 95% will tell you they're a tough stick and they'll start throwing out jargon like, my veins roll, are deep, they use a butterfly on me, blah blah blah, etc

Up Vote Up Vote ×

When I'm in the hospital, I tell them how many units of insulin to give me versus what they want to give. I tell them if they don't listen to my scale versus their scale, they will force me to pull out my Novolog Pen.

Up Vote Up Vote ×
Specializes in Telemetry.

Sure it's ok to suggest whatever you like to the nurse. However, it's up to the nurse whether she/he takes your suggestion or not!

Up Vote Up Vote ×
Specializes in Infectious Disease, Neuro, Research.

:D I've started my own, in similar circumstances. Two perspectives:

1) Yes, you absolutely have the right to make a suggestion. Particularly since most people sticking lack any sort of theory training behind what they do.

2) People recommending that the same "spot" be repeatedly accessed want it to sclerose or become varicose, generally in ignorance. Repeated sticks and med administration causes scarring and/or loss of vessel wall elasticity.

Bottom line, the patient isn't driving the needle. If I can't feel it, I generally won't stick it(stick what you feel, not necessarily what you see). If they insist, I'm up for taking a stab in the dark, if they are...:eek:

Up Vote Up Vote ×
Specializes in ER, progressive care.

I have no problem with it. Personally I like it when patients tell me where to stick them, because they know their body better than I do. They tend to know the spots where people can easily get blood and also spots where it is difficult. And if they tell me not to use a particular spot because it hurts, then that's fine, too.

Up Vote Up Vote ×
I have been telling my husband to start picking out his favorite veins for Remicaide. Lately they have been putting them in his hand or wrist, which sets off the pump non-stop as he tries to work on his laptop during his sessions. The man has ropes of blue up his forearms but they always seem to avoid them for some reason.
My experience from giving a lot of Remicaid is that it seems to destroy the veins after a few years. I always try to start in the hands (to preserve the upper sites) and do explain my rationale to the patient. If he can't even use a laptop with it in it's not so much that it's in the hand/wrist as it is poor positioning. (I also prefer to use a 24 for the shorter catheter and run slower if I have to do a hand site.)

As for being on the recieving end, the only time I've had a HCP have a problem with my pointing out what works for me is EMS. I realize they have protocols but it would be nice if they would listen when I tell them they aren't going to get a 14 in my AC.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have been telling my husband to start picking out his favorite veins for Remicaide. Lately they have been putting them in his hand or wrist, which sets off the pump non-stop as he tries to work on his laptop during his sessions. The man has ropes of blue up his forearms but they always seem to avoid them for some reason.

Long term treatment.....start low then travel up the arm. If you ruin a vein higher up on the arm you may not be able to use that arm for an extedned peroid of tijme. You should never start an IV below an active infiltration.......I have always asked patients when I've been called to start an IV...Do you have one arm/spot better that the other? I worked for years in the inner city......always trust an IV drug user to know where the best vein is.....they usually just used it....:smokin:

Up Vote Up Vote ×

I tend to make my nurses job very difficult when it comes to giving blood and inserting IVs. I'm a hard stick, which makes me scared, which makes her job harder, which makes me feel bad, which just makes me more tense lol. If that wasn't bad enough anytime I get an IV in my hand, wrist, or inner elbow it has to be redone within hours. Last time I was in the hospital, I explained it to my nurse and she suggested a different spot in my arm. It took her one stick, didn't hurt, and stayed in! So I always suggest that spot for my nurses now, and they actually thank me for making it a little easier on them.

I have also considered (more of dreamed about cause I'm too low key to try to make anyones life harder) requesting a specific phelbotomist at my hospital because she always gets it on the first try.

Up Vote Up Vote ×
Specializes in Acute Care Cardiac, Education, Prof Practice.
My experience from giving a lot of Remicaid is that it seems to destroy the veins after a few years. I always try to start in the hands (to preserve the upper sites) and do explain my rationale to the patient. If he can't even use a laptop with it in it's not so much that it's in the hand/wrist as it is poor positioning. (I also prefer to use a 24 for the shorter catheter and run slower if I have to do a hand site.)

That makes a lot of sense! I didn't even think about the damage over time issue and wanting those big blue ropes for later on. He has been on it for about two years now, so far his veins have held up well. He said the last one would set off the pump no matter if he moved or not. Perhaps it was close to a valve or wall?

(I have started two successful IV's in my 5 year career so I am at a bit of a loss when it comes to the fine details of the art!)

Up Vote Up Vote ×
Specializes in CVSICU, Cardiac Cath Lab.

When I was doing my preceptorship in April (sitting around, waiting for the ATT now), I have a patient who REFUSED to let me use his hands. Hands with beautiful, earthworm-sized, straight veins. Instead, he preferred me to try the itty bitty, curly veins in his forearms. By the end of his stay, it looked like both arms had been run over by a semi. (He wanted me to keep trying instead of getting my preceptor--over and over.) It never occurred to me that I actually could have overridden him!

Up Vote Up Vote ×
+ Join the Discussion