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

[Lahryn04]

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!

[ChristineN, BSN, RN]

I don't see anything wrong with suggesting. I have very small AC's but my hands are better. The last time I went to get blood drawn the phlebotomist wanted to stick my AC, but told me she might have to stick me twice to get all the blood. When I asked her to try the hand, she agreed, but said they generally try to avoid the hands for first sticks since they are more painful. Whatever, though, I only got stuck once in that trip!

[kiszi, RN]

Yes, please suggest but be understanding if they don't want to go with your suggestion. In my current job (home health) I do more blood draws than IVs, but the same principle applies. One time I was seeing a patient for a blood draw that I dreaded going to because he had imperceptible veins. Normally I could find one but it would take a while. So after I spent a good bit of time going over one arm, I was getting frustrated. The patient's mom took the tourniquet and found a fantastic vein in the other arm that I'd never noticed before. Now that's the only vein I will ever use, works every time! So yes, patients (and moms) can be a great resource!

I'm a tough stick myself, but unfortunately (or fortunately maybe) I haven't been stuck enough to know where the good veins are. I tell them their guess is as good as mine, ha.

[Mandychelle79, ASN, RN]

I know I am a difficult stick. Ive only had a successful IV start in my hand one time and when I had jaw surgery done, they started one and knocked me out to start the other one. When I had my daughter they were able to start an IV, but it was the most uncomfortable IV i have ever had. It was in a small vein close to the AC but I then couldnt move my arm for days ( long, induced labor) When I had my son I politely asked them to call the IV team to start my IV. They told me they had to try so I explained that I was a hard stick and that my AC was a good spot. They told me No, they dont like using the AC. So I asked about a surface vein and again told No. 4 unsuccessful sticks later in my wrist, they called the IV team who started the IV in the surface vein that I asked for.

I think I will listen to patients when they suggest because of this experience.

[thehipcrip]

This is a fantastic thread. Thanks to the OP for asking the question and to all those who shared their thoughts.

[FlyingScot, RN]

If a patient asks me to use a particular vein I always comply even if I see one that I like better. Experience has taught me that if I coerce the patient into agreeing to use the vein I like it inevitable blows and then I have to go back to the one the patient wanted in the first place. I am an excellent stick so I'm pretty sure it's a karma thing. So now, even if it's a lousy vein I stick where the patient wants me to first and if it doesn't work I move on to the vein I liked better. I don't tell them how much I don't like their preference because if it blows they might think I did it on purpose (wouldn't think of it). This method makes for a happy patient because 1. I listened to them and 2. they feel a sense of control. If their vein blows I apologize profusely, agree that they are the hardest person I've ever tried (which for some reason makes them feel special and important) and then slide an IV in the good vein slicker than snot. Works pretty much every time.

[alotaibi]

I think being a patient doesn't mean you're not a nurse any more. I'ts absolutely ok not only to suggest a vein for IV but also to share with healthcare team members all the necessary measures to help you as a patient.

[SnowStar4]

Whenever I know my patient will be a hard stick I ask them where people usually have good luck. They usually like being included in any process that involves me sticking them less than needed.

[Anna Flaxis, BSN, RN]

Sure, it's okay to suggest, but keep in mind that your nurse may be quite skilled at IV insertion, and may have a different idea of the wheres and whys than you do. A lot of patients tell me they have to have a small gauge in the hand, that's the only place that works, etc. But if they are there for abdominal pain, they need at least a 20 above the wrist because chances are, they need a CT.

99 times out of 100, I can tell the person is going to tell me they're a tough stick before they even open their mouth. Sometimes, they really are a tough stick, which I am perfectly capable of assessing for myself simply by looking at their arms. A lot of times though, they're not any harder than anyone else. They just think they're a tough stick because maybe they've had a bad experience in the past (maybe they had someone who wasn't that good make a pincushion out of them), or they want to be "special" (we deal with a lot of drama queens/attention seekers in the ED).

Anyway, yes, it's okay to suggest, but also be open if the nurse has a different suggestion.

[sharkdiver]

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!

Good thing, because legally you can't. You can try to talk them into it, but if they still say "no IV in my hands", they are specifically refusing consent (not for the IV, just the location) and you have no authority to override their decision. Once you've tried a start a couple times without success, getting someone else to step in and try is usually a good idea....for both you & the patient.

[gcupid]

It depends on how the patient suggests the iv site..

I find it annoying if the patient has adamant belief on getting the iv start in a particular area when I can clearly see other spots that I feel I may have a chance. You can suggest the best spot all you want but if I cant see anything or feel anything, it does no good. I can get another nurse or leave the supplies and let the patient give it a try...at this point, I just need to hurry up because I have about 13 more task I need to complete with in 15 minutes....

What I've learned to do is just stick where ever the patient wants me too b/c the customer is always right.

[steelydanfan]

It's perfectly ok to suggest a site, but I find 10 out of 12 times that pt's feel they are "hard sticks" is because nobody ever looked beyond their hand as a possible site. I find glowing veins in the radial and posterior aspects of most of these pt.s arms

[~Mi Vida Loca~RN, ASN, RN]

I am an extremely hard stick, (majority of the time it's 3 sticks to finally get me IV and blood) I always warn the nurses because I have had a few "pros" have some bruised egos when they couldn't get mine. I once had 4 different nurses try and finally the anesthesiologist had to come do it right before surgery :| So I always suggest where they usually have better luck and I always add in "and for petes sake if you miss DO NOT DIG!!!!! Re-Stick me" The nurses have always thanked me for warning them and some right away take a peek and go get someone else that's a little better with them.