So frustrated with IV starts!!

Specialties Emergency

Published

Specializes in Pediatrics, ER.

I just started in the ER and I can't get an IV to save my life!! Big HUGE juicy veins begging me to stick them and I can't do it. I came from a floor where I was THE go-to person for IV starts. LOVED starting them and only missed one in the past six months!! The new hospital I work at use the snap release angiocaths and butterflies, and I can't adjust. I'm used to the angiocaths you pull back until they click before releasing. I've never even used a butterfly. I'm psyching myself out thinking I won't be able to get one and then I end up not being able to do it. I absolutely hate not being able to do things and it's really starting to tick me off that I'm missing the easy ones. My preceptor actually stays out of the room when I try because I get more nervous when people watch me. She's been great but I'm sure she must be getting annoyed that she has to keep following up and start the IVs when I miss. Did any tricks work for you that you could share?

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

The nerves of being in a new place are probably getting to you. You'll get your mojo back. Just give it a little time.

Specializes in Emergency Department.

Yup, you're psyching yourself out.

Specializes in Home Health.

Tell yourself, 'I can do this'. Don't stress. And, remember, IV starts are 5% skill and 95% luck!

Specializes in hospice, HH, LTC, ER,OR.

Think positive, and the rest will fall into place :)!

Specializes in Trauma Surgical ICU.

The same thing happened to me when I switched hospitals and the IV caths were different too.. Keep at it, stop psyching yourself out :) Relax, take a seat, and hit that sucker LOL...

Specializes in Critical Care.

Going through the same thing, but with blood draws. At my last job, I inserted IVs, did blood draws, and ABGs. At my current job, just no ABGs. Many of the CTAs are certified in phlebotomy, so I find myself asking them to do my blood draws. Why? Because I have become terrified of doing them, and I don't know why. I know that I am psyching myself out. Comes back to what you said about getting nervous when people watch you. At my last job, most patients were so sick, they did not watch me do blood draws. Did not have this problem previously with very alert patents. At my current job, most patients (as well as family members) watch everything that you do. But when I started this job I did not have this problem and often assisted other nurses in difficult IV starts and blood draws. The other night, I decided to overcome this new phobia and drew blood on a patient with very nice veins. However, halfway thru drawing the blood, I started sweating and my hands started to shake. Now I am more afraid than ever. I am seriously considering asking my dr for some prn ativan.

Specializes in CCT.
The new hospital I work at use the snap release angiocaths and butterflies, and I can't adjust. I'm used to the angiocaths you pull back until they click before releasing.

So my guess is the new IV catheters look like this:

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Where as what you used to looks like this:

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I had to do this same transition...and it's not an easy one. A couple of tips.

1)DON'T SAFE THE NEEDLE BEFORE IT'S OUT OF THE CATH! This will lead you to serious frustration, missing lines you really need, ect. Use needle #1 just like the old Jelcos. Thread the cath, pull the needle all the way out, and then safe the needle. It's a little disconcerting if all you've ever used are the sheathed safety caths where the needle has to be safe to remove it from the cath, but it's ok. I've yet to come even close to a needle stick.

2)The whole asembly is longer than what your used to. Take this into acount for contractured limbs, EJs, or anywhere it might be difficult to get the whole assembly positioned the right way to start the line.

3)Practice a two handed insertion technique as well as the one finger "push". Sometimes it works better.

4)You don't get the "blood stopper" effect that the Introcans give you. Have everything set up and ready to go. Cap pulled off the lock and slipped back into the package, back peeled off the Tegaderm, ect. Finally, if they gotta bleed on the floor, well, they gotta bleed on the floor.

5)Again, DON'T SAFE THE NEEDLE UNTIL IT'S OUT OF THE CATH! I really can't stress this enough....

Good luck, relax, and hope this helps (coming from someone who hasn't been able to canulate a water main the last two shifts...)

Those snap release ones is all i know lol. What works for me is the first thing you must do when you first open up the needle slide the catheter slightly up and then put it right back (these are know to kinda get stuck and not finding that out till your ready to advance sucks! so just slide it up and back down so you know its ready) I enter the vein but not all the way. The moment I get a blood flash I advance LITTLE bit more with my needle, then with your index finger advance the catheter using that little ridge that sits at the top advance it all the way THEN push your button to safe your needle, do not push it till your catheter is off. This method has worked for me and I was taught this way for best results. ESPECIALLY the part about advancing the catheter with your index finger, good luck!!

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I used to use the Protectivs as a paramedic and the BD Insyte Autoguards as an RN ... kind of annoying to have to switch back and forth on a regular basis, but I'm kind of glad because it made me more versatile! You'll get used to it ... relax and give yourself time! It's not easy to make the switch. (Personally glad to see that my Army ER uses the Protectiv catheters, yay!!)

Specializes in CAPA RN, ED RN.

You are still the IV queen! If you are using the Insyte they are great needles with a very sharp edge. It is easier to go through the back of the veins. Also, advance the bevel under the top of the vein at least a little before you snap the needle out. Once I have advanced the bevel of the needle I tend to slide the cath off the needle just a bit and use the needle inside the cath as a stylet while I am advancing the cath in the vein. I don't like the idea of pulling a needle out that is not safe. We have had 3 or 4 changes in manufacturers and the Insyte had a bit of a learning curve. Whatever you are using you will be great and regain your crown as the go-to person, I am sure.

It can be hard getting used to different equipment, plus there is the psychological factor.

My facility switched to a different type of angiocath a while back, and I found this type much less forgiving of basics like holding enough traction, going at a steep enough angle, and so forth. I really had to go back to basics when making the transition from the old type to the new type.

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