feeling bad practising IV insertion

hiddencatRN, BSN, RN · Mar 31, 2012

You just gotta. You won't get better until you do it a lot. 4 tries with 1 success is actually decent, even though it may not feel that way. I am good with IVs now and will still have "off" days where I have similar statistics.

When you approach the patients, are you going in with confidence or are you telling them you are learning and need to try to get the line on them?

I'm not a huge fan of getting IVs or blood draws done, but honestly, it's not the end of the world. The pain doesn't last forever, and I need the fluids or medicine or labwork done so I accept it as a necessary discomfort. Not all patients will approach it so rationally, but that's how YOU need to approach it. They need the IV. Someone has to get it. There's no guarantee that the experienced nurse will get it on the first stick either.

Lynx25, LPN · Mar 31, 2012

It's ridiculous that they won't let nurses practice on each other during school.

When I was in the Army, they showed us once, then gave us a handful of catheters, and we were told to "find a partner"

We practiced in the classroom.

We practiced outside in the dirt.

We practiced in moving vehicles.

Nursing school gave me a rubber arm with garden hose "Veins"- and we each got three sticks.

MN-Nurse, ASN, RN · Mar 31, 2012

Keep sticking.

~PedsRN~, BSN, RN · Mar 31, 2012

I'm a new nurse (graduated in December!) and I am working full time in Acute Care Peds. I need to just go downstairs to the ED one night and do some sticks on adults! I have started ONE IV back in nursing school, and it was on a drug seeker in the ED who probably would have let me stick an ice pick into her veins. I have had a few chances to start an IV on my floor, but the thought of holding down a 15 day old and searching for a vein gives me heartburn. I did get a successful lab stick on a teenager last week and threw a party in my head. :yeah: I know practice makes perfect, I just have no desire to torture innocent children. I guess I need to suck it up. :)

Aliakey · Mar 31, 2012

The pain should be short lived, and the guilt... the patient needed the IV for a reason. Missed IVs happen. The guilt is probably a part of the factor in your sticking rate, if I can be honest. You do need to be empathetic with your patient's discomfort, but when the feeling of guilt overwhelms you, then it affects your confidence, which then affects your skill in venipuncture.

Does your hospital have an outpatient-type setting where patients who are scheduled for elective procedures, etc. go in and get their blood drawn for labs, etc.? I've seen a few new hires improve their sticking ability tremendously by spending a couple of hours each morning drawing from fresh veins out of relatively-healthy people. Really helps boost confidence and get a feel for the actual venipuncture without facing the 99-year-old-frail-lady-on-Coumadin-and-aspirin-with-diabetes-history offering that last puny, squiggly thread of a vein that you have to stick on the floor. Our ED made the arrangements for the staff who needed the extra practice.

I precept EMS students in the ambulance setting. I know they also have very few IVs under their belts when I first get them. If I can offer some advice: First off, even if you are nervous, be confident that the IV will happen (even if it doesn't). It sounds silly, but helps my student successfully cannulate even the lil' ol' lady veins if they can be confident in themselves and their ability.

Second, make sure you can feel the vein and its fullness, not just "see" a vein. I make my students close their eyes and search for veins on me... I have quite a few that look good, but are as flat as Lubbock itself. When they assess a vein for a stick, they tell me what they feel... ropes, rolly-polly potential, flat, scarred, etc. so they can remind themselves to consider the potential complications.

Third: The alcohol prep pad is your friend. I do quite a scrub over the venipuncture area, which not only keeps everything clean like it should be, but does a fine job of revealing some of the vein's features missed on a dry assessment. If the vein "disappears" from view but is palpable, scrub again but place the alcohol prep above the site with the corner of your prep "pointing" to the vein to show its location.

And remember, you won't get them all. Everyone misses. My students are usually hitting them on young-adult trauma patients at 60 mph in a bouncing ambulance by the third shift, confidently. Lil' old ladies... we'll sit on scene for a minute . Shoot, I'll sit on scene, lol! It takes practice. You'll get it.

Hope it helps.

psu_213, BSN, RN · Mar 31, 2012

I'm not sure that practicing in school makes a huge difference. As I have said before, there is a big difference between practicing an IV on a healthy 20-something in school as compared with starting one on a dehydrated, generally ill 85 year old who has been stuck many times over the years.

The fact is the latter of those may need an IV. When they are in the hospital someone has to do it, and even someone who is a great stick will miss now and then. I am far from being a 'great stick,' but I also realize that if I am that patient's nurse and they need an IV, I need to stick them. I don't like inflicting the pain, but sometimes it has to happen.

When I was a new nurse I thought like you--I didn't want to hurt a patient--a natural reaction I think. I had practiced in school on classmates...and even in clinical on a real patient (even though it blew after 30 seconds of infusing without difficulty).

Now I work in the ER where I have to stick people all the time. I wish that I had tried more often in my first job out of school...I really feel like it would have benefited my IV skill over the long term. In other words, it has to be done. You don't have to like causing (a fairly small amount of) pain, but you will benefit from the experience now, and it will pay off later.

Perpetual Student · Apr 1, 2012

It's an IV start, not a fist to the face. Don't feel bad. Just do the best job you can.

BostonTerrierLover, BSN, RN · Apr 1, 2012

My very first IV initiation failed. I always hoped I would get my "FIRST" one! I was down all weekend.

You never know, you might be the one everyone is calling for help on IV sticks by next year! Good Luck!!!!

Pixiesmom, BSN, RN · Apr 1, 2012

You know how to get to Carnegie hall? Practice, practice, practice. The same goes for IV starts.

hiddencatRN, BSN, RN · Apr 1, 2012

I'm a new nurse (graduated in December!) and I am working full time in Acute Care Peds. I need to just go downstairs to the ED one night and do some sticks on adults! I have started ONE IV back in nursing school, and it was on a drug seeker in the ED who probably would have let me stick an ice pick into her veins. I have had a few chances to start an IV on my floor, but the thought of holding down a 15 day old and searching for a vein gives me heartburn. I did get a successful lab stick on a teenager last week and threw a party in my head. I know practice makes perfect, I just have no desire to torture innocent children. I guess I need to suck it up. :)

I'm in peds too. The nice thing about learning in peds I felt was that since you need another person in there to hold for the smaller kids, you get to bring along moral support. I started my sticks on teenagers and worked my way younger. When you hold for others pay attention to their technique and ask questions about what they look for.

But really, if you didn't want to torture children, why go in to peds?