frustrated with myself & IV's

EricJRN, MSN, RN · Aug 17, 2006

That can definitely be a frustrating still to master. And here's the even better news: even once you become a pro, there will be days where you can't hit the broad side of a barn.

Is there a particular part of an IV start that you think is giving you more trouble than other parts? Locating the veins? Anchoring?

If you use this site's Search function (look at the gray toolbar at the top of each page, under 'Help' and 'Search') you should be able to access several threads with great links, discussions and tips for successful IV starts.

Good luck!

danh3190 · Aug 17, 2006

I'm an old paramedic and I agree that practice does help and I'm sure you'll get good at it.

It sounds like you didn't get a chance for a lot of practice before you had to work on your own with real patients. We were lucky in medic class. We practiced on each other for weeks (we were constantly black & blue) then in our clinicals some very nice and patient nurses stood at our shoulder and gave us support and encouragement.

When I find myself having a spell of missed IV's it's often because I'm not holding the vein stable, I'm not leveling the catheter along the vein after I get the blood flashback, or I'm not advancing the stylette/catheter combination enough (i.e. getting the catheter into the vein) before removing the stylette. Another reason I miss IVs is that I rush it and try to start IVs in crummy veins instead of taking a bit more time and finding the one good vein that the patient has.

CarVsTree · Aug 17, 2006

When you don't get an IV ask if you can watch the nurse/supervisor that is getting it for you. You will learn a lot that way.

Also, don't be too hard on yourself... It will come.

NHavenRN · Aug 17, 2006

I'm 8 months in as a new grad, and I feel the same way most days! It doesnt help that my only experience has been on our floor, where most pts have terrible veins. Everyone I work with is really supportive though, so they're used to me asking for them to try after I fail - and I watch them every time. I am getting better day by day, but it sure is going slowly!

twinmommy+2, ADN, BSN, MSN · Aug 17, 2006

I have found that I have to take into account if my patient has huge pipes, may not need a tournakit (the pressure blows them wide open). This goes for pts taking steriod therapy, they are pretty brittle. Also, are you using the right gauge? 24g for the hand, 22g for most forarms, lower for that juicy ac.

Pediatric Critical Care Columnist · Aug 17, 2006

Also, are you using the right gauge? 24g for the hand, 22g for most forarms, lower for that juicy ac.

Can I call you next time I need an IV? I had surgery three weeks ago and the nurse put an 18 into the back of my hand. Do you think the thing would run? Even on a pump, every time I moved it obstructed. And I STILL have phlebitis in a feeder vein. :angryfire

truern · Aug 17, 2006

I was never too great with IV's in nursing school. Then, went through one orientation and did a few but wasn't great again...Then, moved to another state and hospital and am still uncomfortable. Tried 3 times on one person today and twice on another and was so humiliated cuz I had to ask the supervisor to start them. I know they say practice helps but I hate never getting them....

Did I write this?!? Because I sure could have!! For what it's worth: you're not alone.

I went right thru a beautiful vein today

cardiacRN2006, ADN, RN · Aug 18, 2006

Because I work in the ICU, we get called all the time to start IVs up on the floor. We went, and my preceptor told me to start this one. I did, and it feels great to come through in a pinch. So I told the ICU that when there are calls to start IVs, that I want to go.

Now, I was a phlebotomist for the 10 years that I was a tech, so that helps immensely, but not in the form of technique. Drawing blood doesn't help there. When I would precept new techs, I would tell them that phlebotomy is 99% nerves. I tell them that it will hurt the pt, nothing you can do about that but be confident. Whenever I had the self-talk in my head that I wasn't going to get this blood, sure enough I didn't get it. So I now just say to myself, I will get this IV.

spejsa · Aug 19, 2006

I got some in school, then have hit a bad patch. We were not allowed to start IV's on each other in school and I went to a county school and all supplies were under lock & key. So, needless to say, I didn't get much practice. And, most patients at that hospital had horrible veins since they were homeless, IV drug abusers, or both....It seems like I never even hit a vein these days. I agree that nerves have ruined me. I know that I will nto get it and I don't.

Hoozdo, ADN · Aug 19, 2006

I got some in school, then have hit a bad patch. We were not allowed to start IV's on each other in school and I went to a county school and all supplies were under lock & key. So, needless to say, I didn't get much practice. And, most patients at that hospital had horrible veins since they were homeless, IV drug abusers, or both....It seems like I never even hit a vein these days. I agree that nerves have ruined me. I know that I will nto get it and I don't.

I get a lot of these type of pts also in MICU. I have found that IV drug users can be easy starts if you just ask them what works for them. Sometimes they only have one good vein left.....the secret is to wheedle it out them. Probably the most bizarre IV site I have ever used was in the shoulder - and we have to use 18 gauge IVs. :lol2:

danh3190 · Aug 19, 2006

Yeah nerves can really mess you up.

In one of my dry spells I remember getting to the point where I was actually afraid to start IVs. I kept thinking going in that I was going to miss it. It helped me a lot when I paused, looked at the vein and told myself how easy it was going to be to put this little piece of plastic in that nice vein. It sounds stupid, but about the time I started doing that I started getting IVs again.