I need HELP!! with IV starts

suzanne4, RN · Jan 11, 2006

Sounds like you need a couple of days of just starting IVs the entire day. That would be the most beneficial to you. If you are only starting a few a week, you may need more assistance than that.

See if you can get assigned to the Same Day Surgery area for a few shifts, and just work with starting IVs. Better place than the ER, as the patients are usually reasonably healthy and are well-hydrated.

Jasano · Jan 11, 2006

Thank you cartoon girl! :)

Well, I did go for 4 hours of day surgery one day, and got one iv start the entire 4 hours. That's pretty bad. Of course I was so excited that I actually got one, that I let my patient bleed all over the bed, before I finally realized, hmm... I think I should connect the IV to something...

It was a horrible day and I'm sheduled to go back for more punishment. I'll let you know how I do. I feel so bad for the patients... I would much rather practice on a rubber arm, but then I hear that they're of little to no value. Ah well, I just have to keep trying I guess - or find a new career.

CHATSDALE · Jan 11, 2006

with taking vitals you can practice with family or anyone handy but with iv starts it is a different story...you may already do this but visualize doing the correct procedure...number each step in your mind and as you are doing the procedure count off each step...

Jasano · Jan 11, 2006

LOL. Well, I know all the steps and I perform them extremely well up to the very moment of insertion. I have my dressing ready, my tape, I've got tubing ready and primed, i've even got gauze pads to soak up the blood. I get them to make a fist, lower their arm, and I rub the site and generally bring up some nice veins.

Actually, the patients are quite comfortable with me doing their IVs strangely enough - because they see that I have the whole procedure down so well that they actually believe I'm a pro! LOL! Poor unsuspecting souls... It all falls apart on insertion however, though I proceed at the recommended angle; though I anchor the vein; though my bevel be up! An IV insert I cannot do. The procedure yes, the insert no. Frustration!? I need an ativan when it's over.

suzanne4, RN · Jan 11, 2006

You need a few days starting IVs, not one 4 hour shift. And only one !V during that entire time? You can't be serious that only one patient came thru the unit. You need to start everyone that comes in there that day. And do not be shy about it.

Jasano · Jan 11, 2006

No, no no. I only GOT 1 IV. I tried many more

It's horrible. They really should have kept teaching this stuff in nursing school; at least then we'd come out a little better prepared.

irishnurse67 · Jan 11, 2006

I find that IV starts are the most frustrating thing that I've ever had to do in nursing, perhaps the most frustrating thing I've ever had to do in my life. I could be, and very likely am, the worst of the worst, the baddest of the bad, at doing IV starts.
You could give me a juicy vein and I could miss it or blow it. You could give me the most cooperative patients, the best lighting, the narrowest needle and a bedside coach and I could still manage to screw it up.
I know basically what I'm supposed to do, and the procedure to do it and well, I could explain it to someone else so that they could give it a try, but hell could freeze over before I could get an IV start.
On the bright side, I'm really good at keeping IV sites. I watch that tubing like a hawk and snatch it up before it snags. I've contorted my patients into pretzels just to keep the lines flowing.
I know it's probably already been discussed ad nauseum, but could anyone help me out? What I need is a straight forward approach, that not only sounds good, but actually works. I mean I'm getting nada here.

Don't worry-you'll get it. I was once like you and now IVs are one of my favorite things to do. Whenever anyone on your flr needs an IV, jump at the chance to do it and soon you'll be confident. Remember to take your time when inserting. As soon as you get a flash, insert just a little bit more AND THEN slowly slide the catheter off the needle into the vein. Before you stick the person, visualize where the end of the catheter is going to land. That will help you w/vein selection. Good luck. You'll get it . Oh, and if a vein is really puffy and juicy, don't use a tourniquet or you'll get in and blow it.

Jasano · Jan 11, 2006

Don't worry-you'll get it. I was once like you and now IVs are one of my favorite things to do. Whenever anyone on your flr needs an IV, jump at the chance to do it and soon you'll be confident. Remember to take your time when inserting. As soon as you get a flash, insert just a little bit more AND THEN slowly slide the catheter off the needle into the vein. Before you stick the person, visualize where the end of the catheter is going to land. That will help you w/vein selection. Good luck. You'll get it . Oh, and if a vein is really puffy and juicy, don't use a tourniquet or you'll get in and blow it.

Thanks for the vote of confidence! Some people have been telling me it's something you either get or you don't. I've been hoping that's not the case - that it's not some innate skill like being double jointed or being able tie cherry tops with your tongue, or pick up items with your feet. :) Thank goodness you actually CAN get better at it. I mean better from zero to some, but that's still better!

I appreciate your tip also, thanks.

suzanne4, RN · Jan 11, 2006

You can get better, but for some it takes more practice. If you need to spend a week in pre-op, then do so.............is there actually an IV nurse in your facility that you can spend some time with?

Jasano · Jan 11, 2006

You can get better, but for some it takes more practice. If you need to spend a week in pre-op, then do so.............is there actually an IV nurse in your facility that you can spend some time with?

Well, hmm... It's not really up to me how long I spend in day surgery pre-op, but the institution itself. I asked for the extra 4 hours - I guess 4 hours is all they give most. And sadly, no, IV nurses have been eliminated right across the province, leaving us to do our own IVs or beg the emerg. nurses for help. Hmmm... maybe they could be bribed... although really, I should try to do my own starts, I just wish I had some idea of what I'm doing wrong - I wish it were a more straightforward skill.

My favourite position for IV starts :) -----> :chair:

Gail-Anne · Jan 11, 2006

There are loads and loads of tips on threads, just do a search.

Take home a stretch of IV tubing and a few IV needles and start kits. (Get your boss to okay this, as you don't want to be accused of stealing needles!)

Tape the tubing to the counter or table at home (tape lengthwise, 8 inches or so of tubing), set up your supplies and insert IVs in it, even lay out a tournique across the top and pretend to put it on and take it off.

I know it sounds hokey but I've taught many people to start IV's. Getting the movements (by the way---you're not bracing the vein well enough!) down pat without anyone around really helps. Actually brace like you really would, figure out how to get your thumb out of the way and still put a tug on the vein. Practice putting a tournique on people and pick out a vein and brace it. Then get a calm person to go with you to insert on people. Sometimes you need to take a break and not even try for awhile. Good luck.