First Venipuncture..........ugh - page 2
Today was the first day I tried inserting an IV. The nurse educator took us to the ER since we would have more there than the floor. Well well, boy is it drastically different from those dummy... Read More
Aug 29, '02Occupation: RN in Nursing Education; House Supervision; Editor RNdex Joined: Mar '02; Posts: 427; Likes: 9The first one I "got" was on a mom about to deliver: young, fluid overloaded, dang vein virtually jumped onto the catheter.
It's just a matter of practice, luck, skill, the phase of the moon, and, for me, an empty bladder.
Aug 29, '02Occupation: none-retired Joined: Jun '02; Posts: 1,085; Likes: 10Keep at it, some day you will be the best with a start like that. If they'll let you, go down to the lab and practice drawing blood, it is a short step from drawing blood to placing an IV, that is how I learned back when the dinosaurs still roamed the earth.
Aug 29, '02Occupation: RN, MS home health Joined: Aug '02; Posts: 7,472; Likes: 49Don't give us. All of us have times we just can't get in! Molly wow I bet that was trip the patient waking up...........wow
Aug 29, '02Occupation: none-retired Joined: Jun '02; Posts: 1,085; Likes: 10When I worked in the SICU, a med student stuck a guy in a coma and he woke up just like Molly's pt. Everyone kept asking her to heal us, it was hilarious in a SICU nurse kinda way.
Aug 29, '02Occupation: QI - medical review coordinator Joined: Mar '02; Posts: 530; Likes: 14I personally feel that your educator selected inappropriate patients for you to learn IV insertion on, both for you and the patient. IV insertion is a skill that is learned. You need to start a few IVs on patients who aren't so difficult to get some confidence as well as experience. Then move on to the more difficult patients. It's not fair for you or the patient.
I agree that we all have what I call "humility days" when we just can't seem to start an IV, but to start a nurse out on two 90 plus year old patients for her first IV attempts on patients is wrong. Even if the veins are visible, they tend to be more friable and frequently rupture even if the catheter is inserted correctly. I would frequently let down the tourniquet before making the venipuncture to minimize the risk of vein rupture. It seemed to help most of the time.
I was an IV preceptor in the ER for many years and we were selective on what patients the students were allowed to "practice" on. If they had one good vein, an experienced nurse, or perhaps a student with several IVs under his/her belt were the ones to start the IV.
Keep at it. As you have successes, your confidence will increase. Your skills will also improve and you'll be starting IVs on the older patients and those with difficult veins.
Aug 29, '02Occupation: RN Joined: Aug '02; Posts: 28Awwwww...........you guys are the best. Thanks for the support everyone~~!!!
Molly and JonRN-I can't believe that happened to you guys. Both you and the pt must of been startled. Hey.....at least they cam out of the coma. Keep healing guys~!! hehehe
Aug 29, '02Occupation: REGISTERED NURSE! Joined: Jun '02; Posts: 47; Likes: 1I just wanted to say that i only got to attempt 3 or 4 iv sticks in nursing school and didnt get one of them. I got my first i.v. last month (i started working july 4th.) and i attempted one today that i just about had, but the vein blew. i soo hate when that happens... i guess what they say is true- it comes with practice! good luck to ya!!
Aug 29, '02Occupation: Stay-At-Home Mom Joined: Aug '02; Posts: 34I don't think your instructor could've made a worse choice for your first stick, but maybe there wasn't anyone else? Dehydrated geriatric patients are tough for experts! I too got my experience doing venipuncture for my doctor and I got really good at it! I had scared pts come in and actually request me to do their monthly bloodwork! Made me feel great. Once you get the feel for going into the vein, it's a piece of cake! Please don't be discouraged. We all have days like this! Take the advice of the nurse that told you to step up to the plate and try again. The instructors know that you're nervous and they'll respect the students who really want to learn and are willing to keep trying. Hope you get a better patient next time.....
Aug 29, '02Occupation: CRNA (Nurse Anesthetist) Specialty: 11 year(s) of experience ; Joined: Aug '01; Posts: 569; Likes: 71I learned to draw blood from HIV+ IV drug users; they walked me thru each stick. Most of them were homeless at the LA Mission; I did community health rotation there. (Never did tell my instructor). My only IVs have been on kids. I do PICU and have gotten pretty good at even 24 g angiocaths! I wonder what it would be like to use a 16g. Maybe like inserting a hose!
Aug 29, '02Occupation: Stay-At-Home Mom Joined: Aug '02; Posts: 34Yeah Quiigley, I was always told that's the pts you do listen to because they know what veins they've blown, etc....Also, you must be pretty good if you're doing kids in PICU! Also, I went to nsg school in Merced, California.
Aug 29, '02Joined: Aug '01; Posts: 892; Likes: 3I thought everybody took home I.V. supplies and practiced on oranges and husbands, friends, co-students. All of us did .... we had a weekend to come back & start stickin pre-ops. We were the IV Team !!
Aug 29, '02Joined: Apr '02; Posts: 31,898; Likes: 20,742I agree with cbs3143, it would have been a more profitable learning experience if the IV candidates were easier for first-timers. CT might have been a better place to begin your IV sticks, if at all possible to arrange w/Radiology. A lot of the out-pts (minus the IVDAs and chemo pts) have fair-to-good veins, walk in (!!) and aren't dehydrated. Techs start the IVs in a lot of facilities, while the nurses and Radiologists start 'em in others. We can start 20+ on a full day in CT (not to mention IVs in MRI, Nuc Med and for IVPs, too). Just a thought . . .
You WILL get better veins to try, and your skills WILL improve! Good luck!
BTW, we learned on each other for the first few sticks too . . .
Aug 30, '02Joined: Mar '01; Posts: 230; Likes: 4Hello PC,
Sounds like you were given some challenging patient veins to work with!! The nursing school I attended didn't allow us to insert IV's. I am an ER nurse now and I had to just practice and practice. When you get that 20 something with pipes it will be great!! I'll bet that you at least got a flash on the 90 somethings right?? I would look at that as a success. Hang in there keep practicing, you will be doing them in no time!