First Venipuncture..........ugh - page 3
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 30, '02Occupation: RN Specialty: 15 year(s) of experience ; Joined: Jul '00; Posts: 639; Likes: 70My very first IV was when they made us practice on each other! That was horrible. When I tried at least I blew it right away, the girl that poked me (whom never had an IV in her life) for five minutes. Lets just say, there is a reason why you make people lay down when you start an IV. I could have used that extra liter of blood that was in my legs as the room started spinning.
I remember too in nursing school, the instructor would ALWAYS pick the person for me to start that even the IV team couldn't start. Talk about bummer. But like everyone says practice does make perfect. Since I have had orientees' that is what I do all day is start IV for everyone else.
Best advice: Confidence, confidence, confidence.
Aug 30, '02Occupation: nurse consultant and writer: author of 'Dare to Be Free: How to Get Control of Your Time, Your Life, and Your Nursing Career' Joined: Aug '01; Posts: 499; Likes: 270Venipuncture is part art, part science. The science can be learned fairly quickly; the art takes a little while. Like several others, I'm sorry you got such rough cases to start off. But you will get better. I've learned that nothing messes up a stick like fear. If I'm nervous about the stick, I'm almost guaranteed to have a problem, but if I go in totally confident that I will make it, I do. (And after 22 years experience, I almost always do: you see, there ARE things to look forward to about old age ;-)
On a related note, I remember reading a study a while back about the reactions of nurses, dentists, and physicians to mistakes. Both nurses and dentists tended to be very hard on themselves when a mistake was made, whereas the typical physician reaction was to say, OK, I made a mistake, I won't make it again, and stop worrying about it.
I think that's a good attitude. One bad or missed stick does not make (or break) your career. You messed up a little. That's OK. You'll do better tomorrow. Go with the attitude that you will learn from your mistakes, and that you will do better in the future: both for yourself, and for your patients.
Jim Huffman, RN
Aug 30, '02Occupation: RN Joined: Mar '02; Posts: 71Please...I am in the same situation as you! We never did them in Nursing school, but my med/surg unit is always putting them in..I have tried four times and only had one that I got. And like the above poster..I was soo happy I yelled ..."Woohooo.".and then forgot what to do next!
Aug 30, '02Occupation: LVN on Med/Surg. Unit Joined: Jun '02; Posts: 9Hey everyone--
I'm a recent graduate and I am 1 for 4 in IV's. The other night(my first night on the floor), my preceptor wanted to know if I wanted to try on a 90-something woman that was on LOVENOX--she was covered in bruises and hematomas--it was horrible. The LVN taking care of her didn't even want to do it. I didn't even try--you couldn't see a vein for all the bruises. I hope it gets easier, you know how some have "the touch"
Aug 30, '02Occupation: LPN (med/surg/ER) vol. Fire, Rescue, EMS Joined: Aug '02; Posts: 25; Likes: 3I had only been doing venipuncture about a month, mostly in our lab and on M/S(I float around quite a bit). It was my 6th or 7th night in the ER, and we got my first code. A gentleman in his 80's, who just happened to be a very respected area MD. There must have been half the hospital staff in the room working on this man. Since I was low man, I tried to stay out of the way and watch. No chance! Next thing I know I'm being told to draw a half a dozen labs from this guy. The only place I could even squeeze in in all the chaos was his leg. Stuck his ankle... nothing. Tried the other one, still nothing. MD's and RN's are shouting orders, people are crowding all over, and I just wanted to run and hide. Eventually a lab tech stepped in and got the draw. I never felt so incompetant in my life. I spent the rest of the night wondering if I even belonged in the ER. Without the support and reassurance of my coworkers, I might have just gone back to M/S or LTC, but I stuck it out, and I feel my skills improving every day. I'm not always on target, but no one is 100% 100% of the time. Stick with it(pun intended), it only gets easier.
Aug 30, '02Joined: Aug '01; Posts: 1,654; Likes: 2,622This brings back memories. I remember how nervous I was when my clinical instructor called me to a patient's room and told me that it was time. He said, "Just quit thinking about it, and do what you know." The patient was an obese woman in her 40s who had had chemotherapy treatment in the past (not a good prospect for veins). I went for the only short stretch of vein I could locate. Beginner's luck, I suppose, because I was successful (and yes, it is much different than the plastic arms).
What my instructor failed to tell me at the time was that five different nurses on the floor had tried to start an IV on this woman and failed.
Aug 30, '02Joined: Jun '02; Posts: 14my senior year of nursing school the last quarter we do a senior practicum in a hospital setting are assigned a preceptor and this is our transition from nursing school to the real world of nursing. my preceptor showed and let me start iv's. the nurses even let me practice on them and i am truely greatful for that. when i started nursing it took alot of the pressure off
Aug 31, '02Occupation: RN Joined: Jan '01; Posts: 511; Likes: 20Years ago, when I was a new RN and the Worle was my med cart,
my nickname was "Oh fer." When it came to IV starts was 0 for 10 then 0 for 100 and then 0 for 1000. I'm still not one of the best even after 18 years. Except on patients with no pulse. I hit something like 97% on pulseless patients. I have started 16 ga on pt's with no palpable BP. Go figure. Keep sticking to them before they stick to you. Gary
Aug 31, '02Occupation: Diabetes educator, Telephone triage Specialty: 31 year(s) of experience in Everything but psych! ; Joined: Jul '02; Posts: 1,265; Likes: 26One of my first IVs happened to be on a younger guy...who passed out when I put the needle in! Thankfully I got it taped before he regained consciousness. I think the young guys are the worst...like the late teens to late 20's. Yes, they're easy, but psychologically they're hard!
Aug 31, '02Occupation: RN in Quality Dept/Case Mgt Joined: Aug '02; Posts: 447; Likes: 20I agree...it is part skill, part luck, part science and part the way you are holding your tongue...:chuckle
My nursing school REQUIRED you to have three successful sticks before you got through that particular quarter. The best place to learn was at the outpatient surgery floor. I and a couple of other students went there for rotation and told the nurses we were there to start all their IV's. I did 15 sticks in 4 hours and was successful 13 times!
But in all fairness, I think your instructors were unfair to you. Maybe give you ONE 90 some year old, But *TWO* ??!!
Hang in there! I KNOW you can do it! Then there will be a day you will decide it is actually FUN! I love starting IVs and drawing blood and giving injections! Hubby thinks that is the whole reason I became a nurse! hee hee
Aug 31, '02Occupation: Retired Specialty: 15 year(s) of experience in Corrections, Psych, Med-Surg ; From: US ; Joined: Aug '02; Posts: 2,246; Likes: 48In my nursing school, we were not ALLOWED to do any IV access until after graduation and receiving our RN licenses. We were told that whatever hospital hired us would teach us that. The school didn't want the "liability." (I wound up being on an IV team, but no thanks to the school.)
Sep 1, '02Occupation: RN.... Joined: Apr '02; Posts: 255; Likes: 6I learned how to start IV's as an emergency veterinary technician while I was in nursing school....after starting a bunch of IV's on cats kittens and dehydrated shocky best buddie dogs, I got pretty good. So, now I am an ER nurse. Let me tell you all about my day TODAY. I went to stick a pt with excellent veins. Missed twice.
pt number two has one vein stuck him with an 18, got it, then inflitrated vein with phenergan....
ok. so we then stick him 6 more times for an actual IV... And indeed, I cannulated accidently, his artery as well.
Victem #3, thank goodness had acceptable veins and got only one stick.
and from there I got a bit better, but to be honest, it is all a day to day thing. Personally, I wouldn't have let you stick anything over 45 yrs until you got a few under your belt, so I would "blame" the instructor for setting you up for a difficult task. Keep working, it is a totally learned skill.... Best Wishes.
Sep 1, '02Occupation: RN, NP Joined: Sep '02; Posts: 479; Likes: 96I agree with a previous post: giving you a dehydrated elderly woman when you are still a 'newbie' is unfair to you and to the patient.
The skills will come with practice...lots of practice!
I remember one of my first venipuncture patients: a wellknown judge who insisted I try a second time after I failed the first attempt. Missed that too, and then he reported me to my boss!
My boss stood up for me, bless her heart.
After 1 year of daily IV and lock starts, I became proficient.
After 2-3 years, I became a superb IV nurse and could start
practically anyone who came my way. It comes with confidence too, when you believe you can do it ...you usually can.
Never be afraid to refer the patient to someone who has better IV skills if necessary...especially if you have tried and failed x2.
So when my patients(I worked in hematology) asked for me specifically to start their IVs, I look at it this way....I learned to
become expert on the'veins' of a whole bunch of other less fortunate patients. Practice does make perfect.