Should new grad be able to start IV at work? - page 2

hi i graduated in may of this year and i learned how to start an iv in a lab in school where we practiced with fake arm, never start an iv on a real patient in a real world. at work, where i... Read More

  1. by   swee2000
    Quote from graduatenurse
    hi. i graduated in may of this year and i learned how to start an iv in a lab in school where we practiced with fake arm, never start an iv on a real patient in a real world. at work, where i currently work in nursing home, if my patient needs iv started, i ask one of the other nurses i'm working with to start an iv for me, but i'm very embarrsed by it. i feel like as a new grad and licensed nurse i need to be able to start an iv on my own patient. iv class was not included in a general orientation. i feel so stupid and incompetent.
    as a new grad and start working in a real world setting, did you guys start iv on your own patient? or did you have to take an iv class to learn how to do it? nowdays in hospital settings they have iv teams who will start iv's, draw blood etc.. . do you think i should just suck it up? any suggestions?
    even though the above might be true at some places, it isn't the case where i work. at my hospital, there is no iv team to start ivs for us. instead, it is the responsibility of the nurses on each unit to do their own iv starts. and in the rare circumstance where an iv could not be successfully inserted, especially after several attempts and by several different people, outside help can be sought(usually from a nurse anesthetist or icu nurse).

    also, my hospital requires & expects that all nurses, regardless if you're an rn or an lpn, be able to successfully start ivs. this includes doing so with the use of lidocaine(policy states that patients must be offered a lidocaine injection just prior to having an iv inserted). it is also required that all new nurses take the hospital's iv therapy class as part of orientation. it doesn't matter if you're a new grad or an experienced nurse who just changed employer, or if you're an rn or an lpn.

    to the op, i understand how you feel, although in a different way. because i'm an lpn, i usually get overlooked by the rns when an opportunity arises to start a new iv on a patient. mainly because i'm the least experienced and the rns don't want to waste time if i can't get it on the 1st try. and that's fine with me because this is not one of my favorite nursing skills. but at the same time, i realize that i'm not gaining any experience or level of comfort with the skill, nor sharpening my technique, if i'm constantly bypassed/overlooked and don't speak up about it.

    does your employer have an iv class that they can send you to, even if it's held by an outside company or facility? i would strongly encourage you to look into this, both for your peace of mind and because it's part of being a nurse.
    Last edit by swee2000 on Dec 21, '07
  2. by   caliotter3
    The only way you can learn how to do any skill is by doing it. So tell the supervisors and your colleagues that you want to practice starting IVs, and take every chance that comes your way to start one. Have an experienced nurse go with you for support so that she can step right in if you don't get it started in two tries. That's what I did when I first started with IVs. Most of the time you won't have to say anything about why another nurse is with you. If the resident asks, just say she is there to help you in case you can't get it started. I was next to impossible to get an IV started when I was hospitalized and after two or three nurses were unsuccessful, they decided to go after the nurse manager. Apparently the nurse manager had extensive experience for some reason. They held a committee meeting discussing my veins. While the NM was conversing with me, she just went right in. I didn't feel her touch me. She was that good. She told me you have to practice and it helps to get a job where you do this skill all the time.
  3. by   JessicRN
    Quote from bagladyrn
    Ask your coworkers who are really experienced to "save" those patients with the best veins for you to start, or those who only need a small gauge IV for intermittent antibiotics or such. After some success with these you will feel more confidence in attempting the more challenging ones.
    I agree, make sure you have the basics by practicing with a coworker either by watching them insert several or play practice insertion on someone so get the steps correct. Then ask everyone around you if they have someone with great veins who needs an IV or lab and start with them and work up. If you are in a hospital, ask to spend a day or two with the IV team nurse if you have one. Also if you have a great coworker or preceptor ask to start one on them. (ask for emla first if you can). IV insertion and drawing lab is a skill that you only improve with practice. But also remember you can have all the skill in the world you cannot help people with bad veins. An intracath that does not thread is not your fault.
  4. by   tigger2sassy1
    agree with all posters above dive right in there girl and experience how good it can feel when you do the first one by yourself successfully good luck
  5. by   Tweety
    It is part of the cirriculum in every RN school. So new grads should know the basics, but not necessarily be proficient. In nursing school unfortunately I only had the opportunity to start one IV.

    I think it should be treated as other new grad skills, you do it with your preceptor, learn on the job, and you practice and practice and practice.
  6. by   MrsCannibal
    I agree with the above posters-jump in, follow other nurses, find out what you need to do to start IV's. I was lucky; during my OB clinicals in NS, some of the nurses decided that we needed real world experience, and 3 of them offered up their own veins for us to practice sticking. Amazing the lengths some nurses will go to to help out newbies!
  7. by   HM2VikingRN
    Just do it....I think it gets easier with time.....(I am no expert but if you can learn how to help your patients relax it will be easier for you to get an IV started on them.)

    Venipuncture techniques are not taught enough in school (IMO). As an HM i let people practice on me all the time because that is how you learn. The lab arms are good but they are no substitute for the feel of the live person.

    One of my classmates started an IV on himself after he completed his synthesis. He is the type that will have procedures done on himself so he knows what patients go through. (He also cathed himself during skills classes.)
    Last edit by HM2VikingRN on Dec 22, '07
  8. by   MrsCannibal
    Quote from HM2Viking
    (He also cathed himself during kills classes.)
    Ewwwwww. :spin: That is dedication (or crazy?)!!!!
  9. by   classicdame
    you just need practice. Perhaps you could bring this to the attention of your staff educator. I offered IV cert classes for LVN's and several RN's came on their own volition. We are not born knowing this stuff!
  10. by   fultzymom
    Our policy for a new grad is that an experienced nurse has to watch the new nurse attempt x3 to make sure her technique is correct and to make sure they know the policy et procedure. When I first graduated, I made sure that everyone knew that I wanted to try to insert them first so that I could get lots of practice so that I could get good at them. I always took an experienced nurse with me until I got comfortable doing them by myself--even after the three required sticks.
  11. by   Davefrank
    Hi I am a medic in the Army and like anything else I believe you have to allow yourself to try it at least a few times. You will do just fine, even if you do not use this skill very often it is something, you can benefit from it by knowing how to give an IV.
  12. by   CoffeeRTC
    No. A new grad shouln't be expected to start IVs all the time in LTC. YOu should be able to recognize the steps you need to take, but hitting the vein and getting it started is another story.

    I've been 10+ yrs in LTC and like to think I came from one of the best nursing schools in the area, but that and a bag of chips will get me what?

    Practice and actually doing things is key. Everyone mentioned this already, but here is my story. As mentioned, I've been doing ltc for yrs, for the last 7 or so its been p/t so I don't get the opportunity to start IVs or draw blood often. When I do, I will try it. Just this weekend I got to do a few labs and hit every single one of them!! Man...the little things make you happy.

    Just do it!
  13. by   RNperdiem
    In a nursing home, there will be limited practice on IV's. Don't be too hard on yourself and be willing to try it before calling the charge nurse.
    On my first job, a couple of LPN's were the best with IV's.
    I also bow down to the amazing IV skills of the paramedics I have encountered. I saw a paramedic a couple of weeks ago put an IV into a convulsing 5 year old in the back of a dimly lighted ambulance and made it look easy.