The first time you ever used a needle and/or cath

[Lala27poodles]

Was it frightening? Were you shaky or confident?

I've actually used needles on my friends before, and it was fine. I double pierced 3 or 4 of my girlfriend's ears, and it was pretty cool.

The one thing that I CANNOT move past is the catheter. Especially the male catheter. It just looks so painful, and it makes my skin crawl thinking about it? Do you think I'll ever get past catheters?

What if i turn white and pass out when the teacher demonstrates? Should I watch videos on youtube? HELP?!

[animal1993]

I haven't started an IV on anyone, yet, but I have given many injections. I have also done foley catheters (all female). None of them were too bad. I think if you really know your catheter procedure well, it makes it a lot easier. (And if you are afraid of causing unneccessary pain, just make sure you are quick about the insertion part--imagine how much more it would hurt to insert it slowly!!!) I was really nervous the first time (and I still get a little shaky sometimes), but I had performed the procedure over and over again in lab, so I was confident in my skills. Also, doing a quick run-through of the steps, in your mind, before going into the pt's room helps a lot. As with anything, the more you do it, the more confident you will become!

[leslie :-D]

i found catheters to be one of the easier tasks...

except older men can get a bit tricky sometimes, specifically those with enlarged prostates.

i warn both genders, that it may be "uncomfortable" and will likely "get the urge to pee".

for women, always bring in 2 caths, in event you get wrong meatus.

for me personally, i've never had a problem with the women.

try not to project your feelings, and it will ensure a much smoother operation.

you will get through this.:)

leslie

[Penelope_Pitstop, BSN, RN]

I've been a nurse for three and a half years and I've never started an IV, either. It wasn't part of my school curriculum and isn't required of floor nurses in my health care system. So I can't give you pointers there.

As for needles for injections, just concentrate. Really. Concentrate only on the task. It may make you forget the "gross" part.

I have a tip for catheterizing women - always have a good look at the anatomy you're going to be working with, and remember what parts go where, haha. Don't just start sticking something in blind. Don't be afraid to get out that flashlight, either. A "spotter" usually helps, too. Another nurse to help direct you, and to help hold legs. (I always do "frog leg" position).

There are a lot of scary things we do as nurses. But practicing and observing makes it less scary as we become more competent. I'm not going to lie to you...I still get scared sometimes.

You can do it!

[sonyah]

I was wondering the samething as the original poster. I am contemplating a career change and in the process of taking pre-reqs for nursing. I was a little worried wondering if I would be nervous about IV insertion. Thinking that I would fail the program if I was nervous about it. I don't think I will have a problem with the course work or anything else.

[RunningRNBSN]

I absolutely dread and HATE starting IV's -- I don't know why either. Thankfully I don't have to start them that often. I work in the PICU and most of our patients have lines started by the intensivists or have IV's from ER. If I do have to start an IV, I might try once but am usually unsuccessful. Thankfully there are many nurses on my floor that are very competent at pediatric IV starts.

I have no problems giving injects, doing blood draws, or inserting foley catheters. During nursing school I started a foley cath on an elderly man and he screamed in pain.. I started having an anxiety attack because I thought I was doing something wrong.

Doing these types of invasive tasks will become easier with time though. And you may not get the chance to do a lot of these tasks -- many floor nurses do not get the opportunity to do these types of tasks because patients usually come from the ER or OR with IV's and cathethers already in place.

[chicklet74]

I'm a 2nd level student and I've done a Foley on a man. It wasn't too bad. The hardest part for me was maintaining the sterile field. The patient didn't think it was painful, just uncomfortable. I haven't done one on a female yet. I've given plenty of injections and am pretty comfortable with those so far.

[CloudySue]

I get weak in the knees when I have to give an IM! All I have to do is see it on the MAR that someone is scheduled for one! I've been nursing for about 6 months and I've only done a handful, so I hope I get used to it. I'm sitting here starting to salivate just thinking about it! Ugh!

[SnowStar4]

I do tons of straight caths at work (as a student nurse) and I'll take doing a catheter on a male over a female any day. It's so easy...just one hole. And unless they have issues, there really isn't any pain involved so don't worry. Mostly they feel relieved to have the pressure of a full bladder being emptied. Once you do a couple injections or catheters it becomes second nature. Just tell them to relax and distract them with random conversation. Seems weird to be talking during it, but many people close their eyes and start talking and don't even realize that it is in.

As for injections...once you get over the fear of hurting people, you will be fine. It took me like 2 shots then I was fine. Once a patient tells you "I didn't feel a thing" then you will feel like a rockstar! Even if they do feel a pinch- you might be hurting them for like 2 seconds but you are HELPING them by doing it. The main thing is to ACT like you are a pro. You never want to tell them you are doing your first one, or that you are nervous. Go in there, suck it up, do it, and celebrate in the hallway :)

[diane227, LPN, RN]

If you want to put in a painless foley on a male patient, do the following: Assure the patient is not allergic to lidocaine. Take a tube of Lidocaine jelly2% (you will probably need to get the doc to write an order for this... Just Lidocaine jelly 2% to bedside for foley insertion). Take a catheter tip syringe (the big syringe that you use for NG tubes) and empty the entire contents of the lidocaine jelly into the syringe and then turn it with the tip pointed up, tape it to get the lidocaine down and push the air out to get the lidocaine to the tip of the syringe. Do this with sterile golves on to keep your syringe sterile. Prep and drape the patient for the foley in the usual sterile fashion and place your still sterile syringe with lidocaine onto your field. Get all your equipment ready... foley, prep etc. Once you have performed the penile prep, grasp the member in one hand and pull stright up. You may have to have another set of sterile hands to assist you. Take the sterile syringe with the lidocaine and place the tip of the syringe down into the urethra. Inject the lidocaine. This will numb up the urethra and will also help to open any stricutre the patient may have. Hold the top of the member closed so the lidocaine does not leak out. Then insert your foley up to the hub. If you do not get urine return, flush with 30 cc saline to clear any lidocaine out of the drain ports. Once you get urine return, you can then inflate your balloon and then pull the foley back gently until it stops. ALWAYS insert the foley to the hub. NEVER insert the foley in a male patient only part way, even if you get urine. You don't want to accidently inflate the balloon in the urethra or you will cause a tear. This works for me every time. This is a technique I use for elderly men or men with known prostate problems. On young men, I just substitute lidocaine jelly for the lube in the kit.

[diane227, LPN, RN]

And as for IV starts, I recommend that if you have an IV team at your facility that you ask to spend time with them or in pre op holding with the nurses and anesthesia there. You will get good practice.

Two hints: When you have a very elderly person, veins are fragile, I don't use a tourniquet. I have them hang their arms slightly off the side of the bed and start that way. Using a tourniquet can result in increased back pressure and can cause fragile veins to blow.

Also, try to start at a lower point and work up if you can. You should never try to start an Iv below a site where you have already stuck someone. Also PLEASE avoid the AC if you can. Otherwise you will have a non stop beeping pump all day and night.

And you just have to jump in there and do it. It was hard for all of us at first. But once you do it a few times you will get the hang of it.

[dnp2004]

Take the sterile syringe with the lidocaine and place the tip of the syringe down into the urethra. Inject the lidocaine. This will numb up the urethra and will also help to open any stricutre the patient may have. Hold the top of the member closed so the lidocaine does not leak out.

One of the most common mistakes, even make by experienced clinicians, is forgetting to hold the member closed for at least 4 minutes to allow the lidocaine to actually work effectively (numbing and opening strictures). At the facilities I ran the use of lidocaine was SOP. Even then I had to make sure my staff would not attempt to insert before the lidocaine had time to work (expect in emergencies). I found the proper use of lidocaine also tended to make insertion easier because many patients would not tense up nearly as much as they would when the plain lubricant was used.