Getting the hang of IVs...

[SoldierNurse22, BSN, RN]

I got spoiled.

In my first job as a nurse, I worked an oncology unit at a massive medical center in DC. Our patients, frequent flyers for treatment and follow-up therapy, almost exclusively had PICCs, ports, Hickmans--a quasi-permanent-type central catheter of some kind that allowed for quick, easy access into the venous supply. If you somehow managed to sneak onto our floor without one, you were soon given one, whether to ease the difficulty with PIV starts in oncology patients or to lessen the chances of extravasation when IV vesicants were used.

Now a clinic nurse who works in two areas that require PIVs, I've struggled since early this year to get the hang of starting them. My close coworker, Amelia*, a nurse who is quickly approaching retirement, is my teacher and avid supporter. Amelia could start an IV blindfolded on a rock with both hands tied behind her back.

For months and months on end, the technique has eluded me. I've watched, tried, failed, and tried again. The quiet anxiety of knowing that I'll have to go into work the next day and start and IV has lingered over my shoulder this whole time, but the deep desire to master this unique skill--to be "that nurse" who can get IVs into even the most elusive, evasive veins--has driven me beyond the anxiety and just. keep. trying. Amelia promised me that's the only way I'd figure it out.

Two weeks ago, I got one--first try, on a patient I had known as a friend, and after vacation, no less. Buoyed by the success and with Amelia out of town on vacation herself, I started a second on a new patient. Third. Fourth. Fifth. This week my record broke, and another coworker had a try at a patient who has been getting IV therapy for over 10 years and whose veins, fragile from constant abuse, I could simply not convince to hold a catheter.

But that's not the focus here. The focus is that I seem to be developing that confidence, that unspoken technique that I've seen older nurses exhibit when they start IV lines. Unflappable, unstoppable and undeterred by failure, I've watched coworkers land lines in the most difficult of patients and wondered...how do I get there?

For everyone who has ever asked that question, I bring you good news from the other side of the problem.

For the pre-nursing students who worry about this issue, for the new nurses who are wondering the same, and for nurses like me, who struggle with a certain skill, the answer is the one we all dread: practice.

Perform that skill every chance you can with as much confidence as you can muster, and accept advice and assistance from more experienced coworkers. You may be the nurse who can't quite figure it out now, but you could become the nurse who someday teaches others if you just keep trying!

[bagface]

Awesome!! Congratulations on your new found skill.. I hope to be there too someday!!

[MassED, BSN, RN]

I got spoiled.

In my first job as a nurse, I worked an oncology unit at a massive medical center in DC. Our patients, frequent flyers for treatment and follow-up therapy, almost exclusively had PICCs, ports, Hickmans--a quasi-permanent-type central catheter of some kind that allowed for quick, easy access into the venous supply. If you somehow managed to sneak onto our floor without one, you were soon given one, whether to ease the difficulty with PIV starts in oncology patients or to lessen the chances of extravasation when IV vesicants were used.

Now a clinic nurse who works in two areas that require PIVs, I've struggled since early this year to get the hang of starting them. My close coworker, Amelia*, a nurse who is quickly approaching retirement, is my teacher and avid supporter. Amelia could start an IV blindfolded on a rock with both hands tied behind her back.

For months and months on end, the technique has eluded me. I've watched, tried, failed, and tried again. The quiet anxiety of knowing that I'll have to go into work the next day and start and IV has lingered over my shoulder this whole time, but the deep desire to master this unique skill--to be "that nurse" who can get IVs into even the most elusive, evasive veins--has driven me beyond the anxiety and just. keep. trying. Amelia promised me that's the only way I'd figure it out.

Two weeks ago, I got one--first try, on a patient I had known as a friend, and after vacation, no less. Buoyed by the success and with Amelia out of town on vacation herself, I started a second on a new patient. Third. Fourth. Fifth. This week my record broke, and another coworker had a try at a patient who has been getting IV therapy for over 10 years and whose veins, fragile from constant abuse, I could simply not convince to hold a catheter.

But that's not the focus here. The focus is that I seem to be developing that confidence, that unspoken technique that I've seen older nurses exhibit when they start IV lines. Unflappable, unstoppable and undeterred by failure, I've watched coworkers land lines in the most difficult of patients and wondered...how do I get there?

For everyone who has ever asked that question, I bring you good news from the other side of the problem.

For the pre-nursing students who worry about this issue, for the new nurses who are wondering the same, and for nurses like me, who struggle with a certain skill, the answer is the one we all dread: practice.

Perform that skill every chance you can with as much confidence as you can muster, and accept advice and assistance from more experienced coworkers. You may be the nurse who can't quite figure it out now, but you could become the nurse who someday teaches others if you just keep trying!

I hate Mediport access on onc kids. HATE them. Hate hate hate them. I wonder if we accessed these all of the time if the technique would be easier to always get blood.... but it stresses me out! Anything else (well most other things don't bring me that anxiety, I should say), no problem.

[SwansonRN]

Awesome!! I, too, am spoiled with central lines so I have good days and bad days with IVs. Sometimes I have so many bad days in a row that I question if I should even be a nurse (Drama queen right here). My favorite memory about putting in an IV was a few months ago. I was floating to a unit where almost nobody has a central line and usually the patients only have 1 peripheral IV. My pt was getting a blood transfusion and looked at me wearily and asked "why is this burning my arm?" He already knew what was coming as I unhooked the blood and started assessing the IV. He started venting that he was such a hard stick and he hated needles and that it took 4 nurses to get that IV etc etc. I had a new one in that arm in within 2 minutes, first time. He was so happy and relieved he called the manager in the room to tell her how pleased he was. I felt like a champ :)

[canned_bread]

Thats awesome, you wrote that so eloquently!! I was told that the key to placing IV's/cannulas is confidence.

[midmichiganRN]

I hate Mediport access on onc kids. HATE them. Hate hate hate them. I wonder if we accessed these all of the time if the technique would be easier to always get blood.... but it stresses me out! Anything else (well most other things don't bring me that anxiety, I should say), no problem.

What is your problem with the access? Are the kids wiggling too much, or is it just accessing itself? I am pretty good at mediports and wouldn't mind helping you if I can.

[FireMedicFlightRN]

The key to IVs is patience. Especially in the hospital setting where time is not always critical. I have been a medic for almost 10 years now working FD on the street, ERs, and now in the air. Working in the ER was the best way to dial in my IV skills since every Tom, dick, and Harry will get labs drawn. In this environment patience and confidence are key. Try to use 2 tourniquets if needed. Nice little trick. And when you get good at them by visualization, then work on them and get good at them by feel. That is one skill that I can say I have extreme confidence in. You will be fine. Good. Luck.

[nrsang97, BSN, RN]

Absolutely right practice, practice, practice. As well as patience and confidence. If you walk into a room and before you even look at the pt and think "I really suck at this" then you will. Every new grad that calls me to do an IV asks me why I am so good and I tell them practice makes me good.

[~Mi Vida Loca~RN, ASN, RN]

Good for you, I used to be nervous too, especially on hard to stick patients. I LOVE doing IV's, I probably do about 30 a week because people come to me now to do theirs as well. Same with accessing ports. I got one in a thumb. I also did my first EJ. I twas awesome. I have patients all the the time that would start requesting me to get theirs. A lot of it was just building my confidence and no longer doubting I was going to get it. Congratulations!

[HeatherGurl84]

Thank you for this.....I have always had such stress about learning venipuncture but I need to be confident and realize that everyone was a beginner at one time.

[OfficerRNBSN]

Patience, persistence, practice.

Develop a method of doing them, don't worry about doing them quickly or looking cool doing it (it's ok to use two hands), keep doing it even if you become disheartened or when the patient says "that hurts" or "get someone who knows what they're doing," and keep doing it. There'll be ruts when you can't get one to save your life (or someone else's, lol), and you'll reach pinnacles where you can stick anything others have failed on. Just keep doing it.

[jennyx33]

congratulations! As a new grad myself, I hope to one day be "that nurse" as well.