How was your first time poke?

Orca, ADN, ASN, RN · Oct 2, 2009

A couple of first stick stories: First, my first injection. I was on my OB rotation in nursing school. I checked my patient's orders and she had an AM injection scheduled. To top it off, the order was written in grains. Fortunately, being a conscientious student, I had my conversion table with me and I figured out what she needed. Now the moment of truth: Time to stick her. She was on a mag sulfate drip (she had been preeclamptic) and she barely knew what I was doing. I'm sure she has no recollection of what was a big moment for me. I remember thinking, "At least if I screw up, she won't know it." It helped to take some of the pressure off.

My first IV start: I was on an orthopedics rotation, and I knew that sometime before the end of the shift I would have to attempt my first IV stick. My clinical instructor came to get me. The patient I was to stick was a young, rather heavy woman. I applied the tourniquet and searched for an IV site. I found one small stretch of vein proximal to her right wrist. I thought, "It's this or nothing." I inserted the catheter and got a flash, taped down the cath and flushed. The vein wasn't blown, so I hooked up the IV tubing and turned on the pump. Only after I finished did my instructor tell me: four nurses on the floor had tried unsuccessfully to start an IV on this woman. Beginner's luck, I guess.

As far as it being easy - it will be once you gain experience. You will be a bit nervous until you get used to it.

chevyv, BSN, RN · Oct 2, 2009

I swear it's an art! I've landed probably half of all my starts. Veins role, some are big and useless, some are so small and move no matter what. I get a bit frustrated but we all have to start at the beginning. I have a difficult time picturing the vein underneath the skin when I can't see them good. I'm very touchy feely but not when it comes to veins

I know it will come in time. The same will be true for you.

lina.561 · Oct 2, 2009

Thank you so much for replying to me. I like to know all I can. I'm very nervous about it and I hope I get over it, unlucky for me, I have hyper hydro sis which means my hands sweat uncontrollably especially when I get nervous about something...I hate it! You can only imagine what I go through during an interview.

So Hopefully I'll be wearing gloves when I stick someone. Oh and another thing, do CNA's have to stick much? I remember when I was in the hospital for dehydration the CNA Lady took my blood.

scootertrash nurse · Oct 2, 2009

The first time I stuck somebody was a Z track and the needle looked to me like it was a mile long but be confident when around you patients. On IV's look before you stick what I mean is that I get called on to start IV's on people that other nurses have already tried and all the good veins already stuck and the people look like a pin cushion so take your time look patients feel better and more assured and in your unit tell fellow nurses that if they have an iv to start is to call you even if you can see the vein start feeling the vein by touch also dark skin/ lite skin - young /old , diabetics , renal etc... ask to start all iv

roser13, ASN, RN · Oct 2, 2009

Ditto to the previous poster....you MUST demonstrate confidence in front of your patients. If they think (know) that you're a rookie, they will flinch easier, watch you like a hawk and worse, they will tense up.

I learned early on that a tentative poke will never work. Once you commit to a vein, you must stick it assertively.

Orca, ADN, ASN, RN · Oct 2, 2009

Ditto to the previous poster....you MUST demonstrate confidence in front of your patients.

On an IV start in nursing school, before I stuck the patient he asked me if I had done this before. My reply was "A time or two." The patient smiled, confident that I knew what I was doing. He had no idea that I was being totally literal about my answer. He was my third stick - ever.

CharlieT · Oct 2, 2009

"I learned early on that a tentative poke will never work. Once you commit to a vein, you must stick it assertively."

I agree with roser13, see it, go for it, and show no fear. I learned to start IVs in the pre-hospital setting, when the patient's lives were often on the line. Just seemed to make it easy for me, because there was no hesitation or thinking about it long enough to even get nervous. If the patient was awake I would usually say "OK you are going to feel a stick, I'm going to count to three, here we go, one, (stick them) three. That way you catch the patient before they tense up. That's just the way I do it, you will develop your own routine. Veins are actually bigger than they look, you can only see a small piece of the top of the vein on most patients. People with NO fat normally have veins that you could hit blindfolded. Practice will help and normal injections are a piece of cake. You will spend some time in school giving injections to a pad made for this purpose or an orange or a lemon. For IV practice there is a fake arm. It's really no big deal, just one of many skills that you will learn and practice. Check out youtube.com for videos. You could look into taking a phleb. class at a local community college in order to rack up some veinipunctures on real patients. I think that you are mistaken about a CNA doing sticks unless this CNA had additional training. I have only seen blood draws done by students, phlebs., paramedics, and nurses. I have only seen IV starts done by students, EMT-I's, paramedics, and RN's.

Good luck with school!

Charlie

CathyLew · Oct 2, 2009

I agree with the poster above, it is an art. And you never know if that will be your true forte, or if you will be so-so at IV's and really good at something else. and even if you are very good at it, we all go thrugh dry spells... when you haven't missed an IV in weeks, then one day, you can't get a single one!

I used to work with animals in a Lab, so I am very good at fragile old veins... veins on the elderly are just like Rabbit ear veins. So I used to be the go-to person for the dehydrated 99 year old lady from the nursing home.... but kids, forget it! I won't even attempt a pediatric stick.

and to tell the truth, my track record on co-workers stinks! Also I don't like a crowd in the room when I start an IV.

One word of advice, if you are only trying to start IV's in the hospital setting, on sick dehydrated people who have had numerouse sticks, and most of their veins are blown...ask to work in Ambulatory for a day. Starting IV's on healthy people just comming in for same day surgery can be the boost a new nurse might need. Those people actually have veins to aim for!

TiffyRN, BSN, PhD · Oct 2, 2009

I don't remember much about my 1st IV stick, which was in nursing school. All I remember is that I got my first one ever, then had a long dry spell of hitting like 20% of my attempts, then eventually got good at it.

My first IM injection as a nursing student was an IM pain med. I had some experience giving injections to my dog, but they were a different technique (SQ fluids). So I had confidence to go ahead and jab the needle well, but I forgot to pull back and I thought my nursing instructor was having a seizure! The patient was prone so she couldn't see us and the instructor was trying to get my attention to stop and pull back on the plunger, which I did and the overall injection went well. Eight years later, after years of doing that routine thing of pulling back on the plunger, I got a syringe full of blood!! Proving there are good reasons for all those steps they have for proper technique.

Also, my first female foley cath placement was on a obese, contracted, trach'd and vented patient. We had to do the insertion from behind, I couldn't really see the landmarks, but somehow, I got it in the right place and urine flowed down the tubing.

Lala27poodles · Oct 2, 2009

How about at the age of thirteen when I pierced two of my friend's ears, and my belly button lmao!

Needles have never scared me, and I love sterilizing things.

Lacie, BSN, RN · Oct 3, 2009

My first injection was a SQ Morphine to a little lady that probably didnt wiegh 70 lbs due to CA. I asked my instructor if I could please administer it to her thigh area since her arms were sticks with very little SQ to grab onto. Instructor of course says No I had to give it to her right arm. As I did and gripped the tissue of her arm, gave the injection, I felt a prick in my finger on the other side!!!! Of course immediately pulled the needle back out with blood running down my own finger. I had gone in and out the other side into my own. I was so embarrased.

IV's actually were much easier for me as at EKU they made us learn to do IV's and IM's by practicing on each other in the nursing lab. So by the time I got to pts, it wasnt so bad as we can be each others worse critics. I learned very quickly to go by what I could feel and not always the obvious of what I could see. You'll do fine, it takes time but before long you'll be a pro!!