Published Sep 19, 2013
RunawayN
284 Posts
Hello Everybody
I just started my first nursing position at a ED of a hospital and things are great but I am having the hardest time inserting IVs in patients. I have been reading so many forums about the subject on this board but I never learned how to put in an IV in nursing school, the hospital taught me how to do it last week, and this week, I only had two successful IVs out of eight.
My coworkers say it just takes practice but my question to you is
How long did it take you to become an IV master?
and How fast can you put in an IV in an emergency situation?
And any personal tips would be greatly appreciated
Sassy5d
558 Posts
Keep doing it. Offer to stick the pts not assigned to you. Watch the different techniques of ur coworkers.
Seriously, just keep sticking just keep sticking you'll get it.
Btw, some days you get em all, some days you miss em all and somedays ur sharp shooter misses and u get it
Guest219794
2,453 Posts
When I started in the ED, I asked a medic buddy the same. He responded: "Yeah, the first few hundred are a little tricky". If you had never had a basketbal in your hands, imagine how many tries it would take to reliably sink a foul shot. And that basket isn't 86 years old or dehydrated.
My tip? Do as many easy sticks as you can. Ask your coworkers for all their easy sticks. This will improve technique and increase confidence far more than flailing on the tough sticks. If you don't think you have a reasonably likelihood of success, get help.
zmansc, ASN, RN
867 Posts
I'm with hhern on this one, take all the easy ones to build up your proficiency and skill level. But if they are a hard stick and someone else is available, let them do it for now. It will help your confidence and keep the patient from suffering while your in your learning phase. Once, you get more proficient, you can start to take on the harder stick patients.
I remember when I was learning, this is the approach I took. One day a medic who always got IVs on his patients came in with a patient and said "I tried him twice, and couldn't get either, I've got another call or I'd stick around and start one for you..." Everyone in the ER was slammed, and I needed an IV. I took my time, mostly hoping I would find some vein for someone else, but I found one that I was sure I could get. I poked him, and got it on the first try.
Even today I would not consider myself an expert, I'm very proficient, but not an expert. Experts have 10+ years on me! Like any skill there are those who are better at it than others. Remember most home run hitters suck at pitching and most pitchers suck at hitting. Both skills, both excellent athletes, but rare that a player is good at both. I'd much rather be great at assessments and ok/good/proficient at IV starts than the other way around.
Belle2013
133 Posts
Just do lots and lots of IV starts! I've been in the ER for about 3 1/2 months and I'm getting 9/10 starts now and even having success on hard sticks like those who are chronic dz or former IV drug users. The more you do the more success!
Fire Bird
42 Posts
Hey I'm in the same boat! I started in a Peds ER not too long ago, and the one thing i was nervous about was IVs. Well, I watched my preceptor put in a bunch of IVs. Then, I started doing the IVs for all our teens (my first one was on a pregnant pt). I just stuck my first febrile neonate yesterday and was 7/10 on IVs yesterday. It really takes watching people do it then doing it yourself. When I'm assessing for a good vein, I apply the tourniquet, rub the area with an alcohol swab(superficial vasodilation), and lower the extremity to increase blood pooling in the vein if I need to. When I go to stick, I only focus on the stick. I don't talk to the pt or the family or think about what I have to do in the other room. Only focus on putting that needle into that "tunnel" aka vein. When you get flash, pause. Advance the catheter slowly, withdraw the needle, apply the t-connector and flush/draw. No need to practice on your friends, get all the practice in at work. And yes, I did sweat alot the first 20-30 times I tried sticking. My first day sticking I was 1 for 5 on successful attempts. But that 1 that I got held for the next few days they were in the hospital once the pt was admitted. Everyone is going to say "you wont be able to get my vein because blah blah said my vein does blah blah blah." Don't listen to that, just get that little plastic catheter in their vein. Hope that helps a little!
ezgreazin
32 Posts
palpation is a better indicator than visualization...keep trying...you don't learn nearly as much on a successful start that you do on a line you blow...learn from each mistake, evolve your technique
I've actually been trying to improve on my palpation IV starting but it's taking me a while especially with those patients with thicker or a lot more skin. Hopefully I get it.
But I understand what everybody means and it does take patience. Honestly, I think I only stuck around 10 patients so far. Hopefully tomorrow is better
itsnowornever, BSN, RN
1,029 Posts
I prefer to stick what I feel as opposed to what I see. They are sturdier for the most part and less likely to blow. You'll get the hang of it. We have days that even our best can barely get a 22in a thumb and then you hydrate as best you can and look for something bigger. Then you have days where you are contorted, reaching around a firemans leg while be smashed by the doc leaning over you and have only feeling to go by the verbal direction of said fireman when you've got a flash- those are the awesome days.
Posting from my phone, ease forgive my fat thumbs! :)
Armygirl7
188 Posts
And that basket isn't 86 years old or dehydrated.
:laugh:
So true!
Ditto all the good advice here. You'll improve with each stick Runaway. There's no getting around experience! Keep at it! And as ezgreazin said you learn more from the failures than the successes so accept those lessons without feeling defeated. Dust off and keep your chin up!
Thanks everybody. So far, I am 4 and 13
But I'm still trying to figure out, I get a flash, but when pushing in the IV, I always seem to hit the wall and infiltrate and have to find a different site. Ahhh hopefully this week.
Esme12, ASN, BSN, RN
20,908 Posts
Thanks everybody. So far, I am 4 and 13 But I'm still trying to figure out, I get a flash, but when pushing in the IV, I always seem to hit the wall and infiltrate and have to find a different site. Ahhh hopefully this week.
Oh heavens....this is a skill and it takes time.....the first hundred or so. I'll bet you are trying to float it too soon. advance just a hair further with the needle....then float. Hold the skin beneath the puncture site taut to stabilize the skin and vein.
It's not 4 out of 13....it's..... YOU STARTED 4 IV's!!!!!!!! CONGRATS!!!!!
The first year is the hardest.....((HUGS))