How long did it take you to master inserting an IV?

floridaRN38 · Oct 9, 2013

You just get Better with practice. If there is a really hard stick to do. Watch the nurse or medic that is able to get it in and their technique.

floridaRN38 · Oct 9, 2013

Go for the AC or forearm. Even though the floor nurses don't like when u use the AC

forgop · Oct 9, 2013

Go for the AC or forearm. Even though the floor nurses don't like when u use the AC

In the ER, it's always best to use the AC in the event they might need a CT scan with contrast or get phenergen. It's a no-brainer if it's available.

Nursepreneur · Oct 9, 2013

totally agree. takes time and once you can drop a line on a level one trauma one everyone is looking at you, because he still doesnt have iv access, BOOM you nail it....gives you a special feeling inside..

It will come.

EmergencyRNBSN · Oct 13, 2013

It took me probably 6 months to get 80% of my patients without asking for help.

1.5 years to become so annoyed with myself that it physically hurt my ego to have to ask for help.

Now at 2.5 years, I'm the guy that gets sent up to inpatient floors to try when numerous people have failed (No PICC team at night and the patient doesn't need a CVC).

It just takes time and always paying attention to other people's techniques. I just changed jobs recently and it made me better to see a new set of people and their techniques with it. Just keep plugging away. It will come.

ron27 · Oct 17, 2013

it takes time but i'm pretty sure that you'll get use to it. The more you insert the more you gain confidence, skills and develop new techniques/

BrooklynRN11201 · Oct 17, 2013

I think I was lucky - it came sort of easily for me - I had a little 1 hour "class" of sorts where I practiced IV insertion and phlebotomy and then started doing it the first day I was in the ED on my externship. The first couple of tries I only felt comfortable with my preceptor looking over my shoulder and giving me tips and also jumping in if I was really messing up (always speak up, people don't expect you to know everything). By the third, my preceptor told me I had it, walked away and sure enough, I did it on my own from start to finish, BUT I will say, what people say is true.... some days I would be so cocky that I was this little vampire and could get an IV in anyone, even the 60 year old IV drug user, and other days I couldn't get one in anyone, it was embarrassing. Just remember, it doesn't make you a bad nurse AT ALL, it's a skill that you have to kind of nurture a bit and you can only get better by practicing.

For some more practical advice, once you see the flash of blood, do NOT advance the needle further, but instead, gently push the catheter ONLY (with your index finger) further into the vein - 9 times out of 10 it slides in gently because it's more flexible than the needle. If you advance the needle, you'll blow the vein - it takes a bit of time to get used to this since sometimes it seems impossible to advance the catheter if you get the flash very early, but take your time with it, roll it back and forth and it should just glide all the way in if the placement is good.

Another thing, don't do what I did once and forget to remove the tourniquet once you get the thing in! I had a poor anemic woman who just kept pushing blood out of the vein and I was having the darndest time flushing the line... oh wait, the tourniquet is still on? um, yeah, bonehead moment, but I'll never do that again.

Lastly, use a chux to catch blood because out of the 50+ I've done so far, only a few of them have been clean to the point of no blood drops - you don't want to have to change the sheets after you're done. Bring extra supplies too, so you're not walking back and forth to the cart and having to change your gloves 100 times.

RunawayN · Oct 18, 2013

I'm starting to realize two big mistakes I'm making.

First, my traction is way to close to the insertion site and as a result, I go in at a deeper angle and puncture the would. I have to remember to apply traction farther away and insert like a subQ but slightly deeper.

Second. When i do get a successful insertion, I'm suppose to apply pressure to the tip of the catheter, not above it! I've been pushing on the vein and then, I always have a pool of blood on the floor.

I think i'm getting this down. A good teacher who can critique is amazing to have!

Emilynn09 · Oct 28, 2013

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

Tell everyone that you want experience doing IVs. Ask them to come get you if you have the time, and let you do the IV. Do as many as you can! Seek out opportunities. The only way to get better is to practice practice practice!

Kipahni, RN · Oct 28, 2013

ask your manager if they would let you follow an I.V. Team for a couple of hours. or float to infusion center. I learned to start I.v.'s in my first job at the infusion center giving chemo, by three months doing 13 I.V. sticks per shift I finally got my routine down.

That would also be my other tip, do the same set up every time and the same steps every time that way you practice your success. A vein is a vein no matter where they are- I have put them in baby's heads and old men's feet and women's chest. The main thing is focus on your task (ask the patient a long answer question just to get them chatting but you don't have to pay attention to it just to distract them so that their nervousness doesn't cause their veins to recede into the body or that they jerk away from you) heated blankets are your friend and can really dilate those small veins. And make sure you use the right size needle.

Feel healthy friends and family veins so you understand what a healthy vein wall feels like vs a weak one. (weak ones tend to be very big and easy to see but look like varicose veins have lots of valves and tend to not be straight and will be on the lower periphery of the arms like hands and wrist. Also when to you quickly add pressure to the vein and run your finger down tracing the vein the blue disappears briefly blanching with the rest of the skin only to return to blue after relieving the pressure applied to it) You can try and stick a weak wall as a last resort but use a smaller gauge and float them in.

ogerpus · Oct 28, 2013

Insert the needle, and get a "full" flash. Slowly advance the needle about the length of the bevel. Then advance the catheter approximately the distance of the bevel. Then advance the entire unit once the bevel has been "hooded" by the catheter. You will feel a "smoothness" in the advance. Then advance only the catheter and withdraw the needle. I assure you that you will not feel a thing!

I'm sure that was confusing, but that is the life in the ED...

Magneshium · Oct 29, 2013

It took me months to 'master' my IV insertion skills, so don't be hard on yourself. And I know it's been said many times in this thread, but really, it pays to be ASSERTIVE! Don't be shy about asking your seniors to help you out or to let you start their IVs on their patients. As many as you can! :) In my case, most of my seniors were happy enough to help me out. Learn from others' techniques, and find out which one works for you.

As for the bloody mess, I usually put a piece of gauze just beneath the hub before I remove the needle/stylet.

As for my technique, usually I prepare just one cannula. I have this mindset that " I don't need another one because I'll get it on the first try". Works 90% of the time. Positive thinking!

Also, don't forget to celebrate the small victories! (Like the shift when you finally get 10/10. :))

Goodluck!