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

Specialties Emergency

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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

Specializes in RN.

Much good,advice here! Thanks! Sometimes I'm ON, sometimes I'm OFF, with no explanation. One day I'll get the hard sticks, the next day I'll miss a huge pipeline.....or what really seems to haunt me are the Valves!! I have had patients with huge veins, you get right in, and then there is a valve and there is no way to advance the catheter....unless I am missing some secret to this.

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Much goodadvice here! Thanks! Sometimes I'm ON, sometimes I'm OFF, with no explanation. One day I'll get the hard sticks, the next day I'll miss a huge pipeline.....or what really seems to haunt me are the Valves!! I have had patients with huge veins, you get right in, and then there is a valve and there is no way to advance the catheter....unless I am missing some secret to this.[/quote']

The notorious valves! I would love to know if there is any way around this?

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More updates for me. I'm doing a lot better on my IVs. I'm getting more wins and while I still get loses, it's hard stick loses that the senior nurses have trouble with.

Before I stick a patient. I always tell myself

"Track from far" - pull back

"Land swallow" - low low angles

"Advance and pull" - advance cath and pull back on the needle.

"Rule of thumb" - apply pressure at the tip of the cath"

And I'm still learning and I still want more experience!

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The notorious valves! I would love to know if there is any way around this?
Sure... float it in with a saline flush.
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Sure... float it in with a saline flush.

I never knew that! So just slowly push 10ml or less and advance the catheter?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
I never knew that! So just slowly push 10ml or less and advance the catheter?

Yep. It's worth a try before pulling the catheter and trying again. :) It'll work every now and then.

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I never knew that! So just slowly push 10ml or less and advance the catheter?
That's the idea.

Also, the vein will sometimes spasm and prevent you from initially advance the catheter. Sometimes just backing the catheter out a bit, pausing, and then advancing, will let you seat it.

Another thing that you learn from doing ultrasound guided starts: Sometimes you'll pop through the back of the vein - so you get a flash but can't advance. Sometimes just backing the needle out a bit will bring you back into the lumen and let you place the catheter.

IVs take a lot of practice on a lot of different veins in order to get good at them. You can learn a lot by watching others and by watching/using ultrasound but ultimately, you just need to poke 'em.

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When in doubt, go IO!

Just kidding. :D But in traumas/codes, it's great!

Go IO... and then grab the ultrasound and take a couple minutes to look deep for what can't be palpated or visualized.
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That's the idea.

Also, the vein will sometimes spasm and prevent you from initially advance the catheter. Sometimes just backing the catheter out a bit, pausing, and then advancing, will let you seat it.

Another thing that you learn from doing ultrasound guided starts: Sometimes you'll pop through the back of the vein - so you get a flash but can't advance. Sometimes just backing the needle out a bit will bring you back into the lumen and let you place the catheter.

IVs take a lot of practice on a lot of different veins in order to get good at them. You can learn a lot by watching others and by watching/using ultrasound but ultimately, you just need to poke 'em.

Good trouble shooting tips i never knew about.

I'm wondering, if I need to draw labs after inserting the IV, would advancing the catheter with a saline flush ruin my blood samples?

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Specializes in ER, ICU.

If you mean by master... never missing? Apparently more than 15 years cuz I'm still trying. But, you will need to a lot of them before you get pretty good. Keep going...

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A couple other pieces of wisdom:

1) Especially on old folks with tissue paper skin and fragile veins, you may need only a very loose tourniquet or no tourniquet at all.. in order to not blow the veins.

2) In a pinch... there is usually a vein just medial to the brachial artery in the AC which you can hit blind sometimes.

3) Look for superficial veins high on the arm, on the chest, or breast... often can get a 22 in there

4) Any access is better than no access... you can push ACLS drugs through a 24 if need be

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Good trouble shooting tips i never knew about. I'm wondering if I need to draw labs after inserting the IV, would advancing the catheter with a saline flush ruin my blood samples?[/quote']

I always draw a tube or 2 to waste when I have to flush with saline first.

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