How many failed IV attempts for new grad?

[anononurse]

We are orienting a new grad on our surgical unit, and she has completed an IV certification course. My question is how many failed attempts at IV sticks should be the max? We have asked her to try once or twice & then get one of us, but she will try 3, sometimes 4 times b/f getting help. By the time she gets one of us, the patient is angry & has few options left for an IV. We have gone to the nurse manager & the DON, and were told "well she has to learn- just give her time". I think one failed attempt by a new grad is enough. As a result of multiple patient complaints, I have been asked by the nurse manager to be with her for all IV starts for 2 wks. I am noticing that her technique is horrible & have to wonder whether she ever really completed an IV cert. class. Suggestions?

[mama_d, BSN, RN]

Our facilities policy is two sticks per person. I've gone over that myself a few times, but only if I know that noone better is around. Working nights, sometimes you gotta do what you gotta do!

Maybe you could have her observe you starting a few sticks, or have a collaboration between the two of you as to which vein she'll try to stick. Often it's not obvious feeling to someone with limited experience when a vein is to hard, valve-y, rolling, etc. to be a viable stick. Share your knowledge with her as best as you're able, although it sounds like she may be the kind of person who is not...receptive...to having said input...so you may have to stretch your diplomacy to the max for the patients' sake.

[TexasPediRN]

2 IV attempts max per nurse, then you must get someone else.

On the babies, I do it once - then get another nurse.

She really shouldnt be doing it that many times on anyone - twice is the normal max before seeing a more experienced nurse..

[TopazLover, BSN, RN]

Two, for sure.

What about her technique is bad? Does she know a good vein from bad?

If you doubt, seriously, that she completed the course, can this be verified?

[Eirene, ASN, RN]

We are orienting a new grad on our surgical unit, and she has completed an IV certification course. My question is how many failed attempts at IV sticks should be the max? We have asked her to try once or twice & then get one of us, but she will try 3, sometimes 4 times b/f getting help. By the time she gets one of us, the patient is angry & has few options left for an IV. We have gone to the nurse manager & the DON, and were told "well she has to learn- just give her time". I think one failed attempt by a new grad is enough. As a result of multiple patient complaints, I have been asked by the nurse manager to be with her for all IV starts for 2 wks. I am noticing that her technique is horrible & have to wonder whether she ever really completed an IV cert. class. Suggestions?

We get 2 attempts.

It sounds like you may need to be a bit more nuturing toward the new grad and mentor her on the technique instead of tattling on her to the nurse manager.

Thank goodness for my nuturing preceptor who guided me! I took the cake when it came to the worst person starting IVs. I would have been ashamed and mortified if she had gone to the NM over this-- and I had graduated with my RN!

Just as the new grad needs to be gentle in their technique-- perhaps you need to be gentle with them, too.

[Surgical_RN08]

its a two stick max for any person at our facility new or seasoned. wow she trys that many times before she asks for help. if i try once and know that i cant get it on the second try i will find someone else.

[Ilithya]

The new grad was wrong for sticking more than twice, and I think that she should be reported for not following protocol.

But as a new grad I can't exactly say that I'm an expert at starting IV, it is hard and we do have to have time to learn, so patience is much appreciated. Then again I usually try to find a more experienced nurse to go in with me when I start an IV and I usually ask the patient if they've ever had an IV before and if there was trouble starting it. If they're a "oh they always have to stick me at least 4 or 5 times, I usually end up with a PICC" then I don't even attempt. I know my limitations and try not to put my patients through unneccisary attempts

[AirforceRN, RN]

If it were me...

I'd take her in with me to show her proper technique. Talk through it while you start the IV and make sure she is paying attention. After she has witnessed a couple (and here's the tough part), grab a 24g or smaller, sit down with her and let her start one on you. Walk her through it slowly and correct her as needed. I know this sounds daunting but it allows the new grad to try a stick while under total guidance without completely freaking the patient out.

For you it might be a painful stick, for her it'll be a good learning experience.

[HappyBunnyNurse]

Two sticks should be the max in most situations for anyone new or seasoned.

I have no problem asking my preceptor or most anyone else on our floor for help because I feel comfortable with them and know I won't be judged. Maybe she tried so many times because she felt uncomfortable asking for help. Now she is being watched by someone who reported her to the NM and DON. This probably makes her technique even worse than usual. Maybe you could make her feel more comfortable by telling her some stories about how you learned yourself and using phrases like "here is a trick" " or "let me show you something I picked up over the years" instead of making a big deal out of her poor technique.

:heartbeatI'm really thankful for the folks I work with, they go out of their way to make me feel less stupid and inexperienced. (Even though I know I really am!)

[southernbelle08]

At my hospital, I have never been told you had MAX attempts, honest to goodness! I never stick over twice before I go and get someone else, but that was honestly just based on my own judgment. Nobody ever pulled me aside and said "Only stick twice before you get someone else to try." Even then, sometimes I get snarky replies from nurses about having to go do it for me, but I refuse to stick someone over two times without getting help. Glad to know I was on the right track!!

[ZooMommyRN, ADN, RN]

ours is a 2 stick policy, but depending on the patient I might only try once or in the case of some of our patients that were a nearly impossible stick in ER and IV's have a habit of blowing in their fragile iens every other day- won't even touch it! I'll get it all set up and laid out and get help to actually insert, we've had times where ohers on the floor wouldn't even try and call down to ER for their help

[UM Review RN, ASN, RN]

You might pull a copy of facility policy on the number of IV sticks allowed and talk with her about it and offer to help her get better at starting IV.

Then if she persists, take it up the chain.

Hope she listens. Good luck.