I cant start IV's!

[Creamsoda]

Ok, so ive been a RN for almost 4 years. Mostly in ICU. We dont start IV's often. So therefore, I am awfull at them. I mean horrible. Ive probably tried maybe 15 times in the past 3 months and have gotten 2. Thats pretty routine for me. The problem is I am starting a new Job in a large trauma emerg and I am worried that ill never get good. Im worried about having to start IV's quickly when I cant start them at the best of times. Im thinking im going to ask to shadow the IV team or something in the hospital because I cant work emerg and not start a stupid IV. did anyone else have this problem and get any better?

[Elvish, BSN, DNP, RN, NP]

I would not say that starting IVs is my favorite thing to do, nor is it something I do on a regular basis...but I have gotten better at it as the years have gone by. I had never ever started an IV in nursing school (sim lab doesn't count!) and was a RN for about a year before I started one succesfully.

This may come as a surprise, but working at a rural community health center gave me more IV practice than working on a med/surg as a new grad! At the CHC, the summer months brought an onslaught of migrant farmworkers (our focus patient population anyway) with a) GI illnesses gotten by drinking dirty water; b) green tobacco sickness; or c) HHNK.

So....they all got IVs. There would be some days we'd go down the hall starting IVs and running fluids in everybody (tobacco sickness, especially, as the guys would come in in groups).

The first few sticks were really embarrassing, especially because these were healthy folks with garden hoses for veins, and I blew them! My supervisor kept on me to keep working on it, keep doing it, and you'll get it. And guess what? She was right.

There is a certain level of a) confidence; and b) psychomotor skill/muscle memory that one has to have before being able to 'get' IVs with any sort of regularity. That takes longer for some than for others, but if you keep at it, you will eventually get it. :)

I work on a mother-baby/antepartum floor, and we don't start a lot of IVs there. I will say this, though - for me, it's far easier to start one 'under the gun', so to speak, than when I'm relaxed. (A previously rock-solid antepartum whose body decides it's time to go *now*, or a bad postpartum hemorrhage, for example.) Maybe it's because muscle memory takes over rather than the higher brain trying to 'think it through' too much.

[TexasER_RN]

Just a technique that helped when I first got started......if you have access and your employer doesn't mind, use drip tubing, foam tape and betadine/water in a syringe.......tape the drip tube to a mayo stand covering tubing with foam tape.......gives a great "vein" have someone else put betadine/water in tubing and start an IV in the tube.......gives you a feel for veins and flashes like blood in the IV needle chamber........sounds silly but works until you get a feel for the equipment!!!!!!! Hope this helps

I'm in pre-nursing and would like practice before NS next semester.

Can you simplify the tubing example and where I could purchase the items?

Thanks.

Maybe through a medical supply company and it is IV drip/gravity tubing........but if you are getting ready for nursing school, just enjoy the time you have off before you start.......you'll get what ya need when the right time comes!!!:loveya:

[southernbeegirl, BSN, RN]

my husband says i'm not happy unless i'm sticking a needle or tube of some kind in someone, lol.

i've worked in geriatrics for 14 years(with one short run in a hospital). i think i've been lucky but i've had tons and tons of IVs/blood draws to do. i almost always get them on the first try.

know what i think helps me the most? my gift of gab. i really have found that if you go in a room projecting confidence (even when you dont feel it) that it helps put the patient and family at ease. we've all heard the "i'm a bad stick, they can never get my veins, i hope you are good, you only get 1 shot at this" type stuff. i always tell them "yes, i'm a great sticker. thats why they asked me to come in here. i'm the one they call when someone is hard to stick" . of course, that is total crap but it really works for me! it puts them at ease with me and then thats half the battle.

i also will spend quite some time looking for the appropriate site before i try a stick. i might look for 10 minits but then can usually get it in one try.

a trick i learned that helps me the most clinically is one i learned here on allnurses.com. i use a BP cuff as a tourniquet on many of my patients. it works so great! i also take a warm towel with me to wrap their arm with so distend the veins. i couldnt do without those two tricks in my orificenal.

and everyone here is so right. practice, practice, practice! you really do get better with every stick. before long...you'll be running around sticking everybody!

[southernbeegirl, BSN, RN]

EMTs here can get IV certified, I know a woman who is.

our EMTs can start IVs here too. and i'm not above asking them for help if i cant get someone and they are in my building either.

i saw where you posted you can draw ABGs. thats something i've never done but would love to try.

[nghtfltguy, BSN, RN]

damn icu nurses!!!

j/k

you CAN start iv's...... your just out of practice

i would bet money that you just get too nervous...... calm down... relax..

i know you can start iv's...... and you know you can too!!!

[nghtfltguy, BSN, RN]

dont go into a room with the attitude that you can't start a line.... go in there with the attitude that you invented it!!!....you will be ok!!!!

[LovingOBFutureFNP]

Two helpful hints:

1) When I was a new grad, I would find a great, bouncy vein and would aim right at it. I blew several veins before a fellow nurse saw what I was doing and gave me a tip. Don't START the IV in the best part of the vein. Remember that it's where you want your catheter tip to end up. Start below it by a bit.

2) If you have to choose between starting an IV in a vein you can feel or a vein you can easily see, definitely choose the one you can feel.

After starting several IVs per shift, you'll be a pro before you know it! It didn't take long to learn to place IVs in the ER... I sure do pity my first few IV patients when I return to the hospital this summer from a year of school nursing though! Stay encouraged. :)

[MissDoodaw]

I imagine you'll be with a preceptor or an ER unit educator -let them know. There are probally nurses or techs there willing to let you atart IV's on them and walk you through it. You'll get it eventually!

Good Luck!

[Roy Fokker, BSN, RN]

Our hospital frequently sends people to our ER when they want practice starting IV's. They just wander around and when we have a patient that needs an IV we let them try to start it.

This would be my advice as well :)

cheers,

[natusia84]

It was a challange when I started working in the NICU and my very first IV was on an infant!! It takes time and patience be be able to feel not just see the vein. But once you know what a vein feels like and slowly advance the catheter, with practice...lots of practice, anyone can do it:) good luck!

[Jennifer, RN]

I agree, lots of practice, and working in an ER, you will get many chances to practice. I was really bad at starting IVs when I first started working in the ER 4 years ago, but have since become much better, though I am, by far, not the best stick in my ER. Remember, you work as a team in the ER. Someone will have your back, and if you are in a situation where you need and IV quick, there is usually someone there that can step in to attempt an IV if you can't get it.

I know how you feel, though. This was one of my biggest stressors when I first started working in the ER. I used to frustrate me so much to not be able to start an IV successfully, after having been a floor nurse for 5 years before transferring to the ER.

Good luck, and, remember, practice, practice, practice. Try first, and only ask for help if you can't get it after 2 trys.

[star77, MSN, RN]

...I was really bad at starting IVs when I first started working in the ER 4 years ago, but have since become much better, though I am, by far, not the best stick in my ER. Remember, you work as a team in the ER. Someone will have your back, and if you are in a situation where you need and IV quick, there is usually someone there that can step in to attempt an IV if you can't get it.

I know how you feel, though. This was one of my biggest stressors when I first started working in the ER. I used to frustrate me so much to not be able to start an IV successfully, after having been a floor nurse for 5 years before transferring to the ER.

Good luck, and, remember, practice, practice, practice. Try first, and only ask for help if you can't get it after 2 trys.

Thank you so much. I'm a new ER nurse and I feel like I'm bumbling because of my IV record. I keep trying, no matter what, 2 sticks per patient, and some days are better than others, but I'm working hard to not let it be a complex.

The worst is the feeling: "I can't start the IV. If I can't start the IV, I can't work in the ER. If I can't work in the ER, I'm going to lose my job..." commence downward spiral into despair.

One month of doing this. My record is already getting better, but it's slow progress.