I Caught the IV Yips

[deberdt, CNA, EMT-B]

Hello all,

To introduce myself, I am a CNA/Nursing Student that is working as an ED Technician at my city’s hospital. Recently, I have been noticing many many MANY failed attempts at starting PIV’s in the department. This has been going on now for about a month, where I’ll go into a room, attempt to place a 20G in someone’s tree trunk of an AC, and somehow mess it up. Before this, I had been the one to slap a 14G or 16G into any trauma or critical care patient that rolled into our ED without trouble (except pediatrics and the little old ladies). I’m just wondering if this is normal and if over time I’ll have good months and bad months, or if I should schedule some time with our RN educator and do some extra practice? Either way I’m hoping it’s just all in my head. Let me know if you guys have had similar experiences!

[VivaLasViejas, ASN, RN]

Just curious: where do you work that allows CNAs/techs to start IVs? In my state that is WAY out of the CNA scope of practice, but then I suppose it's different in other states.

Anyway, it is definitely not unusual to go through a dry spell where you couldn't hit the broad side of a barn with a tractor. I call it The Zone: either you're in it, or you're not. I used to go through times when I was in The Zone and I couldn't miss a vein, not even those of a dehydrated, obese LOL. Then there were times I choked and missed a big, fat juicy one on a muscular 30-year-old guy, or blew the only usable vein on an IVDU. It happens to the best of us, so practice, practice, practice!

[Nurse SMS, MSN, RN]

It isn't uncommon for ED techs/EMTs to start IV lines. ?

OP, you are in a dry spell if you previously had been doing them well. Sadly, the more you miss, the more your confidence in shaken and the less likely you are to hit the next one. A little one on one with the educator could be time well spent. So could just spending an entire shift being the go-to person for PIVs. I hope it gets better fast! I personally could NEVER hit the big fat veins to save my life. Put me in front of a fragile elderly person with crap veins and I got it every time. No idea why. The nursing gods laugh at us sometimes.