I Don't Want to Stick a Patient

[Nurse Beth, MSN]

Dear Nurse Beth,

I want to be a nurse. However, with my experience as a Medical Assistant and PCT, I am uncomfortable with sticking my patients. Why? Well, I'm afraid that I'll hurt the patient. Common sense - needles hurt. I don't want to miss the vein. Common sense - it will improve with practice. Will I get over this? Are there new nurses just as uncomfortable? This is the only thing that worries me.

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Dear Doesn't Want to Stick a Patient,

Yes, you will get over this. Repetition and practice work to your advantage.

You are not alone in dreading needles sticks. It never feels good to cause someone else pain, but you are actually helping them. Concentrate on mastering your skill and becoming the best IV starter you can be.

The key is not to hesitate as a swift puncture with a sharp hurts less than slowly pushing or drilling the needle in. You will learn to distract your patient, administer an injection or cannulate a vein swiftly and hear them say I didn't feel that at all. Are you sure you gave me a shot?”

I bet the nurses here at AN have lots of pro tips for you.

Best,

Nurse Beth

[rubynrse, ADN, RN]

I didn't either. When I was a brand new nurse I even hit the iliac crest giving IM PCN. I wanted to crawl under the linoleum. I got better. But even now, after some 40 odd years of nursing I still hate hurting people. I apologize ahead of time and go for it (mainly when I'm trying to get a perfect bleb on a TB) It gets better. And I agree, talking to the person during the procedure helps. It helps you because you're already nervous and it helps the person pay attention to your words and not their arm/hip/stomach/etc.

[Laurus Nobilis]

I've been an RN for two years now, and I still hate doing IVs. I'm simply not good at them, and no amount of practice seems to help. IM injections, on the other hand, are much easier, though I still do feel a twinge inside when giving them. I think I'm a decent enough nurse though. So, while "needlework" is important, it's not the end-all, be-all skill of nursing. Just practice and do your best. Pick other nurses' brains for tips and tricks.

[learner1108]

I have embroidered and sew by hand for 40 years. In all that time, I have accidentally stuck my fingers many times. There is a sting when the needle goes in, but then it doesn't hurt. Make sure you have the right size needle for the vein, then get your angle right- about 30 degrees and when you see the flash, don't push farther unless the blood doesn't continue to flow. Don't raise the needle, just hold it steady as long as you get a flow. Butterfly needles are easiest to keep steady. You will get used to it and will feel happy and proud when your patient says I barely felt that. You can do it. I was scared at first too.

[Zedrek]

My first IM injection was on a patient in a state forensic psychiatric hospital when I was a psychiatric technician student. I was pretty nervous since the patient was being released from 4 point restraints and was due for his Haldol Dec shot. My friend tried his best to "calm" my nerves by informing me that the patient was going to hit me. I gave the shot in the right buttock and prepared to get hit and then punch my friend for jinxing me. But, nothing. Patient stated that he didn't even feel it. I was relieved, punched my friend anyways, and went on to give hundreds of shots in the prison system that produced varying results of "didn't feel a thing" to "oh my God, I'm going to pass out in spite of being a hard core gang banger with tats covering 90% of my body".

[Axgrinder]

You'll get good at it - then you'll get great. Practice makes perfect. Remember the first time you rode a bike? Drove a car? Wrote a check? Everything takes practice to feel competent. You'd be surprised how little it takes to garner skills.

Rubynurs RN has some great advice: talk to the pt. Distract them. And be real nice … pt's will forgive poor technique if you are friendly. I had a nursing instructor tell us that once. Pt' s will forgive quite a lot if you are nice to them.

And eventually, you'll be friendly and good too.

One piece of advice: when drawing numerous tubes for a pt - find an alternative fulcrum to rest your weight on other than the pt's vein you are drawing from. It's real painful, and leaves a bruise (plus, some pt's will never complain while you're doing it because they feel ackward).

Get practicing! I bet those in your phlebotomy classes would even let you practice on them if you return the favor.

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Once in my first year of nursing me and another new RN went in to replace an IV on a pt on the night shift … he and I went over the steps outside the room, went in - and hit an artery! Bam! The flash in the IV needle filled that fast! We removed it, held pressure for 5 minutes, then started over. Got an 18 gauge in the next try. The pt didn't even flinch!

[knurse10]

Consider what would happen if the patient did not get the stick.

No heparin shot = increased risk for blood clots

No vaccine = potential death depending on the disease and if the patient is a child

No haldol = potential staff or patient injury

When I look at the situation, it always makes me feel better about all the little hurts that I cause so that the big hurts can be prevented. Follow your anatomical landmarks and you will gain confidence and technique that will make the process slightly less stressful to you and less painful to the patient.

[Guest957596]

How about thinking instead that you are helping your patient by starting that I or help find out what's wrong with them by drawing that blood?

[ClaraRedheart, BSN, RN]

You are not the first, nor will be the last nursing student/nurse to have this problem. That was one of my initial objections to nursing school to begin with when my mom was trying to talk me out of photography and into nursing school.

"I hate blood and needles."

"You like people though, right?"

"Yeah"

"Well, don't worry, you get over that part".

She was right.

Most of my hatred of IV starts now has to do with fear of failure and messing up my streak if I've got one, or further demoralizing me if I have a losing streak. I know it's ridiculous, but I take misses entirely too personally. Yes, it hurts the patient and I do not like to cause pain unnecessarily. In order to up my game and get over the fear, I volunteered to be one of the first to learn a small sonogram that our floor got. I'm much better now. I'd be even better if I used the darn sono for every IV start EVEN if it looks easy Live and learn. I also have the opportunity to start some of the tough starts on the floor with it because not many others know how to use it. You really do get better with time and effort. Honestly, IV's don't gross me out anymore because of the concentration that it takes to start one. IM's however, I still get a little weak kneed pushing a needle in that deep.

[MochaFiend]

Oh, yes, you're not alone! As a Corpsman in the Navy (medic), a PCT, and Registered MA, I still have the same fear as you when it comes to sticking patients. With time and experience, i wasn't so nervous and had no problem. However, I'm just now starting pre reqs for my BSN and I can tell you that it will pass.