I feel like I'm never going to get good at IVs

[greyL]

Just when I start think that I'm getting better, and I've had a whole bunch of successful IV starts in a row, I end up in a rut of not being able to start any for a long time. And period of time when I'm in a rut is much longer than when I'm successful.

I've been in acute care for a year now. Surely I should be comfortable with IV starts by now, right? I'm also looking for a new place to work, and I'm so scared that no one is going to want to hire me if they know that I can barely start an IV. =/

[tarotale]

When I was on the floor, I started maybe handful a month. Now at Er, handful times 10 qd. That's really the way, practice and practice. I did get a good lesson from er nurse while a student, so ask someone who is fabulous at iv.

Also no need to be hard on yourself. Er is hard but ICU is tough as well just in different way. Just because you don't know how to do an iv well, doesn't mean you can't handle critical pts. I rather hire someone who can manage critical pts well over ICU nurse who can do iv well (both is plus of course). Good luck in job search

[amzyRN]

Warm packs and having a good grasp on the vein will help. Also know that diabetics usually have fragile veins that blow easily (more easily than a non diabetic), so with those be careful to not tear through the vein with the catheter. Practice practice practice.

[Caffeine_IV]

You will improve at them. Much of it is practice but sometimes we let our mind take over. If you intimidate yourself out about it, you will miss more often. Be confident in yourself.

[OldDude]

The most logical explanation I've come up with has to do with planetary alignment in the cosmos or some other ambiguous force in the universe beyond one's control. How else can you explain the periods you go through when you can't puncture a vein if it was 2 inches in diameter.... versus the periods you go through when you couldn't miss even if you were blindfolded and wearing boxing gloves!

[classicdame, MSN, EdD]

may I recommend an eye exam? If one eye is a diopter or two off the other then you do not have adequate stereo vision for accurate depth perception. Sometimes this does not show up in daily activities, but might in situations such as you describe. Just a thought.

[bb007rn]

I started out working in ER somehow, I became extremely good at IV's.(ok, to be honest, lots of practice with #14s and #16's on ETOHs and ODs) I loved IV's, I lived for IV's! I have put IV's in patients in some of the weirdest places, inside of wrist, top of thumb, forehead (very elderly lady, fragile veins everywhere else), shin, breast, shoulder, upper thigh (IV drug user, no other veins), between toes. Everything that everyone said above is true

Here are some of my "secrets":

1) cop a squat (have a seat, you will feel more relaxed)

2) talk to the patient as you are looking for a vein, a relaxed patient is an easier stick

3) take your time looking for the site, just because I saw one first, didn't make it a good candidate for an IV, Iwas always on the look out for several sites, so i could take my pick of them. (unless it's truly emergent!) and don't be afraid to check out both arms/hands, etc.

4) FEEL those veins... are there lumps (valves=not a good stick!), {my general rule was if I can feel it, I can stick it, I almost never went by sight.}

5) anchor the vein prior to sticking

6) keep talking to the patient throughout the procedure, it doesn't matter what you talk about, just converse, it eases anxieties on both parts ( and if you are nervous about it, DON"T talk about the IV start, try a different topic!)

7) and finally, the "birthday candle" trick. works for anyone who is nervous about the stick, (yes, including you) explain this to the patient first: right before you are ready to poke, have the patient take a big, deep breath, on the count of three, have the patient exhale as you do the poke, just like they are blowing out birthday candles, they concentrate on the breathing, they don't move the limb you are working on, and the IV generally goes well (oh, and you can do the exhale, too, just don't blow out right onto the site!)

8) sometimes you will have to do more than one attempt, don't sweat it, be realistic in your expectations of yourself (and the patient)

9) understand you will have "good'" IV days and "bad" IV days, even the best IV nurses have days where they can't hit the broad side of a barn myself included

10) don't be afraid to ask one of the nurses on your unit to assist you sometime, ask him/her to observe your technique and give you some pointers as to what makes them successful.

11) if the patient has "bad" veins, ask them where IV starts are usually successful (be aware that veins may sclerose over time with multiple cannulations) but they will have a general idea of which areas to avoid or are better to try.

12) don't refuse an IV start, practice makes perfect (no patients aren't guinea pigs, but they are the only way you will become a successful IV starter)

[SmilingBluEyes]

It takes many years of solid practice before being "good at IV's". Don't be discouraged. Even after years, I still can be hit or miss. Keep chugging along, trying to get IVs in the difficult patients. After time, you will be very experienced and able, and will wonder why you ever worried in the first place. Best wishes.

[greyL]

I wear glasses. Does that show up in standard eye exams?