I am having IV anxiety lately....bad!!!!

KnittingRN7 · Jun 24, 2010

Practice makes perfect, honestly you just have to keep doing them to get better. I had changed jobs and needed to get #18's in the Antecubital vein for CT's and I never used those veins before, it took about a month and i could pop them in almost everyone, if your having an off day which happens a lot someone will help you, our IV resource team goes to our ER too. You'll get better I say a little prayer before too seems corny but I think it calms my nerves.

oryxandcake · Jun 24, 2010

It sounds like you are putting a lot of pressure on yourself. You have been brave making a change, and going after your goals - you should be proud of doing that.

Have you considered asking if you can follow an IV team around and start lines with them to get practice? Or maybe taking a day just to practice starting IVs in the emerg? I would ask for some extra support to get more practice.

I have to do phlebotomy a fair bit at work and sometimes you just have days where you can't hit anything. It does suck. But what is more important is your ability to critically think, the skills come after.

Treat yourself to something nice, clear your hand and go into work and attack it! You can do it :)

pielęgniarka, RN · Jun 24, 2010

It does help to get mentally prepared, deep breathe, tell yourself you are "one with the vein" I think phlebotomy and starting Iv's has a huge psychological component to it. As well as anatomy.

Yesterday was the first time I got an IV on first poke. I realized I'd been psyching myself out thus far. Worrying too much about it being messy, missing the vein etc. It was a GREAT feeling to nail it.

Rabid Response · Jun 24, 2010

Aw. Don't let the MDs get you down. Even the nurses who are best at IV insertions miss once in a while. And you didn't miss; if the IV flushed but wouldn't draw, you probably hit a valve or were up against the vein wall. Unfortunately, this stuff always seems to happen when you are under pressure. A few weeks ago I missed an IV start during a rapid response call on a surgery patient who was being reintubated. It was especially humiliating because the surgeon was standing right over me barking orders, and I know that she was p*ssed that I missed that start. Another nurse popped one right in on the other side, making me feel even more inadequate. Ugh. Later I was made to feel a little better when nobody on the unit could start another IV on the lady. It happens.

Then last week at another rapid response call I was able to start an IV and draw labs on a patient that two other nurses had missed on already. The responding MD started to belittle the floor nurses' ability to start IVs, and I shut him right down! Grrrr. What is with those docs???

The best advice I can give is to try to remain calm and not take missed starts personally. You are psyching yourself out! You will improve, but it sounds like you mostly need to relax a little. I like the advice about saying a prayer first. Sometimes I say a quick and quiet Hail Mary before I start--not because I am particularly religious but because it clears my mind. You could learn some meditation techniques to do the same thing.

I wish you the best. Don't give up. Your environment sounds tough and maybe not too supportive, but I'm sure you can make it work for you.

OncNurse1 · Jun 24, 2010

I have been an Oncology RN for 2+ years. In Nursing school I only started about 5 Ivs successfully. However, with Onc, it's all about ports, hickmans, PICCs, etc. So, most of the time the IVs have already been started or are in date. Now I work Outpatient Chemo infusion, and my IV skills are awful. It's pretty much I try...I fail...and I ask for assistance from another nurse. (especially because this population has riddled veins already ...and hardened chemo effects to the vasculature) It is so aggravating that I have been looking into an IV certification course or something to help my confidence. I can get flashback...just can't advance the catheter...I either hit a valve...or actually withdraw the needle before getting enough of the catheter in to have a successful line.

You are not alone.

brownbook · Jun 24, 2010

I am not a natural at IV's, I know exactly how you feel. I started a new job 5 years ago where starting IV's was a must. It took me two years to get over my psychological "hump." I believe starting IV's is 90% psychological and 10% skill. You can start IV's, you just need to have the patience to look for that perfect for you vein. Start hitting some, get the confidence up, then don't look back. Don't feel rushed to try a "maybe this looks kind of good" vein. If possible get a warm towel or blanket around both arms. Have the tourniquet tight, have the patient dangle their arm below their heart and pump their fist rapidly many times. A vein that bulges up, that you can see, will be easier. TAKE YOUR TIME TO FIND THAT PERFECT VEIN. Don't be tricked by large veins that stick up without a tourniquet. They can roll and be as tricky as a tiny deep vein you can hardly see. I swear I am not that great, not a natural, IV starter, but I feel confident and comfortable now. Yes some day's I blow them, then some days I get one's other nurses can't. IT IS 90% PSYCHOLOGICAL!!!! You will do this.

sunnycalifRN · Jun 24, 2010

I absolutely agree with the previous poster!! I've noticed that I can almost always start an IV for a colleague on the first attempt . . . reason? . . . because, no pressure . . . if I don't get it . . . OH WELL!!, I tried . . . I'm very relaxed

whereas, when it's my patient, I tend to put more pressure on myself . . . I want to get the IV myself . . . ego thing . . so I can miss 'em with the best of 'em. I know it's hard to do . . . but, if you relax, you'll hit it every time.