Initiating Intravenous Access

Anna Flaxis, BSN, RN · Aug 26, 2015

Yes, I find it gratifying, especially when the patient tells me they hardly felt it. I get that a lot.

I'm also particularly good at painless IMs. In fact, today I gave one and was waiting for the compliment, but it never came. Sigh.

What I find particularly gratifying is relieving urinary retention. This is one of the quickest ways to make a new best friend.

TheNGTKingRN · Aug 26, 2015

Yes! I don't typically give IMs but I give plenty of SC Heparins and Lovenox. Almost ALL patients give me compliments.

A good pinch. Nice n' quick makes it almost painless. I always do it like this.

TheNGTKingRN · Aug 26, 2015

I also enjoy that first good suction when you drop an NGT. You know, the one where the surgical residents say "go ahead and put it on continuous for about 30 seconds to a minute". You immediately see all this output and the nausea from the pt vanish before your eyes.

MendedHeart · Aug 26, 2015

ðŸ˜„ hence the name

peabozzle · Aug 26, 2015

After 13 years as a nurse, I still love that feeling. Especially on the patient that says "I have the worst veins ever, they roll, disappear, and blow really easy, usually anesthesia has to come do my IV, plus I am dehydrated so good luck" As I am looking & see several great options and BOOM get it the first time. And then they act disappointed. :cheeky:

Karou · Aug 26, 2015

I love inserting IV's. The more I do them, the better I get, and it's very rewarding and confidence boosting to get a hard stick.

I had a contracted, frail 95 year old patient the other day who truly was dehydrated and black and blue from previous attempts/vein blows. I took my time and got one in on the first try that two days later was still drawing blood. For about thirty minutes I felt invincible! Then I missed the next one. Oh well! I still get a rush of pride when I see flashback, especially on those tough sticks.

iluvivt, BSN, RN · Aug 26, 2015

Oh yeck yes...and that is why I do it as a speciality.I will not leave until I get an IV in and if it's difficult more time is spent looking and feeling and using a variety of tricks I know and some I have even invented.I use tape a lot to control loose skin and apply traction.Sometimes patients wonder what I am doing then suddenly there IV is in place without much pain.

Wrench Party · Aug 26, 2015

Flash isn't a problem for me, it's the catheter finesse game. Push in catheter while pulling needle back out- I'm finally nailing this

part :yes: . I blew a lot of veins unnecessarily figuring out how to convince that little catheter to STAY in the vein.

TheNGTKingRN · Aug 27, 2015

Flash isn't a problem for me, it's the catheter finesse game. Push in catheter while pulling needle back out- I'm finally nailing this
part . I blew a lot of veins unnecessarily figuring out how to convince that little catheter to STAY in the vein.

As a fairly new nurse I have to say that that was my downfall too. Pushing that pesky catheter in while pulling the needle.

TheGooch · Aug 27, 2015

As a patient I appreciate a nurse with good iv skills.

KBRN15 · Aug 27, 2015

I've successfully gotten more IV's that I have not, but when I am going to insert one, I still feel kind of discombobulated. I am a new grad, so IV's are new to me, but I am not a newbie to phlebo... obviously theres a huge difference between using a butterfly and a big #18.

My question... what is the order that you do things to insert an IV?

Tourniquet > Find a vein > Cleanse per protocol > Insert catheter at a very flat angle > Get flashback > Try to advance the catheter/withdraw needle > Release tourniquet > Hold pressure on vein > Hook up to saline line..etc

Is this how everybody does it? Sometimes I can't get the catheter to advance, so I worry if I should have released the tourniquet sooner.. help ?