Iv Help Needed

[AnnetteER]

I am a new grad. I started my first job, in the ER. Tomorrow will be my 7th day in the ER. I am still having trouble starting IV's. I was finally able to get a couple of them the other day, but I'm still missing more than I am getting them. It looks like I'm in the vein, but then I'm not getting the blood return. I'm getting so frustrated & nervous about not being able to get the hang of it.

We have techs, but we're so busy that the nurses have to be able to start their own IV's. I want to be able to do them & I want to be really good at it. We put a line in & draw blood on almost every patient. My preceptor has been wonderful. Everyone keeps telling me that it takes time & a lot of practice. Unfortunately, some of the patients we get are such hard sticks, that my preceptor just starts the line herself. I can understand that because neither one of us wants to put our patients through hell with multiple sticks in their arm. She's been a nurse for 10 years & she's great. I hope that one day I will be as good a nurse as she is in every way. Listening & watching her interact with the patients has been an incredible learning experience for me.

My main concern at this point is starting the IV's. I don't want to lose this job. I REALLY LOVE the ER!! I even told my preceptor that I would come in on my days off & work with the techs if she felt I should do that. I'll do whatever it takes to keep this job & to become good at it. I read the postings on this site about IV tips, but I'm still having a problem.

HOW LONG should it take to get good at doing IV's? Can anyone tell me how long it took them to be able to hit the vein successfully. What would be a reasonable time frame?

Thank you for your help.

Annette

[PennyLane, RN]

Annette,

I started out as a new grad in the ER, too, earlier this year. Approach your manager and ask him/her if you can do part or all of one of your shifts with one of the techs or IV therapy. I was offered this at my job. The only way to get good is to practice. Start on the younger, healthier people first--they usually have better veins, as I'm sure you know.

I had beginnner's luck and got my first 15 or so, but then I hit a wall and started missing more than I got. Now I'm pretty good, even on little old ladies, but it took several weeks of trying to feel confident. As one nurse told me---make it your favorite thing to do. I try to keep that in mind. If I'm really too busy I'll ask the tech to do it, but I try to think of it as a favorite thing of mine b/c I feel good once I've gotten it.

I'd say 7 shifts is still pretty early in the game. As I said, it took me several weeks to really get better at it.

[NurseforPreggers]

I think it took me a couple of months to be consistent at starting IVs. I think I was pretty terrible at it to begin with. My preceptor use to tell me that I "HAD TO LEARN" to get them. I would get so frustrated. Now IVs really are my favorite thing to do.

[Mississippi_RN]

I think it took me a couple of months to be consistent at starting IVs. I think I was pretty terrible at it to begin with. My preceptor use to tell me that I "HAD TO LEARN" to get them. I would get so frustrated. Now IVs really are my favorite thing to do.

IV's are one of those really "iffy" things. You can't just "know" how to do them. It is not like all of that knowledge we memorize in skill so we can have it to reference back on, like lab values and signs/symptoms. Being able to get an IV is almost like an art form, definitely a skill. The more you even try , the better you will get at them.

I think the single most important thing that can "make or break" getting an IV is confidence. NEVER underestimate your ability in getting an IV. You never know where you will see, or more importantly sometimes, feel a vein. However, my policy has always been that if I don't see or feel absolutely anything, then I don't stick... I see no need in putting someone through that for what could be nothing. A lot of times, another set of eyes, or hands, will see what you don't.

I remember a couple of weeks ago, we had a renal patient on dialysis in that needed a Heplock for a CT scan she was having. I went in, took one look at her arms that were swollen with shunts in both, and thought silently to myself how in the world I was going to get this. BUT...I tried it in one of her hands, and got it no problem one stick. I was so proud that I tried and didn't just take one look and run.

Give it time... Some days I get everyone I try in a day and other days... couldn't hit the broadside of a barn 2 feet away. It will get better. :)

[suzanne4, RN]

If you do not have an IV team at your facility, see if you can spend a shift or two in the out-patient surgery dept. These are usually relatively healthy patients coming in for procedures, so their veins are usually easier to get.

[carachel2]

You need to tell your preceptor that you want a day where ALL you do is the IV sticks. Tell everyone on your shift that you want to be the IV starter for the day. Don't let them assign you patients for that day.

I was having a tough time too on my first few days and the reason was I was taking patients AND learning this relatively new skill. We had some very sick dehydrated old ladies and I was becoming easily discouraged.

I declared (with preceptor approval) one day to be my IV day and especially told the nurses I wanted the young abdominal pain/chest pain/ obgyn patients who needed IV's. I loaded up on saline syringes and pulled the cart around all day. By the end of the day I felt MUCH better.

[ckh23, BSN, RN]

Be patient and give it time, you'll get the hang of it. I stuggled my first month and as time goes by, you pick up tricks and different techniques that work for you. It's ok, your only on day 7. I would suggest starting on the people that have the good veins and as you get better, move on to the "hard" sticks. What I find to be the best on people with "bad" veins is to ask them where their last IV was. Chances are if their veins are that shot, this isn't the first time they've had an IV. Another thing is to try someone at least twice before asking someone else. I know it's tough because you don't want to keep sticking them, but sometimes it takes more than one try.