IV starts help!

[DIVA_NURSE405]

I have been starting IV's for about 6 months, some days I'm good some days I can't hit anything! Esp with older people, I usually can start on younger folks with no problem, my question is what are some tips and tricks so I can become better with IV starts? I ask my fellow nurses and all they say is " u will get better in time" I just hate having to call our NOW nurses( we have nurses who come and help you if you get backed up or need IV started) makes me feel stupid esp when she comes and hits the vein her 1st try and I tried twice! lol My main problem is when I put the cath in I get blood return but when I try to flush it, it won't flush, and sometimes my cath gets bent! Any tips will be greatly appreciated!

[southernbeegirl, BSN, RN]

some tips I use:

I heat up a wet towel in the microwave a tad and wrap it around the arm.

BP cuff instead of a tourniqet.

Either I raise the bed to my chest level or I pull up a chair. Being comfortable while you are starting the IV is important to your success. If you are uncomfortable, you will be nervous. i work in LTC. I take my chair from the desk down to the room with me so i can roll around if i need too. I dont care what anyone thinks about it either, cuz i almost always get it first stick.

I manipulate the vein with my fingers to hold it still if it's wigglin'.

No matter what, when i walk in the room I project confidence to the patient. When they tell me "im a hard stick, nobody can get me" i always tell them "thats why i'm here, i'm the best stick in the building" (whether i am or not). it really works if the pt is confident in you!

and i know it's a cliche' but you really will get better with time and practice.

[Blee O'Myacin, BSN, RN]

I rarely use a bp cuff, but it does work for a lot of people. My advice is to hold firmly onto the patient's arm to steady yourself and keep the patient from pulling away. It doesn't do anyone any good to be chasing the vein with the angiocath. Make sure your pigtail is primed and ready - if you get a flash and can't advance, you may be able to float the angiocath into the right place. Since we usually collect labs at the time of the IV start, I keep a lot of 4x4's handy in case I make a mess.