IVS and inserting Catheters

student4ever · Nov 16, 2005

First of all, congratulations on starting nursing school next fall! That's the semester I'm supposed to start nursing school too! I'm just finishing up my pre-reqs now.

To answer your question ( I work as a tech in the ED, and I do catheters and blood draws along with other things, but I assist with the other things you mentioned, so I'll give you my $0.02), in the grand scheme of things, these invasive procedures don't hurt as much as they are uncomfortable. Yes, there is some pain involved - more so for some people than others.

A catheter has been described to me as a lot of pressure, and the feeling of having a terribly full bladder that you have to hold - it's kind of like pain, but it's more just uncomfortable.

I have had an NG tube - I was knocked out when it went in, but I know for sure it hurt coming out! It is a feeling of something hard and dry going down a soft, tender, mucous membrane. Of course it's going to be slightly painful. Just keep in mind that the results (removing offending substances from the stomach) generally provide a kind of relief that makes the pain of the NG tube worth it.

IVs - some people make a huge deal about the pain. I personally don't think they're too bad - yeah, you've got a needle poking in your skin, but it's not anything compared to other types of pain I've been through! The better you get at IVs, the less they USUALLY hurt. I've started an IV on myself before - just to see if I could - and it didn't really hurt that bad. The thing that makes an IV hurt more than a lab draw is that the plastic catheter surrounding the needle gives some resistance when going into the skin, and again when entering the vein wall. Of course, that causes slightly more pain than a simple lab draw needle. However, I think most peoples' major malfunction with IVs is that they're just psychologically so freaked out by the whole thing that they work themselves into a huge tizzy, and it compounds the problem.

Hope this helps! Remember, practice makes perfect, and don't be scared to try try again when it doesn't go smoothly. We were all in the same position when learning a particular skill, and had to learn too. Most nurses are very understanding and willing to offer tips and advice on how to best manage all the things you have to keep straight during a procedure (IMO, especially in foley insertion - that one took me the longest!)

nursemike, ASN, RN · Nov 16, 2005

I was pretty terrified of these things in school, too. Worse, I didn't really get many opportunities to practice them. Some things, like catheters and trach suction, have turned out not to be as difficult as I had feared--the hard part is maintaining sterile technique, and that's mainly a matter of being careful.

IV's and blood draws still give me a hard time, and my one attempt at an NG was unsuccessful. But I'm beginning to accept what my preceptors and co-workers keep saying, that these things are just mechanical. Keep trying, and it will get easier.

IMHO, the biggest thing we do is assessment. If you keep up with your patients' conditions, understand what's going on, what meds are given and why, you'll be way ahead of the game. Also, as desperately as I hated care planning in school, learning to see the whole patient, how the systems interact, and the priorities in their care, is crucial. Of course, it's natural to be task-oriented, especially early on, but if you can keep in mind that a nurse's most important tool is her/his brain, I think you'll be on the right track.

nursewannabee · Nov 16, 2005

Hi NurseMike,

Thanks for the info. I have an interview as an LNA at a hospital. Hopefully this will give me exposure to these procedures.

You give me hope that I can do this. One day at a time.

Peace and Grace

Heather:coollook:

tlhubbard · Nov 16, 2005

I was so afraid of needles (in particular IVs) when I was looking at the nursing school situation. Once I had 1 successful start, there was a "sick" satisifaction of seeing that flashback and knowing I could something a lot of other people wouldn't dream of doing.

I have worked in ED, and same day surgery as a pre-op nurse. I now insert midlines and PICCs. So I went from my it being my biggest fear to my livelihood.

I found that my training in school was helpful in my fears (of needles) and my problem with feeling too much for the patient when seeing a wound or incision. You come to terms with things as you develop a bit of a "professional distance". It's not that you don't feel for your patients, it's just that it no longer buckles your knees.

Best of luck in your education process.

KatieBell · Nov 16, 2005

Don't worry too much about doing any of these things. You will have more time doing care plans that actually doing and practicing these skills. I know several nurses who have graduated without starting one IV. The hospital I currently work at does not let floor nurses start IV's- which I think is nuts (I am in ED and we of course do IV's etc).

All these procedures are painful. I don't worry too much about this, as there is generally more benefit to doing the procedure, than not doing it.

Although I am an ED nurse, I want to always stress, nursing is lots more about thinking and a lot less about doing technical skills. :)

nursewannabee · Nov 16, 2005

Thanks Katie-Bell and TLhubbard for your words of encouragement.

I will try not to worry too much about this until I have to cross that proverbial bridge.

thanks for alleviating my fears

Heather :)

Happy-ER-RN, RN · Nov 17, 2005

I was so nervous about those at first too. Then I realized that nursing school was making everything too complicated--like catheters and NG's. For the most part you just lube it up and stick it in, and try not to drop sterile things on the floor.

Sticking a needle in someone was a huge fear of mine also. I shook like a leaf for my first 6 or 7 tries. I still shake when I have to do pediatric IVs. Somehow you just get used to it eventually. You will too.

Daytonite, BSN, RN · Nov 17, 2005

Like everything else you've studied, you will be given information and instructions on procedures before you ever do them. Most schools have a nursing lab where these procedures are practiced. 32 years ago we had a dummy called Mrs. Chase that we were able to practice all these things on. They still have similar "dolls" and manequins at most schools. You can make all kinds of mistakes and say all the wrong things to a dummy. The trick about doing procedures on a real, live human being is to outwardly act confident even though you're a bundle of nerves inside. This is a skill that you will need to use throughout your entire nursing career. I still have to practice this at times, as new procedures that we have to learn come along periodically. :) You will probably get to put a foley catheter in someone, if you're lucky you may get to put an N/G tube in and you definitely won't be starting any IVs on real humans until you get your RN license so don't even sweat that one right now. It'll be the dummy IV arm for you while you are a student and dummy arms don't care if you hurt them.

I've had all three procedures done to me. The worst of having a foley catheter inserted, for me, was the embarrassment of exposing myself while I was catheterized! Each time stung a little, but was tolerable. Having a foley was great because I didn't have to keep getting up to the bathroom! I was asleep in surgery when my N/G tube was put in, but I sure was awake when it was taken out. It was pulled rather quickly, I thought, and I was instantaneously nauseated and probably would have barfed right then and there except my stomach was empty because they suctioned everything out before pulling the tube! While the tube was in place for a few days I developed a god-awful sore throat from it that miraculously disappeared as soon as the N/G tube was out. You'll learn why that happens in nursing school. I've inserted many N/G tubes over the years and learned to be gentle and aim the tip of the tube in the right direction to achieve success. This same skill is utilized when performing naso-tracheal suction on a respiratory patient. IV insertion hurts everyone to some degree. It can't be helped. Smaller needles tend to hurt less than the larger ones. Occassionally, someone will say "it didn't even hurt". It's their lucky day is all I can say. I started my first IV on a television celebrity--see if that doesn't increase your anxiety! It took me two sticks, I felt bad, the guy had huge veins that we refer to as "garden hoses" which means you can't miss them. I managed to miss on the first stick. :cry: Don't think I didn't feel terrible. But, one thing about nursing is that you don't give up. I was a bad sticker when I first started out as an RN. I ended up taking the 30 hour IV therapy course given to LVNs in California who want to get certified to do them. Some years later I went to work on two different IV teams and became a certified IV nurse through the Intravenous Nurses Society. It took me two tries to pass their written test because the first time I was so full of myself that I took the test without studying very much. Big $300 mistake. I am now a superb inserter of IVs, believe me. I worked very hard to get good at it.

I guess what I am trying to get at while blowing my own horn here is that we all start out scared and worried. Practice makes perfect. You will have to put in many foley catheters and N/G tubes, and start hundreds of IVs before you become proficient at it. Even then, there is always a unique situation just waiting around the corner to test your knowledge, experience and patience. You will most likely go through similar, but unique, experiences. That is nursing. That makes life exciting!

nursewannabee · Nov 17, 2005

Good afternoon,

By the way, I love the name daytonite. Very original. Thank you for your long reply. I guess everyone feels nervous. I will take your advice to heart and remember to act confident. This will also put the patient at ease somewhat.

I would like to say everyone has been so supportive and hope I find this same attitude when I become an RN.

Peace and Grace

Heather

SteveNNP, MSN, NP · Nov 17, 2005

I'm a first-year Rn in the Neonatal ICU, and I had to not only catheterize and perform blood/IV sticks on premature babies, but also learn to do IV sticks in the scalp. As a SC SN, I was able to start many IV's. especially in my ER rotation, and did lots of foleys and NG's as a tech. Just go into it not being afraid, looking at it as a challenge. Seek out these procedures while at clinical, by cosying up to the rns on that floor, and ask them If you can do procedures with them. Also see about getting a PCT/PCA job as a SN, or doing a nurse externship, where you'll have lots of opportunities to hone your skills, and be way ahead of your classmates! Good Luck!

purplemania, BSN, RN · Nov 17, 2005

Everyone is scared of hurting a patient or doing something wrong. We all went through that. It is normal. You are normal. I am glad to know you care enough about potential patients to want to do your best! Take advantage of any lab time with manikins. Once you are confident about your skill you will do fine.