IVs

I've been a nurse for 2.5 months now, and I've still started only one IV successfully. I'm in critical care, so a lot of our patients have lines and don't need them. I don't really have any confidence in my skills. It also doesn't help that our patients are usually elderly and dehydrated/edematous - not always the best to practice on. Often I'll try once and fail, then my preceptor will try, and she'll realize right away that we need the docs to put a line in. My preceptor is aware that this is an area I feel weak in, I think I need to remind her again so maybe she can try to create some more opportunities for me to try (with coaching). I wish there was a way to get practice on real people without them being ICU patients. I almost want to take home some start kits and practice on mysef, but I don't think the track marks would look good with my scrubs at my next shift...if IV drug abusers can hit veins when they're high, why is it so hard for me??

IVs are not really my thing too. but when i was a student nurse, i was assigned to GI lab for my clinic rotation. we had to do 10 IVs/day on real patients. got my certification thru those.

what makes me feel calm about IVs at our facility is that each person gets two shots. If you don't get it after that you are 'off the hook'-course you then have to find someone to get it in. Lately that has been me....newer nurses, well, no seasoned ones too, often don't want to try. We could call the resource nurse to try but they at least want us to try to get them in before they have to come up. You will get a feel for it and just don't be afraid to try. Many get good by just doing those two tries - even if they don't get them-they have experience...for next time. We of course can use lidocaine if pt wants to numb area but there is a rumor (I find it is fairly true) that it constricts the vein and a fat popping vein 'disappears.' Also you will find that if a pt knows you are looking for a vein they disappear. We had like five nurses try on a pt one night (I know but it had to get put in and it was a weekend and no one could do a PICC) -nothing. Finally we had just about went to page a doc again, when I was giving her pills and she had her cup up to her mouth. I looked down at her arm and there was a HUGE vein popping out. "Don't Move." I said. The IV basket was there and I grabbed my stuff and stuck it in (per policy of course-I didn't just shove it in:). SO if they are relaxed they pop out I find. Just something to remember...look at their arms when they don't know you are looking.