IVs.... When will I be good at this?

TigerGalLE, BSN, RN · Feb 23, 2007

I forgot to mention.. A lot of my stress comes from the fact that I feel so incredibly guilty when I fail. I feel like i'm using my poor patients as guinney pigs.... And when I don't get it I just feel horrible!!!!

RNLisa · Feb 23, 2007

I had about 10 sticks in nursing school, got 8 of them on the first try. Since graduating and working as a new grad nurse, I have had only about a handful of attempts, I get blood return, then it rolls or blows too. I suck at it now. I don't know if my technique is good or not, but I am doing the same thing I did in nursing school clinicals. I feel your pain. I WANT to be good at them, I want to have confidence in starting them.

Imafloat, BSN, RN · Feb 23, 2007

I am so intimidated by IVs. I never got a chance to start one in nursing school, besides on the rubber arm in skills lab. In my almost 2 months as a NICU nurse, I have attempted to start 1 IV, which I failed at. I am really psyching myself out.

Hoozdo, ADN · Feb 23, 2007

OK, the secret to starting IVs is your mental attitude. I felt the same way as you guys and gals for about 8 months of my first year of nursing. I read some post that said go in knowing you are going to start that IV and be confident you will start that IV.

I tried that method and my success rate sky rocketed. I use to feel so defeated when I had to go tell another nurse - OK, I have stuck this guy 3 times and I can't start the IV. Get that out of your mind!

Another tip, inspect carefully both arms before you stick. I used to like to stick veins I could physically see because I thought it would be easier. Not true. Feel in addition to looking! Now if you feel one and can't see it, try to visualize a landmark on the skin that it is related to, ie it is 1/2 inch from that little freckle. Then stick with some confidence! Think "I definitely can do this, and I am going to do this".

Don't be too afraid of getting blood everywhere. If it happens, it happens, but at least you have the IV in! The smallest gauge I am allowed to use is a 20, and most I put in are 18s. If I can do it, you can too.

Remember that :blushkiss

DutchgirlRN, ASN, RN · Feb 23, 2007

It took me a good 6 months to get proficient at IV's, another 6 months to get good at them, now I'm considered the IV geru, I'm the one everyone comes to when they can't get one. Hard for me to believe too, that took me a good 2 years to accompolish.

Don't ever tell the patient that you're new at it or nervous about it. It's unfair to them and makes them nervous and then they are harder to stick. I learned a trick from a doctor over 30 years ago when learning to draw labs and it works equally well for IV sticks. Use a manual BP cuff and inflate to just between systolic and diastolic. This gives you maximum venous filling. The veins pop up better and don't roll as bad. I've got a nursing student with me now in Home Health. I've been letting her do the blood draws and using this technique she has gotten every one of them on the first stick. Once you get the feel for the veins drop the BP cuff. I still have to use it sometimes when I feel there's no other way.

Go in and be calm, matter of factly, get your 2 tries. If you don't get it still be matter of factly, "gee I'm sorry let me find someone else I've hit my limit for today".

all4schwa · Feb 24, 2007

This is only in addition to what the other nurses have said...but it really is about attitude. I take more time selecting my vein that I actually do with the stick itself. I'm determined to do one stick only. I also make sure I'm projecting confidence. Pts are usually freaked out about iv's, they definitely don't need their nurse freaking out.

As far as blowing them, for myself, I stop as soon as I get flash and dont advance untill I pull the needle out. I feel like I blow em by going through the back of the vein with the needle. Also, when it comes to blowing them...If it's an old person and I can see the vein, I just stick them without a tournaquiet.

KnarfKS · Feb 27, 2007

At my hospital we have an "IV team" that takes care of central lines and hard IV sticks. I followed them and watched them when I had the time and when it was my patients and asked questions. Luckily for me most of them are very willing to teach. Because of that people call me in if there is a difficult stick. I also watched the phlebotomists from the lab when they were drawing on difficult patients and learned from them as well.

TigerGalLE, BSN, RN · Mar 17, 2007

Ok so just an update... I got 2 IVs today.. woo hoo... and I got one on Wed. too.... Maybe I am improving?? haha I don't know but my confidence is definately going up!!

onduty23 · Mar 17, 2007

congrats

CHATSDALE · Mar 17, 2007

one thing i learned from a very proficient nurse that a lot of other nurses have put their noses up at: you do not have to put the tourniquet above the elbow..place it mid forearm if you are trying for a back of the hand anyting below it...you have better control and rub with alcohol several times to get the vein to pop up not just for cleaning

any skill takes time and practice but if a shaky addict can hit on first try then you will be fine

whitman · Mar 17, 2007

Hey there, the more the better!! You might actually be better than the last person that tried and the patient will appreciate that, dont be too hard on yourself. Good aseptic technique, then even if you miss you know you've done the best and safest job you can. Well done!