OHH I feel so frustrated!?! In nursing school I actually had quite a few good attempts at IVs... I did about 20 and actually got about 50% I'd say.. Most of my successful attempts where when I would spend my days in the ER.... But since I have actually been a nurse I am doing terrible!! I work on a renal/respiratory floor and I've only actually gotten maybe 2 out of 10.. and those were both in the AC...
It seems like every vein rolls.... Then i catch it... then it blows... I'm very good at getting flash back... but they seem to always blow!!! My preceptor says I have good technique... I know it just takes practice... But how long until I'll be successful at this?
How long did it take everyone to get good at IVs...??? Are some people just never good???
OK!! I love this thread!! I too am having trouble with the vein "disappearing" or blowing.. I am a new RN and feel intimidated by IV therapy in general.. I am having the same problem though, I get flashback everytime then seem to blow the vein as I try to advance the cathlon. I also have trouble not having enough hands to keep the cathlon in and getting it secured. I have done several sticks over the past couple days, and am trying to get my confidence up, but hearing your stories REALLY helps to make me feel like I am not alone!!
I do the same thing "TigerGal". It frustrates me when I do that, then a seasoned nurse walks in, sticks, and slides the cathlon in one fluid motion. We will get it!!! Just gotta keep trying :)
We have an IV team where I work, so I have never done one as a RN and only one as a student. I will never be good at them. Sometimes I wish that we didn't have an IV team because it is something that I will never learn while working at this facility. The other day, I had a patient who needed a new IV and paged the IV team, it seriously took them over an hour and 3 pages to get my IV. My patient was a little frail old lady with horrible looking arms. I did think about starting it myself, but didn't dare. I was too scared!
I could see where having an IV team could contribute to losing the skill of starting IVs!! Next time things aren't very hectic (if that's not fantasy) see if the nurse starting the IV will let you do it. It might give you a little more confidence having an experienced person there, and you will get to practice a skill.. My hospital doesn't have an IV team, and I seem to be getting plenty of practice, but I don't know if it's helping.ha :)
I got one today on my first try.. I was very excited! maybe i am getting better? I do think i am getting a better feel for it.. Also advancing the needle a tad further after flashack seems to help.
No advice, but I'm in the same boat. I'm actually becoming obsessed! Today I was watching Barefoot Contessa on FoodTV and I was checking out Ina's veins on her hands while she was mixing ground beef. I was thinking, "Oh, I bet I could get an 18 gauge in there..." :doh:
I mentioned this before in another thread but I practiced starting IVs on a banana at home. I'd position it with the outer curve of the banana towards me. Like an arm, it doesn't lay flat and I had to keep a steadying hand on it while practicing threading the catheter and taping it down. It doesn't mimic actually threading into a vein but it did help steady my hands and I was less worried about botching it while trying to secure it if I manage to thread it without blowing it.
I have been a NICU RN for 2 years and just recently switched to the busiest LD in the US or 2nd busiest....depends on the day...anyways I have also had such a hard time starting 18gauge IVs in these pregnant women...What is wrong with me? I do get flashback most of the time, if the vein does not roll, however it seems to blow almost everytime. It is so sad. I think my technique is okay, I do not feel nervous about the skill.....I do not know what to do. I will try the manual BP cuff trick this week. All of your help is great to read. Thanks...:chair:
I have been a NICU RN for 2 years and just recently switched to the busiest LD in the US or 2nd busiest....depends on the day...anyways I have also had such a hard time starting 18gauge IVs in these pregnant women...What is wrong with me? I do get flashback most of the time, if the vein does not roll, however it seems to blow almost everytime. It is so sad. I think my technique is okay, I do not feel nervous about the skill.....I do not know what to do. I will try the manual BP cuff trick this week. All of your help is great to read. Thanks...:chair:
I know the feeling! I'm working L&D as well, and I'm going into my seventh week and just now starting to get them on my first try. My first few weeks were horrible - as soon as my preceptor would see another nurse priming IV tubing she would say "Rebecca will start that IV for you!" and I would feel like dying. I was blowing great veins left and right. Now I'm the one stalking the nurses looking for anyone who needs an IV started. :rotfl:
The one thing I started doing that helped me more than anything is stopping as soon as I see the flashback, lowering my angle a bit, and going in a tiny bit farther before threading the needle. I have gotten every one since I started doing that....I'm still a bit messy and tend to have to clean up some blood, but at least I get the IV in! I'm getting better at that as well.
Have your preceptor go in with you and help you. The first few that I got, my preceptor helped me a lot once I got the flashback (she would thread it, hand me the tubing, etc.) and that's where I learned that I had to go into the vein farther.
You'll get it. Give yourself time, and keep practicing!
I learned from an ER nurse of 20 years on how to start IVs.
She was super strict and loved pushing me to try and try on my own - despite my shaky confidence.
It was under her tutelage that I learned the whole "don't look - feel" approach to finding veins. Besides, since it was the ER and everybody got IVs; I had plenty to practice on
Last week, I got an IV "blind" - couldn't see a blessed thing, but I could "feel" it waaaaay down in the arm. Patient was dehydrated but the vein felt "good". Felt right for an 18 guage too.
I stuck it and it bled like a stuck pig :chuckle But hey! #18 in there now!
I am almost finished my consolidation in a busy ER in BC. For the first three weeks or so I was blowing ALL my IV starts. It was horrible and it got to the point where I didn't want to try anymore. All the nurses had watched me do it and nobody could say that I was doing anything wrong. But, I found the trick (for me at least)...here it (they) is (are)...
1) The hand isn't always the best place to go...lots of valves, twisty veins...look everywhere, not just there.
2) Insert needle with authority! Don't jab it in but be assertive. As soon as you see flash, drop the angle to about 5-10 degrees, advance another 1/8th of an inch before you thread. If you don't continue advancing you run the risk of the cathlon not being in the vein yet, remember, the needle is longer than the cathlon.
3)Practice practice practice
4) read all the other posts....good advice there.
Now that I have grown in confidence I have started getting the majority of my IV starts. I found my main problem was either starting out too shallow and just skimming the top of the vein (getting flash but it would just blow) or going in too deep and puncturing through. I found a happy medium and now I (and my patients) are much happier.
rose1135
12 Posts
OK!! I love this thread!! I too am having trouble with the vein "disappearing" or blowing.. I am a new RN and feel intimidated by IV therapy in general.. I am having the same problem though, I get flashback everytime then seem to blow the vein as I try to advance the cathlon. I also have trouble not having enough hands to keep the cathlon in and getting it secured. I have done several sticks over the past couple days, and am trying to get my confidence up, but hearing your stories REALLY helps to make me feel like I am not alone!!