Learning IV Skills Outside of My Job

[Brae30]

I know this is gonna sound like a weird question, but please bear with me. I'm going on almost my second year working as an RN. My first year was in Medsurge and I am now in women's services. I still cannot start an IV for the life of me. I feel like I just end up hurting patients. I have an absolute fear of it at this point and I'm always looking for help and everyone's giving me a really hard time. How can I learn to become professional with IVs without having to practice them at work? Are there outside classes or ways of doing this where I don't have to do it at work and be continually judged and mocked there? This is a serious question. Thank you so much for your kind input! 

[Been there,done that, ASN, RN]

Nurse Beth said:

Check to see if your Education department has a mannequin arm for starting IVs

I have passed IV skills during orientation, on a mannequin  arm. Haha.. I couldn't have started an IV, if my life or the patient's' life depended on it. 

 

[hppygr8ful, ASN, RN, EMT-I]

You know you can buy a practice arm at start kits for under a $100.00 from amazon

 

[JKL33]

Honestly once you understand the process that needs to happen (the steps and the basic dexterity) the arms don't add a whole lot. They always have a big ol nice non-rolly vein, the pretend skin is nice and firm and doesn't move.

The missing piece (which could be initially idemonstrated on an arm but not as much benefit from practicing on the arm) is generally the other details: Choose the right/best vein and the best specific location over that vein to puncture, choose the right equipment for the vein you chose (gauge, etc) stabilize the vein properly while keeping your own hand, wrist and fingers out of your way, approach from the correct angle, and slide the catheter off at the right stage of the process (neither before entering vein nor after the needle has punctured all the way through the vein).

[vintagegal, BSN, DNP, RN, NP]

Depending on your hospital system they can move you as a float to outpatient infusion where you can continue to practice your skill set in an environment that is more conducive to learning. Also try ambulatory surgery centers. 

[BeatsPerMinute, BSN, RN]

vintagegal said:

Depending on your hospital system they can move you as a float to outpatient infusion where you can continue to practice your skill set in an environment that is more conducive to learning. Also try ambulatory surgery centers. 

Not opposing the idea but wanna just share a FYI not all places are the same. I've worked inpatient ICU / ambulatory / PACU / Cath lab and currently work in outpatient IR, mostly with elderly ESRD patients. The place does not have a vein finder and we are not allowed to use ultrasound at this facility either. My point is that this may be a good idea however would def ask about what resources you would have available at any facility. 

[Mickeyii]

I think many nurses are putting on the tourniquet on too tight.  You want to cut off the venous blood return but not cut off the arterial flow.  Allowing arterial flow will plump up the veins and restricting the venous flow will keep the veins from emptying.  Also, on old people (like me), if they have big veins I have sometimes started IVs without using a tourniquet.  Over dilating old veins makes the vein blow when the stylet hits it.  This won't work if you need to draw tubes of blood.   Luckily,  I have pretty good veins because when I've been a patient the tourniquets have been so tight they never would have found a vein if they had not already been bulging. 

[Mickeyii]

Also,  when I was starting I would ask someone else to get it if I missed after 2-3 times.  A fellow nurse told me "you're never going to learn unless you keep on sticking them until you get it.  You need to see what it feels like to get some successful sticks.”  It sounds means but that's how the residents learn to put in lines.  And I remember at a different hospital the nurses told me "ask Bill to get it.  He's real good.”  So 15 sticks later he got it but I could have done that myself in 15 sticks!    I became very good but when I had some bariatric patients that vein finder thing didn't do any good.  The residents used to get the regular ultrasound machine and they'd get it.  I forget the name of the vein finder we had for nurses but it never found anything I couldn't find myself ??‍♀️?‍♀️