8 months in and suddenly can't start an IV!

emmy27 · Oct 10, 2013

Now for my past 3-4 shifts, I suddenly am not able to start an IV to save my life! I don't know what happened, but now my confidence is shot and I'm stressing over something I used to be able to do with my eyes closed...I now have no confidence!

This is almost certainly the root of the "problem". It's a skill that takes a combination of finesse, focus, and confidence, and a blow to your confidence can make it seem suddenly impossible. But it's not. You've done it before, you'll do it again. Everybody has bad days (a series of tough sticks? Patients who jump? Exhaustion or stress or too much caffeine making your usually steady hands wobble? Some combination of the above?) but a few bad days does not an incompetent IV starter make. Worrying that you look bad to your coworkers or feeling bad for your patients can compound the difficulty, but remember: your coworkers a. Have had bad days and tough sticks and were once new grads themselves and b. are not keeping a running count of the number of failed sticks you have (or if they are, holy hell, you need a new job). And as for your patients, nobody likes to inflict pain, but you're doing your best to give them needed care, and if the worst thing in their day is that they got poked twice, they're doing better than a lot of ER patients.

Chin up. Take a couple of deep breaths and tell yourself you *will* get that stick each time you go in to a room (not you will get that stick *or else*, don't beat yourself up, just be positive and kind to yourself) and you'll get back to business as usual before you know it.

If you're really worried and can't seem to break the cycle, consider volunteering to start lines for your coworkers on patients who either have gorgeous gimme veins or who are unconscious. I was an *atrocious *stick as a new grad (I hated causing pain to patients and I was sure all my coworkers were waiting for me to fail and the more times I did, the more certain I was I would just never be able to do it and... Downward spiral) and making myself do it over and over and over in low-stakes situations was how I finally achieved real competency. You've already shown you are capable of doing well at this. You've had a few rough days, but this too shall pass.

BostonRN13 · Oct 10, 2013

I remember my first IVs were on fellow RNs with big, fat veins. Ask if a coworker will let you try on them..

DavidDudley · Oct 14, 2013

So here's my deal, I would initiate the IV, get a flash, and then have trouble advancing the catheter. Like when you hit a valve... except there is no way I am hitting a valve every single time. When I am advancing the catheter, I can see the vein "pull" on the overlying skin and not want to advance into the vein.
I've never had this problem before... I've literally started hundreds of IVs. I don't know what's wrong with me!

A fundamental mistake with an easy solution. I too had the same problem in my ER. Initially, I was doing fine with my IV sticks and then I eventually couldn't get any sticks anymore for the life of me. My confidence was blown and I felt like less than a nurse. So I turned to allnurses to find a solution and its simple:

As soon as you initiate the IV stick and get a flash, DO NOT immediately advance the catheter. Instead, advance the entire IV needle itself 1/8 more into the vein, and THEN advance the catheter. Once I implemented that simple step, I no longer had the problem that your facing. But be careful not to advance the needle too far because you risk going through the vein.

Hope this helps.

Editorial Team / Moderator · Oct 15, 2013

As soon as you initiate the IV stick and get a flash, DO NOT immediately advance the catheter. Instead, advance the entire IV needle itself 1/8 more into the vein, and THEN advance the catheter. Once I implemented that simple step, I no longer had the problem that your facing. But be careful not to advance the needle too far because you risk going through the vein.

That is exactly what I teach people to do - after the flash, advance the needle just the length of the bevel before trying to thread the catheter - that pretty much ensures that the catheter will enter the vein without issues. :)

BSNbeauty, BSN, RN · Oct 15, 2013

Great tips!!!

nrsang97, BSN, RN · Oct 24, 2013

I have my dry spells and I have been a RN for 12 years. Some days I can't hit the broadside of a barn and others I am able to get IV's in that I never thought I could.