My IV Skills are Terrible!!!

Jory, MSN, APRN, CNM · Mar 4, 2019

Oh, nobody was worse at these than me. It was a running joke. I used to say, "Can you go your whole career and never learn to start one?"

Even today, I can stick by sight, I can't do by feel. But this is what helped me.

I wasn't retracting the needle soon enough. Push it in just a tiny bit when you get a good flash, push the button to retract the needle. Hold steady and push it the rest of the way through. Have your flush ready OR use your finger at the cannula base to momentarily stop the bleeding until you can connect it.

Tip: I see too many nurses lose the IV because they allow the cannula to manipulate too much after placement--that is how you lose it. Always have at least one piece of tape ready, secure the end first, then put on your tegaderm, flush again and then continue securing.

Daisy4RN · Mar 4, 2019

Learning this skill can be difficult. Like you I never needed IV skills when I first started so never really learned until later when I need to. I know you want more than keep trying but the more you practice the easier it gets. I was horrible also while learning, it didn't come easy for me either. I remember missing on veins that looked like fire hoses, getting (a lot) of blood everywhere etc. I just kept pushing forward and eventually got it!! One thing I would recommend is watching YouTube videos for more information and viewing. You will get it, good luck!!

brownbook · Mar 5, 2019

Over half the nursing population in the USA could have written your post. There are brilliant nurses who have gone their whole career, even in acute care, that seldom have a need to, thus are not good at, starting IV's.

Put in how to start IV's, or bad at IV's, in the Allnurses search bar and you will get 100's of ideas.

I was terrible at IV's for most of my acute care nursing career, yet ended up in pre-op starting IV's. At first I was terrible, but eventually my inner IV nurse came out...kind of like Luke and The Force ?. I do believe it is 80% psychological and 20% skill.

I never did like the advice about follow an IV team nurse, or ask a nurse who is good at IV's. To me that is like asking a fish how to swim....it comes so naturally to a nurse whose good at it I think it is hard for them to get down to your (my) level. So often perfectly good advice that "always" works for them just doesn't work for me. Talking it over with a co-worker who is also learning and struggling can be more therapeutic. But that is just my opinion.

YouTube is a great place to start.

JKL33 · Mar 5, 2019

I think it's nice to have someone who is good at it (and kind/encouraging) observe the one having trouble vs. the one who is having trouble being told to watch people who are good at it. People on their first try ever can often be coached to success in real time. Someone needs to look at the site you select, the way you hold the skin/surrounding area, the way you hold the needle, the angle of approach, etc., etc. These are all areas for possible troubleshooting.

Anyway, OP, we need more info. How are you missing? Total miss, or get blood return but then can't advance catheter, or "blow" it? Or some of each?

Party_of_five, BSN · Mar 5, 2019

There is a really informative and helpful Instagram account called IntravenousQueen. Look her up. She also lots of tips, tricks and videos.

OldDude · Mar 5, 2019

No one has yet to mention mojo, cosmic upheaval, supernatural interference, disturbances in the "force," and other negative effects of the universe. You'll get there...just keep on keeping on!!

I would go through periods where I could start an IV on a 1 month old with my eyes closed and wearing boxing gloves...and then I'd go through periods where I couldn't get a vein if it was like a water hose laying on a concrete driveway!

Hang in there!!

CardiacRNLA, BSN · Mar 5, 2019

14 hours ago, JKL33 said:
I think it's nice to have someone who is good at it (and kind/encouraging) observe the one having trouble vs. the one who is having trouble being told to watch people who are good at it. People on their first try ever can often be coached to success in real time. Someone needs to look at the site you select, the way you hold the skin/surrounding area, the way you hold the needle, the angle of approach, etc., etc. These are all areas for possible troubleshooting.
Anyway, OP, we need more info. How are you missing? Total miss, or get blood return but then can't advance catheter, or "blow" it? Or some of each?

Howdy!

So yes, it’s a mix of both. Mostly, lately I notice I get flash back, and I’m like “yay!” But then I can’t advance, or I advance and there’s no flush. But then they are some where I just flat out miss. Sorry I didn’t mention that before!

CardiacRNLA, BSN · Mar 5, 2019

2 hours ago, OldDude said:
No one has yet to mention mojo, cosmic upheaval, supernatural interference, disturbances in the "force," and other negative effects of the universe. You'll get there...just keep on keeping on!!
I would go through periods where I could start an IV on a 1 month old with my eyes closed and wearing boxing gloves...and then I'd go through periods where I couldn't get a vein if it was like a water hose laying on a concrete driveway!
Hang in there!!

Thanks so much! Seriously! It’s like some of these nurses have some juju or vein conjuring skills that I’m missing! Lol! Some of them will literally go in the same spot I was in and voila! It works! So frustrating haha!

ruby_jane, BSN, RN · Mar 5, 2019

Back when Mr. Ruby Jane was a wee ADN starting out in the late 90s, both hospitals where he worked actively promoted the idea that new nurses should try to start as many IVs as possible. It helped that he worked in the ER at the time.

Flash forward to my entry into the field in the early aughts - Don't start that IV! We have an IV team!!! As a result, Mr. RJ can still stick the hardest to stick patient, and while I'm a whiz at phlebotomy, I can't. If this is your job and this is what you have to do then practice, practice, realize that you win some and lose some, and practice some more. Good luck!

CardiacRNLA, BSN · Mar 5, 2019

4 minutes ago, ruby_jane said:
Back when Mr. Ruby Jane was a wee ADN starting out in the late 90s, both hospitals where he worked actively promoted the idea that new nurses should try to start as many IVs as possible. It helped that he worked in the ER at the time.
Flash forward to my entry into the field in the early aughts - Don't start that IV! We have an IV team!!! As a result, Mr. RJ can still stick the hardest to stick patient, and while I'm a whiz at phlebotomy, I can't. If this is your job and this is what you have to do then practice, practice, realize that you win some and lose some, and practice some more. Good luck!

Thank you! And yes, I agree! In RN school, we are not allowed to practice IV skills, except on a manikin. Not even on each other. And then you’re expected to do it on the floor like magic. I understand some people just take to it. But others, like me lol, don’t. Thanks for the encouragement!

guest974915 · Mar 5, 2019

I worked as a phlebotomist in a large hospital for about 3 years while attending college and gained great venipuncture experience that has has really helped me over the years, especially with IV starts. One mistake that I commonly see, is nurses who fail to properly 'anchor' the vein and instead, chase the target without success. If you firmly compress the vein with your index finger and thumb and then insert the IV between your two digits, the vein has much less tendency to 'roll'. Voila. Hope that helps:)