My IV Skills are Terrible!!!

Nurses General Nursing

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So I’ve been a nurse for 5 years. And my IV insertion skills are horrific. I was an inpatient nurse for 3.5 years, but I always wheeled and dealed with other nurses to insert my IVs. And now I’m been in an outpatient setting for almost a year.

Now ive been moved to a position (still outpatient) where I need to insert IVs every day. At first I wasn’t getting a couple, Now I’ve just been missing. It makes me feel like I’m not gonna make it in this position. Should I take a course? Not really sure what I can do. My confidence is tanking. Any ideas on how to better my skills and calm my nerves?! Any ideas ( other than keep trying lol) would be appreciated? Thanks!

19 hours ago, kbrn2002 said:

IV's are nursing kryptonite for me. Would you believe I've been a nurse for 25 years and have never started one? Yep, not a one. In school we had one practice session using a fake rubber arm filled with beet juice. In clinical's students weren't allowed to start IV's, heck the floor nurses didn't even start them as every hospital we did a clinical rotation at used a dedicated IV team. In my working career I've exclusively worked in a SNF where peripheral IV's aren't terribly common, the few times we get one ordered thank goodness I've always been working with somebody else that is good at it. Hopefully that continues to be the case. I'm pretty good with blood draws so I'd try it if I had to but boy would I feel bad for the poor guinea pig of a resident that got stuck with me.

I have been a nurse for 20 years and have done very few. I have gotten lucky and worked in environments with a lot of PICCs/central lines, and now I'm away from the bedside. I was IV certified in nursing school, but was never confident in my skills at all!

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Specializes in NICU.

It is ,selection,preparation,all tape ready, tourniquet once in awhile,sit on a chair,breathe ,be calm and steady,loved transilluminator for those hard ones help spare the patient,unnecessary sticks.

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Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.

In addition to all the wonderful tips here, I have also found that when you find a vein you like, place a finger on the distal portion of the vein and hold it down with one finger use another to trace the vein proximally, this will flatten the vein while leaving the valves visible allowing you to locate them and plan accordingly to the "perfect" starting point. I would also go to work and ask anyone and everyone on the unit and start as many IVs as possible to gain the experience and learn the tricks.

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Specializes in Neurology/Med Surg/Telemetry Intermediate Care.
On 3/4/2019 at 7:35 PM, brownbook said:

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.

This is so accurate. Starting IVs is not something you can read in a book and nail on your first attempts. I was horrible also. My first year it was a huge source of anxiety. My unit was a busy med/surg telemetry unit and I would say 99.999% of the patients required IVs. I would pray that I wouldn’t have a patient that had an IV go bad or needed one started. It really was horrible. Now people come to me to start their IVs and I actually volunteer to do them for others if you had asked me in my first year I thought I would EVER willingly volunteer myself to start an IV I would’ve laughed in your face! ?

My facility offers new nurses or nurses that aren’t familiar with starting IVs an opportunity to go to the GI lab to start IVs. I did this and still struggled for over a year. ?

My advice, like many others, is to tough it out and at least try each stick once. Go in like you own the place and give it a shot. Practice, practice, practice. Soon you’ll have your own groove down and people will be coming to you for IVs!

Hang in there!

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I think there is some self fulfilling prophecy here. A new nurse randomly gets lucky or unlucky on the first few sticks, and then they think " I am good at this" or "I cannot do this". Then it seems to perpetuate itself.

Everyone will have failures. Some people deal with that much better than others. They don't develop a failure mentality.

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I work in a BMT unit with lots of central lines and I swear I dont have an IV skills. I'm a lot less scared doing them now than before though. I can usually get it in, and that's the easy part for most people. Securing it is another story though.

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Any suggestions about where one should learn/practice to become skillful?

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Specializes in Surgical, Home Infusions, HVU, PCU, Neuro.
2 hours ago, HiFive said:

Any suggestions about where one should learn/practice to become skillful?

Some facilities will let you work an extra shift in places like day surgery, pain clinic, GI lab etc that will give you an abundant exposure to IV starts. I would suggest asking your supervisor if they can facilitate this or even ask the supervisor of the department you are wishing to go to for the day. Most places are very accommodating in this type of request.

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Specializes in Community Health, Med/Surg, ICU Stepdown.

I agree with stick in at slight angle (my angle depends on the sight... practically flat for hands, 5 to 10 degrees for shallower veins and a little steeper for deep veins). When you see the flash lower the angle to flesh with the skin and then thread the catheter. I’ve seen some nurses flatten the angle and slide the entire needle and catheter in and then retract the needle but for me this blew the vein the very few times I tried it. You will find what works for you!

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My IV skills are black and white.

I either poke and poke and get nothing.... OR....

I poke once, and get in so good that the entire room ends up having to be pressure washed afterwards and the patient borderline needs a transfusion.

I will drop NG tubes all day. I love them. But please don't make me start an IV. PLEASE.

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32 minutes ago, humerusRN said:

My IV skills are black and white.

I either poke and poke and get nothing.... OR....

I poke once, and get in so good that the entire room ends up having to be pressure washed afterwards and the patient borderline needs a transfusion.

I will drop NG tubes all day. I love them. But please don't make me start an IV. PLEASE.

Been there done that! It took me a while to get the hang of IV's. What was annoying was early on when I did get a good stick, (often requiring a pressure washer), I didn't really know why that one worked? I didn't have a technique, I felt like it was pure luck!

For me it just took practice, practice, practice, finally I found what worked for me.

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I really do think practice makes perfect in this case -- but I'll be honest. I have IV PTSD, and with all the resources available in my hospital (skill coworkers, a dedicated IV team, etc), it's easy not to FORCE myself out of that comfort zone TO practice. I should just bite the bullet and start sticking babies..... lol..... or maybe I will just start with hydrated teenagers.

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