need advice on starting ivs...

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Specializes in Float pool for 14 months.

Idk what it is about starting lines on someone, there are days when I can slap an 18 in someone, and other days I miss everyone. I just started a new job in the ER, and they basically want an 18 in everyone. I came from a hospital where I rarely had to put in an iv. I feel stupid bc when traumas come in they need two lines. I get so nervous when I have to put them in. Yesterday I tried to put an iv in an elderly lady whose veins where very scelrotic, and the cath wouldn't advance. Her daughter got nasty and asked me what was wrong with me that I couldn't get an iv in her. She had nothing to work with. Even a nurse with way more experience than me had a hard time. Any tips on how to start a line? I know some ppl go by feel, others by site. Some ppl have told me, I've put an iv in them the best they have ever felt. I feel inept. Nevermind the fact that I'm doubting my job change. Any tips would be helpful. Thanks!

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sounds more like you have a confidence problem than trouble with your skills. if you can get away with just doing a lot of easy sticks for a couple of days will help. also dont try to force an 18 into everyone. a 20 will work for just about everything in our er. very often we just want an iv any size.

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Specializes in all things maternity.

Experience breeds confidence so start every IV that you can. I felt the same way you do until I asked my co-workers to check with me before they started any IV's. If I had time, I started them. After a few weeks I felt great about my IV skills. Also, remember that we all have those days when we couldn't hit the broad side of a barn. Don't let it get you down.

:twocents:

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Specializes in ER.

Every day someone asks about IV tips, if you use the search function you'll get tons of information.

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Specializes in Pediatrics.

I am interested in what others say too, I am doing my precptorship in the ED and my 1st day I got 3 in no problem. On my 6th day I missed on every patient that I had, and I watched my preceptor get them in almost blind folded.

I had one patient which his skin was so hard and thick it bent the belvel of the needle.

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Someone gave me this link when I asked about iv insertion:

https://allnurses.com/emergency-nursing/iv-tips-tricks-3793.html

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Specializes in Med/Surg.

Nurturing Angel is right. Practice makes perfect. It is simply one of those skills that comes with experience. Practice all you can and don't let a few misses discourage you. Always take your time and don't rush yourself (when time allows, of course). Remember, the further up the extremity, the bigger the vein. If the patient is elderly or particularly frail, I don't use a tournicate. It seems when I do, it always blows the vein. A friend also showed me a useful technique. If you have to use the hand, lower it from the side of the bed with the tournicate tight on the wrist. Use an alcohol prep to slowly push the blood toward the wrist over and over. This makes the vein sorta balloon out as it refills making it bigger. My favorite "sweet spot" is the outer forearm. I call it the "big-n-juicy" vein...lol...Sometimes you gotta be a contortionist to get to it, but its always a good spot. Don't give up. you'll do great!:D

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Specializes in Med Surg.
Experience breeds confidence so start every IV that you can. I felt the same way you do until I asked my co-workers to check with me before they started any IV's. If I had time, I started them. After a few weeks I felt great about my IV skills. Also, remember that we all have those days when we couldn't hit the broad side of a barn. Don't let it get you down.

:twocents:

I agree. so far 98% of the time when I ask more experienced nurses to start IVs on "hard stick" patients, they can't do it either, plus there are times when they ask me for help with their IV starts - so that tells me that I'm not the only one having a difficult time with IV starts at times. Try not to appear too nervous (even if you are) because pt's pick up a lot on that. Like the above post said try to start every IV you can - in this way you will continue to get a feel of it and hopefully reach a fair comfort level. Reading may give you tips, but nothing builds confidence and technique/skills like hands on experience.

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