Need to work on my "dexterity". Any advice??

[Shorty11, BSN, RN]

I am having a difficult time with adhesives. I know that sounds strange, but let me explain. In my clinical the other day, we were working on IV insertion using a manikin. I had no issues selecting the proper "vein", size of catheter to use, applying the tourniquet, inserting the IV catheter at the proper angle and into the vein, attaching the saline lock, etc. My problem arises with properly dressing the site. For some reason, as soon as I am at the point where I am ready to apply the dressing, things go wrong. As I was applying the dressing, I had issues with it sticking to my gloved fingertips. As the adhesive on the clear dressing began to stick to me, I did my best to try and maneuver it onto the manikin's arm, but it just got worse. It started sticking to my fingertips even more and began to misshape. As I got the edge of the dressing unstuck from one fingertip, it was all the sudden stuck to another. I finally applied the dressing, but it didn't look pretty. My instructor told me I need to work on my dexterity. I was so embarrassed. I want to be a good nurse. I do well at skills, until it comes to the mix of adhesive and gloves. I don't feel that my dexterity is necessarily bad, because I am good at the majority of steps involved in skills. But obviously I do need some work because this is not the first time I have had this issue. For some reason, I am just having issues with being able to properly apply adhesive dressings or coverings without it sticking to my gloved fingertips. Any advice??

[jadelpn, LPN, EMT-B]

This is not easy, even for the most experienced nurse. Make sure you have set everything up within reach. If you are allowed to use tape, take a few pieces, and hang from the mayo stand. Use one of them to hold the IV in place and then get the tegaderm and apply. If tape is not feasible (and some facilities don't allow it) make sure that your patient's arm is on a pillow, put the IV in, ask the patient to hold arm still while you get the readily available tegaderm. Good luck and you will get it!! It is all in the set up, I have even put a chux on a pillow and set everything up around the patient's arm. But as you do it more and more, you will find your own niche.

[Music in My Heart]

The best advice I can offer is: practice, practice, practice.

I took home some old angiocaths and some tape and just got used to the feel of working with them.

At this point, it's all second-nature but in the beginning, I had some similar problems as you describe.

[Esme12, ASN, BSN, RN]

Unfortunately this is an experience thing.....and sometimes it takes a while to get your mojo down. The key is practice practice, practice. Personally I HATE gloves and adhesives. I try to open and cut tape to size before I start to do anything. There are certain tegaderms that are easier to apply (from the manufacturer) than others.

We have ALL had sticky issues. At least you are learning with gloves.....for once you "know how to" without them it is really hard to learn to do it with them.

Good luck on your nursing journey!!!!

[hodgieRN]

This happens to me all the time. You use tape, tegaderms, band-aids, and if any part of them hit the gloves, it like glue.

What you can do is peel off the back of the dressing as you apply it. You know how to apply a band-aid at home...it has the white tabs on the side. You put it to the skin and then peel back the tabs as you extend the band-aid on the skin. You can use that technique with IV dressings. Have one tiny spot on the very outside of the tegaderm that is touching the glove, and then peel off the backing as you are laying the dressing over the site. Some IV start kits have tegaderms with the two tabs. What I mainly do is peel off the whole thing, have only one part of the tegaderm touching the glove, then I press it on the site with other hand. I push down the dressing with my other hand and fan my fingers out (away from the center). Once I have everything attached, I just pull away the gloved hand.

Just what until you have replace the band-aids on an NG tube and you have to peel away the two sides sticking together with gloves on. Everything just sticks. Next time you are at clinical, get a couple of tegaderms and try applying it to a table with the gloves. You'll work a method out :)

[hikernurse]

The earlier suggestions were great. The only thing I can add is to take a few extra seconds and visualize where you are putting the tegaderm before you lay it down.

I wanted to note that you gave me a good laugh on a really crazy day :). A few years ago I would have written the same post, lol--and depending on the shift, maybe even a few days ago . Ain't sayin...

You'll get there. Really.