Nervous about starting IV's help

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I'm kind of nervous bc Im gonna start a job in home health and will likely start a lot of IV's or do blood work, I don't know why but sticking people with needles makes me nervous b/c I feel I am hurting them and I'm terrible at IV sticks.

My problem is sometimes I can hardy see the vein and when I stick them where I think the vein is, I don't get any blood return. Some nurses tell me that I'm under the vein, some say to pull back a little, I really have a hard time knowing where I am and this makes me nervous. Any advice? Thanks

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You said you can hardly see the vein. My advice would be to not worry about seeing the vein at all. You need to be able to *feel* it.

Leave the tourniquet on for a bit with their arm relaxed and then have them make a good fist (this is what I do for putting IVs in the AC fossa). Work your fingers across the fossa and see what you can feel. Feel for something with good rebound and then gently place one finger there so you know where you are going. Don't have them let go of the fist until you are in.

Personally, I kind of like the deeper ones....the ones you can't see at all. For whatever reason I seem to be a lot less likely to totally go through those.

Good luck!

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Do you stick at an angle or are you almost parallel with the skin

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I work with a nurse who has been a nurse since before I was born. She has worked ER and ICU and she is the IV queen. I swear, she could throw an IV across the room and get a perfect stick! When I asked her how she got to be so good?

"Just like anyone gets to be good at anything. You practice a lot, and every now and then you completely mess it up."

Under the vein, above the vein, blew the vein--I'm in the "completely mess it up" stage myself, but I can slowly see things improving. I also don't like to hurt people and am sensitive to people's pain thresholds when starting IVs/drawing blood, but I figure, I'm the nurse. I have to get the blood. I'll try to keep the pain to a minimal, but some of the process of becoming a nurse is tough love--doing what's best for the patient even when they may not like it sometimes. (as long as they consent, of course!)

The point is, keep practicing! Like most things in nursing, IV starts aren't only as science--they're an art, too.

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I was trying to look at my arm, and I cannot see or feel anything on my forearm, the AC and hand are the only ones I can see and feel

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I was trying to look at my arm and I cannot see or feel anything on my forearm, the AC and hand are the only ones I can see and feel[/quote']

Do you have a tourniquet on your arm?

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Specializes in Emergency Department.

You really need to put a TQ on that arm. That should make your veins fill up like the AC and hand veins and be palpable too. Try this, get your TQ on, palp that nice big vein in your AC area and follow it distally. "See" just how far it goes before you can't feel it anymore.

Another thing when starting an IV: get everything set up, after you pierce the skin, bring the cath almost parallel to the skin and aim the bevel right where the cath should end up. Once you get a flash, pause, advance another couple mm or so, stop, then advance the hub to skin.

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Specializes in Pedi.

What kind of home health job is this? Is it with an infusion company? I NEVER start IVs in home health and very rarely do peripheral blood draws. Presumably you will be oriented to this new job and someone will assess your ability to start IVs/draw blood independently? That's the thing with home health... there's not always another nurse to call if you can't get it. I send my patients to the clinic if, for some reason, I can't access their port or their line isn't drawing but I'm working in pediatrics and my patients are typically not homebound.

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Keep trying... And go slowly. I was having 40% success on IVs until just recently. Now I am 90% or better. What changed ? After I find my spot, I stick and if I don't get blood initially I SLOWLY AND SLIGHTLY pull back or re adjust my needle or angle in differently. After u stick them you have already done some damage, and chances are (if u don't get blood immediately) u are just a few mm off. Slightly and slowly adjust. Fight for your iv.

Something else that helped me.....I just kinda got annoyed at myself/impatient with having to wait for somebody else to help me. It is much easier to just take care of it yourself.

Good luck ...it will happen. I have been working about 18 mo as a nurse on med surg unit.

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