New ER nurse...is there any hope for me?!?!

Altra, BSN, RN · Jun 27, 2013

Even experienced ED nurses get 8-12 weeks orientation in my ED. Nurses coming from other specialties -- 12-16 depending on experience and progress during orientation.

You'll get there. :)

ChuckeRN, BSN, RN · Jun 27, 2013

A monkey can start IVs. Don't sweat the small stuff.

Guests · Jun 27, 2013

Regarding IVs, Just keep sticking them, you'll get there.

A couple things to consider: (1) if they're blowing a lot, you might be going too deep... that's a pretty common mistake... try missing shallow, and (2) only put the tourniquet on as tightly as needed to plump the vein. A lot of older folks don't need a tourniquet at all.

SweetMelissaRN · Jun 27, 2013

Regarding IVs, Just keep sticking them, you'll get there.
A couple things to consider: (1) if they're blowing a lot, you might be going too deep... that's a pretty common mistake... try missing shallow, and (2) only put the tourniquet on as tightly as needed to plump the vein. A lot of older folks don't need a tourniquet at all.

^^^thats great advice... I was one of those that was 1:15 for successful sticks starting out, a lot of it came from a lack of confidence... I'd say I didn't get semi decent until after probably 300 sticks or so... Now, I'm the go-to for hard sticks... Trust in yourself that you have the abilities and don't sweat blown veins... To build your confidence try going with smaller gauges for non critical pts (like the 20 yo with burning chest pain who just ate Taco Bell)

You'll get there, just keep at it :)

luvcharlie · Jun 29, 2013

I am new in the ED from tele floor nursing. I was lucky enough to get 14 weeks orientation! When I first started I was one of the best on my floor before the ED but they had different catheter needles with their IV's and it busted my confidence too for the whole thing, and I felt stupid too because something that should be simple was being the time killer! Don't let it get you down! Once my confidence picked up I am back to my usual success rate of 95% on first stick! Two things I was doing wrong, First I was going too high (and maybe too fast?) "Low and slow" is the key phrase in our ED! Second, I was giving up too soon! I was usually right beside it, under it or over it and once I stopped giving up I would pull back palpate and aim better and usually get it! Regarding "getting fired" they want dedicated ED RN's, if you are dedicated they want you! Don't worry so much! You will feel better and perform better if you relax and focus on what is important, your patient care!

One more thing on IV's that blow remember a lot of the ED patients are dehydrated and this makes the veins blow more easily too!

Guests · Jun 29, 2013

I was giving up too soon!

I forgot about this. After awhile I discovered that sometimes I get a flash but then can't advance the catheter much and don't get any blood out but then by slowly (very, slowly) withdrawing the catheter, blood will begin to flow. Sometimes you can tape it down with a substantial portion of the catheter outside but the tip is in and the IV is patent and sometimes you can float it in with saline.

It kinda sucks for the patients but you really need to experiment a little bit.

There's an art to IVs and experience makes a big difference.

Keep sticking.

When patients object to having a newbie stick them, I point out that the only reason that I'm good at it is because of those who've gone before them on whom I was able to practice. Most see the logic and agree to at least one poke.

MereSanity · Jun 30, 2013

Thanks to everyone for the wonderful encouragement. I know I'm not giving up...just hope they will be patient with me! Thanks again!

MereSanity · Jul 1, 2013

Well I started 2 IV's over the weekend (successfully)..their ivs are just so different...hard to get used to. Missed one start and had to get help...and begged off the start on the 550 pound patient (a little disappointed in myself for that but I was with another patient anyway). Feel a little better...now to scour the Internet on any info on this brand of IVs ...I want to be prepared tomorrow!

OlivetheRN, ADN, BSN, RN · Jul 1, 2013

Well I started 2 IV's over the weekend (successfully)..their ivs are just so different...hard to get used to. Missed one start and had to get help...and begged off the start on the 550 pound patient (a little disappointed in myself for that but I was with another patient anyway). Feel a little better...now to scour the Internet on any info on this brand of IVs ...I want to be prepared tomorrow!

That's awesome! I'm curious, what kind of IVs do they use?

XmasShopperRN, ASN, RN · Jul 2, 2013

Also, place the limb in a dependent position and let gravity help you out once you've spotted a vein and are getting set up. And reassure the pt's who question your IV skills that you're just looking and won't stick if you don't see anything; once you spot a juicy vein and are all set to go, most people will let you continue.

**NickiLaughs, ADN, BSN, RN** · Jul 2, 2013

I was 3 1/2 years ICU, it took me 6 weeks to have any luck with IVs, and after 10 weeks orientation, I was able to be on my own. The first 3 months my IV skills really started to improve, and now at 7 months, I'm rockin it. I got. 20 in a severely dehydrated former iv user/homeless dude with thick skin...after a nurse who usually does better than me tried 3 times. You will get there and you will feel awesome! Each specialty just takes time. There's different knowledge required, different skills. Don't beat yourself up! And I'll bet one day your OR knowledge will come in really handy on some complicated patient. Nursing knowledge is never a waste!