Just got off orientation on a busy med-surg unit. :) So I admit I have not had much experiance or practice with starting new IV's but have been succesful at it when I have done it in the past. My experience with starting IV's is this, 0 in nursing school, 2 hrs starting IV's with a RN for pts. about to have a colonoscopy maybe a total of 15 pt.s, 3 successful IV starts with my preceptor, 2 succesful IV starts and 1 fail on my own after orientatation. Also it does take me quite a bit of time to gather equipment, apply warm blankets to the pt.s arms, set up, etc.
I had a crazy busy shift on 11p-7a and a pt. said to me while I was in their room hanging antibiotics that there IV site was hurting, and they were tired of having to keep it straight so as not to cause the IV pump to start beeping. I assesed the site for infiltration, redness, heat etc and flushed it and there was no pain while flushing with normal saline. So I felt the site was fine it was just irratating the pt. because of it being in his antecubital fossa or AC. I would have changed it if I had had time or asked another nurse to help, but I had neither. Also the pt. didn't mention it again and so I thought it wasn't a problem, and I was so busy I was grateful not to have to find time to start a new IV.
Then just before I left the floor to go home my charge came running up to me and said that he had been rounding on all my pt.s. He let me know I should have started a new IV and did it in such a way that it left me feeling like an incompetent jerk for not doing it. I later looked up the policy and didn't find anything that specifically stated I had too start a new IV. But still now I feel horrible, that I was uncaring to the pt. by not starting a new one, and maybe that I am a little incompetant.
What are your thoughts? Anyone in similar situations? My question is to everyone and all the experienced nurses out there what would you do? Also given the situation, was what I did really wrong?
While there is science behind starting IV's, most of it is practice and building up your confidence. Take all the time you need, sit if you can, talk with the patient (it will calm both of your), organize your supplies, build habits that work everytime, and offer to start every IV that comes your way. Soon you will be that nurse that everyone calls on because you're the expert.
Thank you, I am certainly hoping this will be something I can say one day. It would be cool to go from where I am now to others asking me to help them to start a new IV.
In an ideal ivory tower world you would have "slipped in" a new IV.
The the real world of a newbie on a busy unit uncertain of her IV skills you did the best you could do to survive the shift.
Computers, (electricity, ha ha) weren't invented when I was trying to become good at IV's so I can't attest that this will help but there are excellent YouTube videos about starting IV's. Watch them over and over and over.
REMEMBER TO TAKE THE TOURNIQUET OFF, (we all, even years of experience nurses, have done that)!
Can I say wow, you definitley have good insight on what I was going through. Yes I think that is a great idea and am looking for some good youtube videos. Does anyone have a good link or two?
it does take me quite a bit of time to gather equipment, apply warm blankets to the pt.s arms, set up, etc.
Practice, practice, practice... before long you'll be grabbing your stuff and hustling it done. And don't bother with the warm blanket thing unless you really can't find anything and you're desperate.
IV site was hurting
Well, an IV site that's hurting is one that is starting to become symptomatic and worthy of being changed... but not urgently... as time and workload permit.
I was grateful not to have to find time to start a new IV.
As I think someone mentioned, I think there was part of you that was looking for a reason not to do it.
He let me know I should have started a new IV
I agree with him
and did it in such a way that it left me feeling like an incompetent jerk for not doing it.
Maybe he's being a Richard or maybe you're being oversensitive... hard to say.
now I feel horrible, that I was uncaring to the pt. by not starting a new one
I don't see anything in this story to feel horrible over... so the guy was a little uncomfortable for a few hours... it's not that big a deal. I agree that you should have started a new one, or at least tried, but you're overreacting.
maybe that I am a little incompetant.
Way overreacting...
what would you do?
I would slap a new line in him
was what I did really wrong?
I think it was wrong but on the spectrum from
wrong to Wrong to WRONG to F'ING WRONG!!!
you're at "wrong"
Really not a big deal all the way around in my book.
It may have been causing the patient some discomfort, but it might also have caused discomfort if you tried to start an iv and were unsuccessful a few times. Then you would have needed to find someone else, which would require a third attempt.
Also I can say from working in the emergency room, that an iv is started in the AC often because this is a larger vein, which makes it easier to hit and obtain blood for labs.
I later looked up the policy and didn't find anything that specifically stated I had too start a new IV. But still now I feel horrible, that I was uncaring to the pt. by not starting a new one, and maybe that I am a little incompetant.
powerful/painful lesson to learn, thanks for sharing.
carebear1980
26 Posts
Absoulutely this is how I try to approach situations. It helps lesson negative feelings I may have and also I love a challange on most days. :)