Pretty bad at starting IV's

Nurses New Nurse

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I am a new RN, just out of school, and have been off orientation for a few weeks. I am having trouble with starting IV's and find that I need help with about half of them. It is very frustrating because it is bringing my confidence down and making me feel like I am a burdon to other nurses. When did you begin to feel like you needed less help with nursing skills from other nurses? I have only been a nurse for 4 1/2 months and Im wishing I could fast forward to a time where I felt more competent!

I have started IV's almost everywhere. Thumbs, toes, etc. The trick is not to rush. I will find one of those thin gabage can liners (sneak into the cleaning room) from a box and take about 3-4 wash cloths. I take the cloths, wet them, wring them out and put them in the microwave (oops) and heat 40 sec. They are hot as heck so I move them about, then when not scolding, I wrap around the arm/hand and put the plastic bag over it and keep it there for at least 5 min. I tell them it is their "spa" treatment. Then (with arm still in bag) I hang their arm down for about 20 sec. and take bag/damp cloths out and usually a vein is there.

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Thank you guys so much for the advice. I know that I need to take my time looking for a good vein, but because Im working in the ER I feel like I need to be quick because most patients need fluids/ meds quickly. It seems the only ones I can get are the easy ones that pop right out at you lol. I am working again on friday and Im going to try to take my time with each one and have a little more confidence in myself. I am really trying not to get to upset because I really want this first year of nursing to be a big learning experience with my skills. Thanks guys!

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You are correct; being in the ER may mean you have to act fast. Just keep at it and let the pros give you advice while you are doing it.

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Specializes in OB.

In my L&D we did 18 guages...all the time.

I really like all the advice.Hereis the only thing I have to add. If you see a bifurcation in a vein(there's usually that hand one that comes straight down the ring finger and then forks into a "V"), always go in the middle of the "V", it''ll stabilize the vein and I have never missed that one.

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AnggelRN you are 100% correct. I teach all nurses to "look for the Y". I forgot to add that earlier post.

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Thank you guys so much for the advice. I know that I need to take my time looking for a good vein, but because Im working in the ER I feel like I need to be quick because most patients need fluids/ meds quickly.!

Think about it this way -- it's likely actually quicker for you to take some extra time, than it is to miss twice and have to go hunting for another nurse. As for the patients, I tell them "I like to look twice and poke once." This prevents them from taking my diligence for a lack of confidence.

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One thing that really helped me when I was a new grad was to go to our hospital's ambulatory surgery center and start IV's for 1/2 a shift for a few days. Our ambulatory surgery center sees 40-50 patient's a day so I had a LOT of practice, it improved my confidence level quite a bit.

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You used bigger gages in L&D than in the ED?!

Yes! 18 in l&d and unless we suspected blood products a 20 or 22.... Sometimes I think we are using something larger in l&d I swear I'm sticking people with blood donation straws!!!!!

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Specializes in Cardiac, Med-Surg.

Practice makes perfect! I'm also a new grad with 2 1/2 months of experience on a med-surg floor and my IV starts are always a hit or miss. Don't be discouraged and just do your best to find a vein. You have two chances, so why not use it, right? The ones that I don't always get are the elderly population. The one thing that my co-workers told me is to bend their arm and use the side of the forearm. Also, I read on this thread that they went to the surgery center to practice.. That is also a great way to boost the confidence. Our new grad residency program gave us a chance to practice our IV starts at the peri-op for 2 hours. It was definitely a fun experience.

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I don't know if this helps, but it's something I made the mistake of once...once you get a flash, undo your tourniquet, otherwise you will blow it (with it still tied).

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I don't know if this helps, but it's something I made the mistake of once...once you get a flash, undo your tourniquet, otherwise you will blow it (with it still tied).

Or use a manual BP cuff!

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Specializes in Emergency, Pre-Op, PACU, OR.
Yes! 18 in l&d and unless we suspected blood products a 20 or 22.... Sometimes I think we are using something larger in l&d I swear I'm sticking people with blood donation straws!!!!!

Different ED, different culture I guess ;). We use 18s and 20s as standard (preferrably 18s though) and 22/24 only on children or the patient that is impossible to stick (eg a 22 in the thumb).

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