Problems with IV starts/blood draws

[ClaraRedheart, BSN, RN]

I've only been on the job as a med-surg nurse for about a year this week. However, I STILL hate and get shaky at having to draw blood or start an IV.

Call it a personal phobia... but I DON'T like invasive lines. Period. I wanted to be a nurse at 19. Took some pre-nursing classes. In psychology 101 they showed a video of a guy sticking a needle through his arm. I HATE needles. I withdrew from all of my prenursing classes. Married a sailor and was a family photographer for a couple of years. Ten years later, I went back to it with some encouragement from my mother, who is a nurse.

My mom told me "if you like people, you'll like being a nurse". I do. And I LOVE my job. I love EVERYTHING about nursing except for inserting lines. I can handle MOST needles now. I still hate needles... don't get me wrong, but I barely even cringe now at lovenox or insulin injections. IM injections: I still feel weak in the knees, but I feel that I'm getting used to them to. IV starts... It takes concentration and skill. If I've got the time, I don't mind one try at it, and honestly, concentration of mastering the skill takes my mind off of my weak mind for blood. But I feel that me trying on one person more than once or twice is just torture since I'm not entirely confident in my own IV skills. I have NO problem giving blood btw, or priming it, or looking at it. Just taking it causes severe anxiety for some reason with me.

One of the last few days that I worked, our lab techs called out because of the snow/ice. I had a patient who had an order to draw cultures if his temp was over 101. At 0400 vitals, I felt the need to retake his temp because it was at 100.00. It was 101. An order to draw blood cultures 15 min. apart at >101 and above was in place. I almost regret my decision to reassess. I had to draw blood cultures AND labs, which means at least 2 DIFFERENT sticks. I could have gotten the labs fine, but switching between the blood culture and lab tubes, I blew the veins. I saw the hematoma collect under the skin with BOTH blood draws. I feel that I hurt him and have a HARD time with that. I know... a hematoma is a SMALL thing on the grand scale of things. But, with the bubbling under the skin, It bothered me and I had a HARD time keeping it together for morning report. I'm here to HELP people, not cause hematomas and stick them multiple times. To make matters worse, I collected one of the lab draws that was expected, but for the second, the blown vein couldn't give out any more blood on the second blood culture draw. I asked another nurse to help, and she VERY kindly did. However, she drew the wrong color of tube and the lab called at shift change to ask me to draw blood from him again. I lost it. No screaming, no outward crying, but I had to spend 10 minutes in the bathroom fanning myself with one of the posters from the board to keep from crying/hyperventilating, melting down.

I can give blood to patients, so... that doesn't bother me. Taking blood does. How do I get over this?! I'm considering asking my MD for Xanax for situations such as this. If I could surgically have my tear ducts removed, I would. I think that would be the easiest solution. I'm a relatively new nurse. Does this get easier with time?

[BIGT68]

Yes it gets easier, get out of ur comfort zone and do any IV u can, and b4 u know it you start having success, your confidence gets better, and then ull start to enjoy doing them, and ull learn how you can improve ur technique with every stick but you will have to practice to get good, so start doin any IV u can and improve urself everytime, good luck

[CrunchRN, ADN, RN]

Practice, practice, practice. Occasionally I even taking Propranalol which blocks the adrenalin cascade effect. It is a inexpensive harmless therapy for performance anxiety.

[ClaraRedheart, BSN, RN]

Practice, practice, practice. Occasionally I even taking Propranalol which blocks the adrenalin cascade effect. It is a inexpensive harmless therapy for performance anxiety.

My doctor did prescribe propanolol for anxiety when I started as a nurse. My heart rate was consistently over 100, and most often in the 120s when I began. It's been fine lately, and sometimes I forget to take it and have still been fine, and heart rate WDL. However, the day in question, I DID take it before work, but the blood draw almost-meltdown happened over 12 hours later, so... not sure it was still in effect.

[akomismo]

I agree with crunchRN. Keep on trying and trying. Iv start is a skill not in the book or everywhere else. You must face ur fear and keep urself relax when doing iv start u will master it as long as u keep on trying.

[k-t-did]

Keep practicing. People can overcome phobias with repeated exposure. Do no take Xanax! Seriously? You don't want to be a practicing RN with those drugs onboard. Not safe.

[KelRN215, BSN, RN]

This is a rather extreme reaction. You wish you didn't reassess your patient so that you wouldn't have to do blood cultures? I think you need to speak to someone about your fear, this isn't normal. What if the patient had gone septic? The blood cultures are necessary and you ARE helping the patient by drawing them. If your hospital has an EAP, it may be wise to schedule an appointment with them.

[ClaraRedheart, BSN, RN]

I suppose I was being dramatic. I'm GOING to do the right thing for my patient, and I did. If he had a temp, I think we need to know what's causing it.

[TammyG]

I was always terrible at drawing blood and starting IVs, to the point where I just got someone else to do it. I should have asked for extra time in the ER or something so that I could practice doing them but I was too afraid. I no longer am in a position today where I need to draw blood, but I have always regretted not facing my fears and getting over that fear. I had the same problem with mediport accesses, but really worked at them and became quite expert.

[ClaraRedheart, BSN, RN]

I don't think I'm good at it. I'll try at least once. With this poor patient, however, I blew 2 different veins, and got enough blood for the cultures, but when I switched to the lab tube, it quit... so I couldn't get that. He had 2 sad little lumps on his arms and I felt SOOO guilty and bad about it. We got the cultures we needed, but I just couldn't handle sticking him again and causing yet another blown vein. I know blood is needed, but if it's a difficult stick and I know it, I just feel like I'm causing undo pain by even trying.

[canigraduate]

I don't think I'm good at it. I'll try at least once. With this poor patient, however, I blew 2 different veins, and got enough blood for the cultures, but when I switched to the lab tube, it quit... so I couldn't get that. He had 2 sad little lumps on his arms and I felt SOOO guilty and bad about it. We got the cultures we needed, but I just couldn't handle sticking him again and causing yet another blown vein. I know blood is needed, but if it's a difficult stick and I know it, I just feel like I'm causing undo pain by even trying.

This sounds kind of harsh, but it works for me. I imagine I am the last nurse in the world and my patient will die if I don't get his blood. I go into a tunnel vision kind of mode and can get it 9 times out of 10. And I am a horrible stick.

Perhaps you need to stop focusing on the potential harm and focus on the very real benefit.

Henry Ford was very famous for his quote: "Whether you think you can, or you think you can't-- you're right."

I think you are setting yourself up for failure and need to retrain your brain for success.

[CrunchRN, ADN, RN]

Keep practicing. People can overcome phobias with repeated exposure. Do no take Xanax! Seriously? You don't want to be a practicing RN with those drugs onboard. Not safe.

Nobody was talking about Xanax. Propanalol. Look it up.

OP - it only lasts about 4 hours max.