OBSFlightRN

OT, I know, but why should insurance pay for your baby's food??

Wow, that must be nuts. I wonder how many nurses they have on each shift?

Are there other new grads on your unit? I ask because new grads tend to be rare in L&D and many experienced nurses are a little wary of them. Just make sure that you are asking for help when you need it. Don't act like you know how to do things if you don't or people will worry that you may get in over your head and not admit it. Maybe you're not doing that, I'm just making suggestions from what I see new nurses doing in my unit. Ask lots of questions, get help when you need it, and people will start to trust you. Nurses in L&D get a huge amount of autonomy. You really need to recognize when you need help and not be afraid to ask for it. If you're giving off an air of over-confidence all ready, people will worry about you when you're on your own.

We also use the "wheal" method but we use 1% lidocaine. It makes a huge difference for the pt and it's actually a positive for a novice IV starter too because you can move the needle around a lot more without causing the pt a lot of pain. The key is to palpate the vein above where you've put the wheal. So as I'm inserting the needle through the wheal with my right hand, I'm palpating the vein with my left hand about a cm or so above the insertion site. That way I can aim the tip of the needle in the direction or my fingers. Does that make sense? It's hard to explain, I wish I could draw a picture. ETA- to the PPs who have said that an IV start isn't painful enough to warrant using freezing, I work in L&D and all of our pts get 18Gs. An 18G is big and really friggin' hurts. When I use freezing I always get happy comments from my pt's that they didn't even feel the IV go in. So freezing gets a huge thumbs up from me and my pt's.

I had to do ACLS when I started my flight nurse position. Otherwise it's not required on our L&D unit. It makes me feel better to have it though because the code team in our hospital (OBS, gyne, and NICU only) inludes 2 L&D RNs. A real code is very, very rare in our hospital but if I ever have to run to one, it would be nice to have some clue what's going on. As for post C/s, we have our own recovery room on our unit. After a general, 2 RNs stay until the pt is fully alert. In most instances, niether of those RNs would have ACLS.

I agree with the others that it has a lot to do with confidence. Even now that I'm experienced, I'll occassionally get on a "bad run" where I miss a bunch. The more you miss, the more your confidence drops and you start to missbecause you think you will. It's important to relax, take your time, and pick a vein that you're sure you are happy with before you stick anything. I most often use the cephalic vein. It's the one that goes up the inside of the wrist and up the inside of the forearm. In most people it's big, straight, and easy to palpate. Good luck. Relax, keep practicing and one of these days it will just kind of click for you.