Published Oct 18, 2016
Chimio
16 Posts
Hi everyone,
im writing here because I'm a bit discouraged.
im in my last year of a third year program. And I SUCK at everything related to veins!
In total, I had 5 opportunities to draw blood and start IV's. And every single time I missed the vein and/or my clinical instructor had to help me replacing the needle. I have no problem finding a good vein, it's really about sticking the needle right in and replacing it after..
I have never been able to do one of these things by myself and I feel very behind from all of the other students of my clinical group are comfortable with those techniques.
Anyone was in a similar situation? Did it eventually got better?
oceanblue52
462 Posts
The only suggestion I have is to have instructors watch you and see what you are doing wrong. If you are finding good veins you are likely having trouble with either the angle going into the skin or pushing the needle in too far. Just keep trying to find opportunities to practice and take your time. Even the best nurses, MAs, and phlebotomists miss sometimes.
bgxyrnf, MSN, RN
1,208 Posts
You've done it FIVE times... in other words, hardly at all.
If your classmates are proclaiming comfort and competence after a similarly scant number of sticks, they are either deluding themselves or lying to you.
It probably took me 25-50 attempts to feel marginally competent, another hundred or so to feel competent, and a few hundred more to be an expert.
Give yourself a break; you'll get there, you just need practice.
akulahawkRN, ADN, RN, EMT-P
3,523 Posts
Not to toot my own horn, but I'm pretty darned good at getting IV sticks. It took me way more than 5 sticks to get here. I'm usually pretty good at being able to put an IV catheter into just about any vein that I can feel. There still are patients that I have that will easily humble me because they've got no surface veins that can be catheterized. These patients tend to be dehydrated diabetic IVDU types with hard leather skin. Being that we don't (yet) have an IR Vein finder and I'm not (yet) trained to do ultrasound IV sticks... it's still amazing that I can get lines in some of the patients that we do get at work.
What does it take to get good? Practice. Lots of it.
What do I do to get the sticks that I do? Well, I let my fingers do the "seeing" and I feel for the size of the vein, bounciness, and I palpate the direction it goes. I then go in at about 30 degrees or so just to get under the skin. Once I'm under the skin, then I shallow-out the angle to nearly parallel with the skin and continue advancing. I imagine what the tip of the catheter would be seeing and "look" for the vein. Once I get a flash, I advance about 2 mm more and start advancing the catheter off the needle. Usually everything works great. Sometimes I either just barely get into the vein and tear it a little bit when advancing the catheter (not good) or I have perforated the opposite wall and end up advancing the hub basically into normal tissue. In either event, I consider that vein as "blown." I then switch to my alternate site. I'm not afraid of using small gauge catheters as sometimes only the really small ones will do the job. I'll just use whatever works.
brownbook
3,413 Posts
You've done it FIVE times... in other words, hardly at all.If your classmates are proclaiming comfort and competence after a similarly scant number of sticks, they are either deluding themselves or lying to you.It probably took me 25-50 attempts to feel marginally competent, another hundred or so to feel competent, and a few hundred more to be an expert.Give yourself a break; you'll get there, you just need practice.
Of the thousand of IV posts I've read this says it all!
Put how to place IV's in the all nurses search box, you will get 100's of tips.
Watch you tube videos, they can be very helpful also
TheCommuter, BSN, RN
102 Articles; 27,612 Posts
This is my 11th year of being a nurse. 10 of those years were spent at the bedside in direct patient care.
I've always been hideous at IV lines and blood draws. I'm simply not a hands-on person and would rather pass these task on to someone who enjoys procedural skills. In exchange, I'd complete paperwork or some other task for them.
Out of thousands of opportunities, I've successfully started about 30 IV lines. I've successfully drawn blood perhaps twice.
NurseGirl525, ASN, RN
3,663 Posts
I suck at drawing blood. We had mannequins with huge stickable veins in nursing school. Sadly, you don't get to do this in this day and age of clinicals. I can get a blood gas no problem from a random arterial stick. They to me, are much easier as I can easily prolate pulses. I cam often palate when my coworkers cannot.
On the other hand, I'm terrible at finding good veins. Last night, both of my patients lost their good peripheral IVs, so I had to stick for morning labs. I said to myself, suck it up and find them. I can count on my two hands less than ten times I've ever had to peripherally stick and I have yet to get one.
I ask for help and try to learn from them. I think I'm getting better and at some point may get it. We don't stick much in an icu as most patients come up with access. But, I won't give up!!!
nutella, MSN, RN
1 Article; 1,509 Posts
5 times and you are surprised that you are not good with it?
Let me give you some perspective - after 20+ years I am still a total looser when it comes to blood draws and IVs. I did not have to do that in ICU (everybody had arterial lines, PA lines, central lines, and PIV) - there was not need for it.
Later on I found that it was not my skill. I was send to the blood draw service to get better skills - total failure on my part - it is just not my thing.
I am able to stick a dialysis needle into a fistula or graft though ... go figure .
You need to practice much more...
Wow that actually helps a lot! I'm starting a new med-surg rotation tomorrow and we will probably have to do a lot of these techniques so I'm definetely stressed out, just hoping I can finally get my first IV!
blondy2061h, MSN, RN
1 Article; 4,094 Posts
Can you ask if you can work a shift in phlebotomy, or cat scan, or somewhere else where they do a lot of blood draws or IV's?
AvaRose
191 Posts
I'm great at blood draws, can find a vein like a champ, but I suck at starting IVs. Once I'm in I either ruin the vein trying to advance the catheter portion, or I somehow jiggle the angle as I move the catheter and it ends up hitting a valve...either way I miss and have to try a second stick. I was the last one in my class to get signed off on IV starts and that was only once I hit the Critical Care rotation and was able to hit 3 in one day. Prior to that I had ample practice in the MA course with real people to draw blood from (we practiced on each other daily). Sadly you can't do that in RN school. I'm still not comfortable and I don't know that I'll get a lot of tries working short-term rehab. Usually if the patient needs good IV access (for antibiotics most often) then they call in someone to drop a PICC line. I am however really good at drawing labs from the PICC...most of my coworkers hate doing this so I'll volunteer to do the draw if they will input orders for me :)
Sour Lemon
5,016 Posts
This is my 11th year of being a nurse. 10 of those years were spent at the bedside in direct patient care.I've always been hideous at IV lines and blood draws. I'm simply not a hands-on person and would rather pass these task on to someone who enjoys procedural skills. In exchange, I'd complete paperwork or some other task for them.Out of thousands of opportunities, I've successfully started about 30 IV lines. I've successfully drawn blood perhaps twice.
I'm in year seven and still haven't figured it out. I don't even like to try, because I just know that I'm not going to get it. Once in a while I do manage to get a moderately "hard" stick, but I frequently miss very easy ones. It's embarrassing, but thankfully my co-workers have been understanding and willing to trade tasks with me, as well.
I feel pretty competent, otherwise. I'm not sure what went wrong with the IV thing.