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?
Practice, practice, practice. Any of your colleagues who says they're good at it after 5 tries is a liar. I was in the OR for three years and did maybe one IV. Then I moved to the ER and in the 15 months I've been there I've probably done at least a thousand IVs and blood draws, and I still don't get every single one on the first try. I'm quite proficient now, but I'm learning how to do ultrasound guided IVs and I'm struggling again. But the more I do, the better I'll get hopefully. Stick with it!
Specializes in Tele, Interventional Pain Management, OR.
In my nursing program, everyone in my clinical group got to rotate through day surgery and/or ED with the sole focus of starting IVs, priming lines, gathering IV start supplies, etc. Anything possible to get used to the feel of a peripheral IV start.
I wish I could say that mini-rotation made me an IV starting expert. Ehhh, no.
It wasn't until I became a nurse that I really got to practice IV starts. And by practice, I mean attempt 1-2 times per patient, get the stick maybe 50% of the time, then punt it to a relative expert (really experienced nurse or charge) if needed. In exchange, I would toilet one of his/her patients, give a PRN med, something to help out.
Working as an RN has forced an improvement in my psychomotor skills, but I was pretty much starting at a deficit anyway. Hand-eye coordination has never been my strength, AEB my deplorable tennis-playing ability!
OP--Don't beat yourself up too much, even if you never become the go-to for IV starts as a nurse--though you very well could. Assessment skills (detecting changes from baseline), patient advocacy, and solid documentation are most important.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
You're way ahead of me.
I am about to graduate in December and I have never placed an IV or drawn blood. We aren't taught these skills in nursing school. Our school allows us to practice them in clinical, but my clinical sites do not. Luckily, it's standard around here that you get trained to do it as a new grad.
I was horrible at IVs when I started. What helped me the most was practicing palpating my own veins (in my hands, arms, etc). I would practice whenever I had a minute or two by just clenching/making a fist and touching the surface of my hand. When I started being able to notice my veins I'd bounce my fingers on them and then on the regular surface, over and over again. This helped me get the "feel" for what a vein feels like, the bounce. Good luck!
Specializes in FNP: Urgent Care & Primary Care; RN: Med-Surg.
I used to say the same thing. But your clinical instructor has started thousands of I.V.'s versus your 5. Which is good! It can be defeating to miss a vein and cause the patient another stick, but the more you do it the better you will get. Once you get on the floor and it's do or die, I have great confidence that you will hit the vein. Keep practicing your technique and find a way to do that you are comfortable with. Once you find your own position, every vein is the same. :}
I can draw blood easily using vacutainers and butterflies, but am terrible at IVs. But that just comes from experience. Working in jails and prisons, you don't have to start many IVs, but have plenty of DUI blood draws and STD tests..
I never even got the chance to draw blood or start an IV in nursing school. I was told that was learned on the job.
Sometimes you miss, but you can't let that fluster you. Just try to figure out what went wrong, and try again (if the patient will let you) or get someone else to try.
There's a video that I found helpful for avoiding valves. Nothing sucks more than finding a good vein, getting a good flash, and ending up with a catheter tip stuck in a flap of tunica intima.
There's also a book I found pretty helpful, called The Art of the IV Start. Nothing groundbreaking, just a good, compact reference that covers the major tricks and tips.
I definitely was not at all confident at IV starts until I had done 25-30 of them, and I still wouldn't say I'm "good" at them. In most of my experience, difficult UE sticks just turned into EJs or IOs, so I'm a bit apprehensive moving into an environment where those wouldn't be part of the normal protocols.
In addition to many of the comments I've read, I will make the following suggestion is the facility where you work allows it. In many cases, our patients may be in a compromised state. I found using a blood pressure cuff made the vein pop and therefore easier to stick. It took me a while to realize this because we used tourniquets in clinicals. Don't give up on yourself. You have time and will be fine given the right opportunity.
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 .
Keep on trying. Don't let the nay-sayers get you down. I sucked at IVs when I started, and these were healthy, juicy ones. I would miss, get flustered, and not know how to proceed or I would hit it and go clean through it either basically ruining all chances of it keeping or blowing it instantly. And all the people around me didn't let me forget that I sucked at IVs. It was a process of asking how others do it and learning my own technique; what I thought went well/what worked when I did get one in.
And you know what, now I draw blood like a champ and can get an IV in like it's no one's business. And the best part of all of that is that the veins I'm working with now aren't these 20-30 year old nice ones. They are 24-40 week babies. The tiniest veins you can imagine, and I'm actually pretty good at them.
So yea, you can't get an IV in to save your life. But neither could most people. And now, a good majority of those people don't think twice about it. It takes time and practice, both of which you will have. So forget everyone else, and just don't worry about it. You'll get there and it doesn't have to be tomorrow.
I was terrible at it too. It made me super anxious and I was liable to go cry in the bathroom if I blew one. I still HATE blowing veins. My manager asked if I would like to be one of the first to train on our new baby sono veinfinder. I figured it wouldn't hurt. Even THAT took time and confidence to get the hang of, but I can easily get the hard ones now. I'm training others now how to use the sono!
There's a video that I found helpful for avoiding valves. Nothing sucks more than finding a good vein, getting a good flash, and ending up with a catheter tip stuck in a flap of tunica intima.
There's also a book I found pretty helpful, called The Art of the IV Start. Nothing groundbreaking, just a good, compact reference that covers the major tricks and tips.
I definitely was not at all confident at IV starts until I had done 25-30 of them, and I still wouldn't say I'm "good" at them. In most of my experience, difficult UE sticks just turned into EJs or IOs, so I'm a bit apprehensive moving into an environment where those wouldn't be part of the normal protocols.
That valve video is pretty cool. I am going to try that. I start a lot of IVs, and the whole valve thing isn't really much of an issue- I either float past them, or pull back just a bit, and that works fine. Nonetheless, it looks cool.
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pluckyduck, MSN, NP
41 Posts
Practice, practice, practice. Any of your colleagues who says they're good at it after 5 tries is a liar. I was in the OR for three years and did maybe one IV. Then I moved to the ER and in the 15 months I've been there I've probably done at least a thousand IVs and blood draws, and I still don't get every single one on the first try. I'm quite proficient now, but I'm learning how to do ultrasound guided IVs and I'm struggling again. But the more I do, the better I'll get hopefully. Stick with it!