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?
I found using a blood pressure cuff made the vein pop and therefore easier to stick.
Monitors frequently have a "venipuncture" setting which pumps the BP cuff to approx 50 psi for 2-3 minutes.
If I have any question about finding a vein, I use that setting. Like you, I find it to much more effective at causing veins to plump up. Patients also seem to find it more comfortable.
It's a skill that takes practice. You know those medics? They have to usually do over 100 successful IV sticks before they graduate. Those people in the ER? They do it every day. It is a skill or task that needs practice and refinement. It also requires me to be awake and not tired. There are also times we all miss and times we all get it too.
Not to mention different style needs can make it harder or easier. The easiest to use? The ones that slide through followed push button ones. I hate the ones that slide back and lock. I make a mess with those all the time whereas I rarely have issues with the other two. Although I just learned that there are catheters with valves to prevent blood from getting everywhere. I think there are also additional types of catheters too.
Oh, and an anesthesia resident who swore he knew how to start IVs? You should have seen his face when I showed him the catheters and he realized they aren't universal.
One of the best tools I've ever invested in as a nurse is the Illumivein light. It doesn't replace skill but it is a great tool to reassure that you found a good vein before poking around. I use it in ICU all the time and it works wonders.
I was lucky in clinicals my instructor sent each of us down to the ER for a day and we got a crash course in IM's, IV's, foleys and all of that. I had blast that day. I was very good at starting IV's. Then when working at the hospital, I couldn't start a vein. Their IV starting equipment was different than what I was used to - took me about a year before I got it. Once I got it, I had my MoJo back.
Then my other job got rid of their lab gals in the mornings and made lab draws part of our nursing job along with passing meds (like we had time). I became a wiz at that also.
The large hospital I worked at would float you over (when slow) to the ER to spend a day or two with them - claiming that it will be a big help in teaching you how to nail that vein. Some will shadow the Code Nurse for 1/2 a day and learn from her also.
When lab would do their draws in am's - provided I could be caught up on med pass, I'd ask them if I could shadow them - they always agreed and I would see different techniques and bounce questions off of them.
Like 1 guy would use a large needle / syringe, where others would use butterflies and why?
I liked the butterflies myself for draws - but one morning we found our supplies were not reordered and we were stuck finding our own method for lab draws - but no butterflys. I found a larger syringe with a 22 guage needle and made most attempts directly via the AC. Actually went well - no complaints from the patients either.
Once you get it - you'll be great, just getting it is the thing.
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 almost feel mean saying this but this makes me feel SO much better. At this juncture, it's not the actual IV skill that I'm worried about. Yah, there's always someone who can get a IV in. For me, it's the skill of not freaking out when I fail at starting an IV. For some reason my mind associates being a competent nurse, with starting an IV. WTF lol. Maybe I will be not so good like you, maybe I"ll be good eventually. Right now I need to just chill if I mess up. Plus I keep getting like the crappiest hardest sticks :/ My floor is full of them.
When I was in medic school, we had to go to the coast guard and preform all the inoculations and blood draws for the cadets before we could go on the rescues. One weekend of that, 3 fainting cadets, and a lot of reassurance/direction I felt kind of comfortable.... it took me at least a solid year on my own before I felt confident in my skills... practice and patience makes perfect 👌
bgxyrnf, MSN, RN
1,208 Posts
If I have any question about finding a vein, I use that setting. Like you, I find it to much more effective at causing veins to plump up. Patients also seem to find it more comfortable.