Starting IVs for first time ever in nursing school

ZooMommyRN, ADN, RN · Jan 30, 2008

IV's are just as much skill as it is an art, it's a difficult thing, my hands shook like never before when I started my first IV, I've done a total of 6 in almost 2 yrs of nursing school and am a loooooooooooooong way from comfortable, I myself have been on the recieving end of a unsuccessful stick and know it's not the nurse's fault (had 8 bad sticks from registered nurse anesthesist when I had oral surgery a few years ago so even the most practiced can have a bad day)

Daytonite, BSN, RN · Jan 30, 2008

i am going to tell you that i think that iv's are probably one of the most difficult skills to learn. when i started my career as a nurse i was horrible at it. it took me years to become proficient in starting iv's. for rolling veins you have to learn how to stabilize them so that they will stay still when you pierce them. even as experienced as i am, i am not always successful at this. and, i have worked on iv teams now for a number of years and have been nationally certified in iv therapy (i worked hard to become proficient in this skill).

get this! i worked in a very affluent area. i started my first iv on a television celebrity. do you think i was nervous? i missed the first time. i felt terrible. he was very sweet about it. thank goodness i didn't miss the second time. he had garden hoses veins, but they rolled too. i never forgot it.

there is a thread over on the emergency nursing forum that you might like to read. a lot of people have contributed to it. it has all kinds of practical advice about the nuances of starting ivs.

https://allnurses.com/forums/f18/iv-tips-tricks-3793.html - iv tips and tricks

hang in there and just keep starting ivs. you miss some; you'll nail some. eventually you'll nail more than you will miss. starting iv's is like pistol shooting at targets. it takes hours and hours of practice, practice, practice to hit the bulls-eye. and, where a target on the shooting field doesn't move, veins move, are tortuous, and do all kinds of funky things that you have to make adjustments for. plus you have dermal tissue you have to go through and it can do some funky things too.

locolorenzo22, BSN, RN · Jan 31, 2008

I hear ya...I had a funky vein today as well.....However, when I do IVs, I tend to either go too deep or go through the vein....I've done 2!!!!!....I think the biggest relief is knowing that eventually, it will work...I know my limitations, and until I get good...I may just need somebody else to stick a patient until I get the hang of it.....I also learn good tips from my instructors....just go in, get your blood return, advance a lttle farther, then remove needle and flush the line....you're good to go...

I had more anxiety doing my foley cath today!!!!

Daytonite, BSN, RN · Jan 31, 2008

I tend to either go too deep or go through the vein

Visualize in your mind as you are inserting an IV that you are putting a long rigid pole into a pipe. You have to be in the middle of that pipe all the time or you will pierce the vein and "blow" it.

CABG patch kid, BSN, RN · Jan 31, 2008

I hear ya...I had a funky vein today as well.....However, when I do IVs, I tend to either go too deep or go through the vein....I've done 2!!!!

I used to have the same exact problem, until a nurse observing me straight up told me "Your angle is wrong". Picture going into the skin at a 30 degree angle versus a 10 degree angle. Even though that is a lot shallower than you may have been taught, I've found it is safer to go in almost like you are doing the intradermal injection, then increase the angle (if that makes sense).

So start more shallow, then go deeper as needed. Once I started doing it this way, I rarely miss. Practice makes perfect when it comes to IV therapy. I missed about 3 or 4 before I ever got my first one, now I'm much better at it.

I advise all nursing students to get jobs where they can practice their skills (if it doesn't conflict too much with school). I have a lot more confidence in my skills because of my old tech job, and I wouldn't have had hardly any opportunity for skills practice if it weren't for that job.

Good luck!

NooNieNursie · Feb 1, 2008

Today in clinicals (Labor and Delivery) I tried to start an IV on a pregnant woman who was due for C Section a short while later due to her baby being breech. My clinical instructor was talking me through it the whole time and I wasn't nervous, but I had a ROLLING VEIN! Needless to say, I couldn't start the IV and my instructor had to take over and start one on the other arm. I almost cried. It was the first time I tried to start an IV on a real person (as opposed to the plastic arm in Lab).
Has anyone ever been able to start an IV on a patient the first time they tried? I somehow feel like a failure because I hurt the patient for nothing. Does it get any easier?

Even the RNs in my hospital have problems starting IVs, house doc usually does the difficult ones.

Don't feel bad, it's a tough skill, and remember you are helping the patient in the end.

WDWpixieRN, RN · Feb 1, 2008

I had an internship this summer in an ED and had the tremendous opportunity of doing IVs almost daily!! I started out my first 2 days doing almost a dozen IVs and hit them all right off the bat!! Keep in mind, my preceptor didn't let me start any she perceived would be difficult or on any peds pts.

Then a few weeks in, after having a great run, I swear it was like someone put a blindfold on me!! I couldn't hit ANYTHING!! I felt horrible!! And I had progressed to doing some more difficult pts like elderly with somewhat hard-to-find veins.

The nurses in the ED told me to give myself a break. They said they all went through phases where they couldn't hit the side of a barn if their life depended on it. I think it's very difficult when we get so few opportunities in NS to start IVs to really get a feel for them. I've read on these threads that some schools aren't even teaching the skill!!

I haven't done one since June and I'm somewhat petrified again; I feel like I'm starting from square one.

I think you need to give yourself a break and look forward to the opportunity to try again in the future. I wish you some very understanding pts who will smile and tell you, "Go ahead and try again" as I did. Those were always my VERY favorite when I was struggling. They helped me relax and helped boost my confidence in the down times.

Hang in there!!

Batman24 · Feb 1, 2008

Putting in an IV is the thing that scares me most about NS. I will be okay with foleys, shots, etc. but the IV gives me nightmares. It could be because I had a terrible ordeal with an IV with a nurse the only time I was ever in a hospital. The nurse was very sweet and maybe new because she seemed very nervous. I'm not afraid of shots, etc. so I wasn't leery. She tried several times and then got a doc who was obviously mad and jammed it in. He took it out on me. If he did that today I would have made a stink over it. I believe I am now afraid to give them in part because he hurt me so terribly. Thankfully it came out about 2 hours later because my hand was killing me.

WDWpixieRN, RN · Feb 1, 2008

It could be because I had a terrible ordeal with an IV with a nurse the only time I was ever in a hospital.

Then use this as a learning lesson and motivation for doing the best you can with IVs. You know that extreme nervousness and fright isn't going to help you, so relax as best you can. Review the steps for IV insertion. And just know that no one's 100% with them.

You will find that a lot of people are very understanding and forgiving. Some will be willing to let you try, try again (my husband is one of those!!). Others, if learning you are a student, will absolutely insist you not come near them with a needle of any kind (I always loved those folks :icon_roll, lol. Thankfully my preceptor allowed them their wish!!).

Best wishes...there are so many people who insert IVs everyday that you have to have confidence that you, too, can learn this skill and be the kind of RN a patient welcomes when it comes time to have an IV inserted!!