Starting IVs

shape0fmyheart · Aug 18, 2005

I haven't had any patients say things like that yet but I have had my 6th in a row of unsuccessful blood draws. I'm going for a winning record I think... I haven't even attempted any IVs yet. It is VERY discouraging and frustrating to come across something you just can't seem to get. Everyone tells me it comes with time and practice but in the meantime, I'm "practicing" on these poor people.

JentheRN05, RN · Aug 18, 2005

I haven't had any patients say things like that yet but I have had my 6th in a row of unsuccessful blood draws. I'm going for a winning record I think... I haven't even attempted any IVs yet. It is VERY discouraging and frustrating to come across something you just can't seem to get. Everyone tells me it comes with time and practice but in the meantime, I'm "practicing" on these poor people.

I used to be a phlebotomist, so finding a vein is cake for me, I don't need to see them, I feel for them. Practice feeling your own veins, they feel bouncy like. I am lucky I have a nurse for a mom and have had access to IV start stuff for a while and many family members willing to lend an arm to practice! I lost my favorite practice arm when I was in my senior year of nursing school. My niece was killed in a car accident. That's neither here nor there.

Back to the sticks. When you "hit" a vein you will feel a definate pop (if it's a good vein) once you've felt the 'pop' you will know when your in a vein from that point forward. My biggest problem was going through my entire education on up to date IV starts (push button retractors) and going to an old fashioned hospital still using the slide in ones. SO I've blown my share of veins, but I'm getting used to it slowly. Just don't give up. See if your co-workers will allow you to practice on them. Many times they will. I know I have loaned my arm several times over my education. Luckily I have good veins so most get positive results when they hit it on the first stick :)

MedSurgeMess · Aug 18, 2005

Don't feel bad, I am very thick-skinned, and I just don't feel (or even see) veins. I have had 62 unsuccessful attempts......they say I just need my confidence, but how can I get that if I can't even get started? Any ideas on how to feel if you have thick skin and lower sensitivity in fingers? Any tips would be great-I've exhausted all of my own ideas:o

dianacs · Aug 18, 2005

I, too, stink at starting IVs! Am just ok but not spectacular at blood draws either. You are not alone in this. Wish I had some words of wisdom...

RaeT,RN · Aug 19, 2005

One nurse told me to hold the skin tight before you stick them bcuz it keeps them from rolling - that seems to be my major problem.

JentheRN05, RN · Aug 19, 2005

One nurse told me to hold the skin tight before you stick them bcuz it keeps them from rolling - that seems to be my major problem.

Definately, bevel up too. I strongly would suggest asking another nurse for a practice arm. Someone who has good veins. I have a pipeline myself, that's why I offer so often. But once you get the 'feel' of hitting a vein, it is something that will stick with you. I would be able to help better in person. LOL this isn't something that is easily spelled out in words. Sorry I couldn't be more help.

AM-RN · Aug 19, 2005

I'm having real trouble with blood draws and IV starts. The patients aren't generally very gracious about being used as pin cushions, and I can't say I blame them, though it makes it harder when they say things like, "You don't know what you're doing". (Actually it does annoy me; *everyone* was new at IV starts at some point; how do they think people learn?)
Anyway, I'm very frustrated because I can't seem to do it.

CONFIDENCE is what you need.....and lots of practice. Find someone with big, bulging veins and practice on those. when you get the hang of hitting the big ones you'll have better luck with the old, dehydrated, contracted patient in the hospital. And don't let the patients make you feel bad. You can do it! Everyone feels bad when they miss. If you miss and feel flustered, get someone else to do it. Starting IV's is a skill....just like anything else. Nobody is perfect at first. Good luck!

Gail-Anne · Aug 19, 2005

If you do a search on this site you'll find lengthy posts with suggestions for venipuncture skills.

Often pts know you are new because of how long you take to pick a vein and how long it takes you to poke, not because it may not work.

If you need practice getting the routine down, tape a piece of IV tubing down on the table and go through all the steps over and over (even lay out a tournique and go over when to tighten and release). An IV tubing is about right in size for a good size vein (and it doesn't "ouch" or pull away). I've started many beginners off this way. Look at others arms and pick out best veins, many team-mates will be willing to have their arms looked at, not poked.

All these things help to build confidence, much of venipuncture skill is in your head! Be like The Little Engine That Could......I think I can...I know I can...

Having said that.... without even watching you, you're not anchoring the vein well enough!

JPrince · Aug 20, 2005

Also, consider the angle of your approach. Don't start with the needle at too much of angle. I start at least 10 a day and for me the trick is to hold the skin taught and then approach at a low angle so the needle is almost parallel with the area you're sticking. This helps prevent blowing through the vein and provides smooth entry. Once you start a few and gain practice, it truly is a feel you get and confidence is definitely key. Good luck!

amber1142 · Aug 21, 2005

Also, consider the angle of your approach. Don't start with the needle at too much of angle. I start at least 10 a day and for me the trick is to hold the skin taught and then approach at a low angle so the needle is almost parallel with the area you're sticking. This helps prevent blowing through the vein and provides smooth entry. Once you start a few and gain practice, it truly is a feel you get and confidence is definitely key. Good luck!

ok, i've been practicing. I've managed to get the needle into the vein a few times (progress!). Once the needle is in, how hard or easy should it be to advance the hub and thread the catheter in? It seemed like it didn't want to go in. Should it be very smooth and easy if it's in the right place?, or will it always take a little bit of pushing and manipulating to get it in?

JentheRN05, RN · Aug 21, 2005

ok, i've been practicing. I've managed to get the needle into the vein a few times (progress!). Once the needle is in, how hard or easy should it be to advance the hub and thread the catheter in? It seemed like it didn't want to go in. Should it be very smooth and easy if it's in the right place?, or will it always take a little bit of pushing and manipulating to get it in?

It shouldn't take much, once your in the vein. Once in, tip the needle towards the top part of the vein only a tiny bit. advance from there. Sounds like you might have made the same mistake I was making for a while. The Catheter is somehow ahead of the needle. That will make it hard, well impossible. Depends I guess on what kind of IV start your using. Does it have a push button? Does it have a butterfly? Or is it a straight without a button? I had the hardest time converting from the butterfly and button to the old fashioned straight without a button. Kept sliding the catheter before the needle UGH!

See if you can get a IV needle to sit and practice with another nurse, practice the technique of holding the needle. Advancing the needle. But don't let it lock, because you can't unlock them. Hope this helps, I am still very new myself, but I have basically had to learn IV sticks all over because of the change of setup. Hitting a vein is the same, advancing is what changes.