Struggling with IV starts and Starting to Get Discouraged. Help!

[CNAKatlyn]

Hey everyone!

I am in my final year of nursing school, and I am struggling really bad with my IV starts. While each time I get a flash of blood, I feel like I am never able to progress the catheter! I can't be hitting a valve with every IV I start can I? I would love to get any advice possible, because I am starting to get discouraged that I am never going to be able to finish an IV.

Thank you!

[ssrn13]

What's happening when you try to advance the catheter? Are you blowing the vein or hitting tissue? I don't know if this is necessarily best practice but something I've done (and plenty of my coworkers have done in various units) is to release the needle as soon as you get blood flow (before you finish advancing the catheter) and attach the tubing to the hub. Then unclamp just a little to start the fluid dripping (but not enough to cause major infiltration if you accidentally went through the vein) then you should be able to slowly float the catheter the rest of the way in if you're still in the vein. I've done it on babies and adults and that works pretty well for me if previous attempts were unsuccessful. Of course you have to be careful and use good judgement depending on the fluids you're running if you do it that way. Like I definitely wouldn't do that if I was setting up a heparin or insulin drip, etc. :) mostly just if it's maintenance fluids or antibiotics or something.

[LoveMyBugs, BSN, CNA, RN]

Once you get the initial flash do you ever so slightly lower the angle of the IV before you advance?

I work Peds, so once I get the initial flash, I pause and let the pt take a breathe and try to relax before advancing, in my experience people hold their breathe and tense up with the poke making the advance more difficult.

[applesxoranges, BSN, RN]

You may be going too deep or not deep enough. Usually not deep enough.