The art of learning to place a PIV

[Kharma711]

I will preface by saying, I'm still a "new" nurse in my practice, with about 1 1/2 years experience. When I was in orientation, it took the full 3 months for me to get my required 3 successful IV starts to be allowed to place an IV independently.

Fast forward 3 more months and I am still having trouble starting my own IVs. Naturally, I ask for help. A couple RNS on the unit also frequently pick up shifts in ICU. They are the go-to nurses for IV placement. I never let them place one for me without being there to watch and learn.

Prior to this, I had no idea that the index finger and thumb had viable veins in some patients. I never even thought to look there, instead opting for the obvious hand/wrist/forearm. She also taught me they could be placed in the upper arm, which in my limited experience, I had only seen used for midlines.

I would always try at least once, sometimes twice if I thought I could get it, before calling on these lovely vein whisperers.

Fast forward 6 months and I have somehow become one of the whisperers myself. I practiced on my own patients until I had a bit of confidence and then would offer to help others if I noticed they were busy and/or said they needed a new line on a patient. All I can say is, practice made perfect. I am by no means the best ever and occasionally I still ask for help from the lovely nurses who taught me.

Since my meager beginnings, I've started all sorts of PIV, including feet/legs when needed and that elusive upper arm vein that took much practice to figure out. Somehow, I have joined the ranks of these beloved nurses who can start a line in a pinch and/or hard stick. I've had nurses exclaim excitedly when I report they now have a working 18/20g in the forearm/had, etc. Or had doctors/nurses thank me when I place a 2nd IV when a patient is going downhill fast. I've even placed a couple in code situations.

The point here is not to toot my own horn so to speak, but to encourage the nurses and students who struggle with IVs or are not allowed to practice in school. I got to start all of 2 IVs while in school, one on a classmate and one on a patient. And then a few months went by between those starts and graduation and nclex and moving to another state for licensure before I got to try again.

To those that struggle, especially those like me who don't have IV teams at thier work, I encourage you to keep trying! And don't take your local "vampires" for granted. Take the time to observe and learn from them. Good luck and may your patients always have ropes for veins.