The Elusive Vein

[Joe V]

Nurses do it ... They meet someone for the first time, shake their hand, and have to bite their tongue to keep from blurting out, "You have great veins". Most of our patient's veins go into hiding and we practically have to be an expert sharp (no pun intended) shooter to get in an IV. Are you an expert starting IVs? What do you do to find that elusive vein?

[AJJKRN]

The padding/fingerprint area of my right index finger. None of my other finger pads will work when feeling around for that very specific "bounce" of the vein.

[sirI, MSN, APRN, NP]

AJJKRN said:

The padding/fingerprint area of my right index finger. None of my other finger pads will work when feeling around for that very specific "bounce" of the vein.

Agree with you, AJJKRN, only I must use both right index and middle finger.

[AJJKRN]

sirI said:

Agree with you, AJJKRN, only I must use both right index and middle finger.

My middle finger is reserved for impromptu sign language!

[Farawyn]

I clicked on this for the title. Good bait.

That being said, I do NOT bite my tongue when I run into great veins. I point it out, often eliciting strange looks.

I miss drawing blood, really enjoyed it. The bounce of the antecub is a lovely thing. I one gloved it. I was good at securing rollers, too. *fans self*

Carry on.

[OldDude]

I seldom start IVs or draw blood now since I work prn at a Pedi Urgent Care; my full time job is an elementary school nurse. But when I worked in the ER I was NEVER able to "feel" the right vein. My deciding factor was always visual. Which one looked like the right one to go after. Anyway the thing I was never able to figure out is, why could you go through a period of time when you could not miss a vein on the first stick; you could close your eyes wearing boxing gloves and you'd nail it - this period, however, would be followed by a period where you could have a vein laying like a water hose on a sidewalk and you couldn't hit it, no matter how many times you tried. Of course, I've never started an IV on an adult. Maybe that's different.

[ThePsychWhisperer, BSN, MSN, APRN, NP]

ED nurse here. Don't be afraid of your ultrasound machine. Feel around and look for the perfect site before sticking (I rely on both for finding the right site). Don't be afraid to venture to unknown places, especially for those patients with an *ahem* history. I've gotten many IVs in superficial spots such as shoulders and veins that run under the clavicle. They may not be the best, but they last throughout the ED visit, and most times until the PICC team can be consulted for harder sticks

[RainMom]

Anybody else get the feeling of smug satisfaction / vindication when the next nurse following your failed IV attempt also fails?

[Farawyn]

Anybody else get the feeling of smug satisfaction / vindication when the next nurse following your failed IV attempt also fails?

And feel kind of intimidated why she/he gets it first shot?

[brownbook]

Heat, heat, heat. What ever you can do to get something warm on the patient, their arm, their hand. Amazing what pops up. Don't tell anyone, this is just between you and me, and totally against policy. I have even warmed a damp wash cloth in the microwave and put it on a patient's hand. (Yes, it is against policy because you could burn them.....well....I do put it on my hand first, it isn't rocket science to tell hot from warm.)

Yes Rainmom, I do that too, just despicable on my part!

[PACU.LVN]

What about the illusive roll!!! I find it, I feel it, I go in for the stick and ..... Where did it go??!? How can I lock those suckers down!

[PACU.LVN]

Guilty!