Took my relative to the ED

eatmysoxRN, ASN, RN · Mar 23, 2013

It's a nice feeling to accomplish that "hard stick." I give a lot of it to luck sometimes.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

Altra, BSN, RN · Mar 23, 2013

Consider that paramedics start 20# and larger IVs in the back of a moving ambulance as a routine part of their day. I'm glad that you were happy with the care.

akulahawkRN, ADN, RN, EMT-P · Mar 23, 2013

Paramedics are usually REALLY good at starting IV's. I've met some nurses that do an OUTSTANDING job of starting IV lines, but they do multiple starts per day. Most paramedics I've met also start multiple per day... It's not that hard to do when the patient has great veins but it can be absolutely almost impossible when the patient has veins so fragile that they blow when you touch them with the needle... I've had a couple of those. I was once completely humbled by an IVDU patient whose veins were pretty much all scar tissue...

CodeteamB · Mar 24, 2013

I'm glad you had a good experience. This thread made me smile! It's a great feeling when you get warned within an inch of your life about poking and then slide one in like it's nothing.

Luckily I have this experience many, many times in a day because *everybody* does it, lol!

The reasons patients tell us they are an impossible poke seem to be

1: they have extreme IV anxiety and every poke sticks out in their mind like a major trauma

2: they think that if they make a big deal they will get the unit "sharp shooter" and avoid any mess ups from the young-looking nurse

3: they have had truly awful experiences due to their truly awful veins (your morbidly obese, your IVDUs and your frail LOLs with friable veins)

4: they have had truly awful experiences due to the truly awful skills of the people trying to poke them.

I think the last group is probably the biggest, there are a lot of people performing venipuncture out there who do not get enough practice and do not really know what they are doing (I know because I was one of them).

In our ED we don't have paramedics or techs, it's all RNs all the time and we draw our own labs too so depending which pod we are working in we may start more IVs in one shift than I did in the entire first year of my career, and every one of those a 20g or bigger (except for peds). You get proficient real quick. :)

mish_RN · Mar 24, 2013

I love getting the lines in when pts tell me they are a hard stick. Feels good

akulahawkRN, ADN, RN, EMT-P · Mar 24, 2013

I love getting the lines in when pts tell me they are a hard stick. Feels good

So did I! And yes, it does...

CP2013 · Mar 25, 2013

Well not to give too much information away, but while in the ED she got 4L of fluid just to hydrate her within an inch of life. She has some health complications that cause extreme, profound dehydration.

This paramedic made my moms day. So thankful for that. :)

And now with all that fluid, she's an easy stick!!! She's had the IV changed and multiple blood draws because now she looks like she has pipes on her arms!

I know this site can bring us down from time to time, so just wanted to post some positive energy.

Sent from my iPhone using allnurses.com

whichone'spink, BSN, RN · Mar 25, 2013

I had a very irritating patient who was a bear towards me and other staff. She insisted very strongly that she was a very hard stick and didn't have good experiences with IV starts. I managed to impress her by getting her on the first stick. Granted, it was an AC. Normally, I don't go for the AC unless it's truly necessary. I like to go for a distal vein in the hands or forearm. Using the distal vein was stressed to me during my orientation. But with her, I didn't want to take any more crap from her so I saw the AC and went for it. I'm not ashamed to admit it.

CodeteamB · Mar 26, 2013

I had a very irritating patient who was a bear towards me and other staff. She insisted very strongly that she was a very hard stick and didn't have good experiences with IV starts. I managed to impress her by getting her on the first stick. Granted it was an AC. Normally, I don't go for the AC unless it's truly necessary. I like to go for a distal vein in the hands or forearm. Using the distal vein was stressed to me during my orientation. But with her, I didn't want to take any more crap from her so I saw the AC and went for it. I'm not ashamed to admit it.[/quote']
I think the AC is underrated! Any critical patient coming in to me is getting a 18 or larger in the right AC first thing unless there is some major contraindications. CTPE? You got it; cath lab? Good to go; adenosine? I can be ready in 20 seconds; pressure bag a bolus? No problem!
You get the drift... For the majority of patients the forearm is my preference (I avoid hands when possible) but if what I see is a nice juicy AC and not a whole lot else I am also not ashamed to jump on it.

SaoirseRN · Mar 26, 2013

I had a very irritating patient who was a bear towards me and other staff. She insisted very strongly that she was a very hard stick and didn't have good experiences with IV starts. I managed to impress her by getting her on the first stick. Granted it was an AC. Normally, I don't go for the AC unless it's truly necessary. I like to go for a distal vein in the hands or forearm. Using the distal vein was stressed to me during my orientation. But with her, I didn't want to take any more crap from her so I saw the AC and went for it. I'm not ashamed to admit it.[/quote']
While I prefer a more distal vein, when faced with that sort of personality, and/or when I could "maybe" get something else but know I will get the AC, AC it is!

whichone'spink, BSN, RN · Mar 26, 2013

While I prefer a more distal vein, when faced with that sort of personality, and/or when I could "maybe" get something else but know I will get the AC, AC it is!

Good to know I'm not the only one who operates that way.