Venipuncture

[melstei]

I started on a Med-Surg as a new grad about 6 weeks and cannot seem to grasp venipuncture or IV starts. I've had one successful IV start and one successful (although not a true success because the vein blew when I had just enough sample). I'm so nervous about the whole venipuncture process and feel I am never going to be able to do it. Any ideas on how to build confidence? Would taking a venipuncture class help? Any advice would be much much appreciated.

Thanks!!

[bobby123]

yes sinsei

[turnforthenurse, MSN, NP]

You're a new grad with 6 weeks under your belt. You're not going to become an IV/venipuncture wizard overnight! The only way to become good at this skill is to practice, practice, practice! Take all of the opportunities you can get. And also realize that you will have both good days and bad days - some days I feel like I can start every IV, even on those patients with horrible veins...other days I feel like I can't start anything to save my life!

[mt4now]

Gaining confidence is the first task....I have taught IV therapy and I tell all my students ..the patient knows when you walk into the room if you are going to get the Iv or not..they look for your confidence.....if you can get them to relax you will also...securing the vein is the trick...use your hand to figure out the best way to keep the vein from moving...have the patient take a relaxing breath ...dry practice on your family...no pocks just figure out what works for your hands and your fingers to become comfortable for you and will work for your patient...it's all in art.....

[Music in My Heart]

I went through a phase early on where I couldn't get any IV I tried, even on guys with garden hoses. I got myself totally psyched out and convinced that I just *couldn't*

One week during my off rotation I brought home with me a couple of angiocaths and spent several hours holding them, manipulating them, pretending to start lines on my desk... just to get comfortable with the tactile sensations of manipulating the device.

Next, I spent several hours reading everything I could find on starting IVs, including some of the references mentioned by earlier posters. I would then sit quietly, with the angiocath in my hand, close my eyes, and imagine starting the line.

I then sought out several opportunities to watch senior nurses start lines, paying particular attention to angles and post-flash technique.

Finally, on my next patient, I walked in calmly thinking, "what would an expert nurse do?" As I was doing my prep, I chatted calmly with the patient and even made deliberate efforts to momentarily stop and look out the door at people walking by, pretending that I was so good at this that I could split my attention... it was all fake of course but it was to get myself to relax. When I had all my stuff ready to go, I just took his arm and started the line... without any trouble.

From there I had several more successes and decided that I *could* do it. I kept seeking out opportunities to practice and became minimally proficient.

Once I moved into the ED, I started lines all the time and have become pretty good at it... except on toddlers and infants... just not much opportunity to practice on them where I am.

You can do it; you just need to wrap your brain around what you're doing and then... do it.

[MauraRN]

I practice on a beat up stethoscope. Brought home several start kits and just practiced getting into the "vein" w/out piercing the other side. Just handling the equipment without anyone watching will help you. But it is really all about practice, ask the experienced nurses on your unit if you can start any of their IV's for them.

[SoldierNurse22, BSN, RN]

Back when I was a student, my preceptor told me to "fake it til you make it". Sounds kinda cheesy and perhaps a little dishonest, but there were never truer words spoken. Go in there confident, take your time, and do your best.

IV's are still hit and miss (literally) with me, but I tend to try for them on the difficult patients because there's no way to get better if you sit back and make someone else do it. One of my friends told me once that, as a nurse, you should do something everyday that challenges you. IV sticks and lab draws, at this point, still count for me!

[ObtundedRN, BSN, RN]

PS Avoid IV starts until you are the queen of venipuncture!

I have to say, when starting out and even today I find IV starts to be easier then venipuncture...

A lot of it comes with lots of practice, a lot of failure, and a few successes to find what works. Sometimes I've found that too tight of a tourniquet will blow the vein. I barely tie the tourniquet on the old frail veins, it seems to work for me. Watching other nurses who are good at it helps a lot. Just rewatching their technique can be as good as trying yourself.

[hiddencatRN, BSN, RN]

PS Avoid IV starts until you are the queen of venipuncture!

I disagree- do as many of whichever you have the opportunity to do as you can. If you don't get the vein, stay and watch whoever tries next to see their technique. The more you do, the quicker you'll learn.

[Music in My Heart]

PS Avoid IV starts until you are the queen of venipuncture!

I have to say, when starting out and even today I find IV starts to be easier then venipuncture...

Oh good, I'm not the only one. I also find IV starts to be easier than simply drawing blood. Perhaps it's a matter of experience since my IV:draw ratio is probably 20:1 or more.... and often the straight draws are on drunks whose cooperation varies, with 1-4 cops looking on...