Vent: "I should warn you, I'm a tough stick..."

nerdtonurse?, BSN, RN · Oct 17, 2011

That's me. "Okay, you're a hard stick so where do they usually put an IV?"

When I get a blood draw, I do make a point of telling the lab tech not to use my R basilic vein -- it looks beautiful, and the minute you touch it, it blows and I have a huge bruise for weeks. I dislocated that elbow years ago, and I think I pretty much toasted the vein during the stretch of the joint.

AnneS · Oct 17, 2011

I just wish I could start an IV with confidence. Lately, I haven't been able to stick anything. I am a fairly new nurse and always try, but I am thinking I will never get it.

Anna Flaxis, BSN, RN · Oct 17, 2011

If you don't want any posts that are contrary to your opinion, I suggest you don't post in in an open forum.

Which is why I posted in the Emergency Nursing forum, and made it clear that this is a *vent* thread. How long have you been an Emergency nurse? How many times a day do you hear "I'm a tough stick"?

Some people are a hard stick.

I'm confused. Didn't I acknowledge that already?

Why would you let one person's comment about their own body and their past experiences offend you so much?

Wow. That's what you think this is about? :uhoh3:

To everyone who gets it, thanks! :redbeathe

Anna Flaxis, BSN, RN · Oct 17, 2011

I just wish I could start an IV with confidence. Lately, I haven't been able to stick anything. I am a fairly new nurse and always try, but I am thinking I will never get it.

Well, we're going off topic here, and there are numerous threads about how to develop IV insertion skills. But I will say that confidence comes with experience, and that if you work an inpatient unit, you probably aren't starting that many IVs on a regular basis, whereas in the ED, we do it all day every day.

What I suggest is to always try at least once, if the patient will let you. I've found that most people who claim to have difficult access will readily agree to let me try just once. I offer them a deal. Just let me look, and if I am not reasonably sure I can get it, I won't poke you. But if I see something I think I can get, just let me try once, and if I don't get it, I will go get someone better than me. Nine times out of ten, they are agreeable to this plan, and it's a win-win. The patient wins because their anxiety is assuaged by the knowledge that you're not going to make a pincushion out of them, and you win because you feel less pressure to be successful.

Now back to our regularly scheduled rant....

Anna Flaxis, BSN, RN · Oct 17, 2011

And this is my closely related contribution to this vent:
"You're gonna have to use a baby needle"
or
"Y'all got a butterfly needle?"

And isn't it interesting when you get an 18 with no problem, or a 20 and they say "Wow, I didn't even feel that."?

Medic2RN, BSN, RN, EMT-P · Oct 17, 2011

And isn't it interesting when you get an 18 with no problem, or a 20 and they say "Wow, I didn't even feel that."?

When that happens, after they already told me they are a tough stick - I let them know exactly where I found the juicy vein, so they can instruct future pokers to the land of plenty. This makes the patient feel better....at least I think it does. :)

Editorial Team / Moderator · Oct 17, 2011

I love it when they are tatooed (is that a word???) all over and state that they are afraid of needles. REALLY???

Yes, really. Tattoo needles are totally different than IV needles -- it's not the same thing at all. I can tell you this as a heavily tattooed person and the wife of a tattoo artist. (But I'm not afraid of IVs, either. Hahaha!)

Back to the topic ... I will always ask these hard sticks where their best veins are. When they start pointing to boobs or feet, I look at the underside of the wrist, or the EJ. Depending on what we need from them, there are few people on whom I can't get at least a 24g in a knuckle vein for labs and maybe hydration. My last "hard stick" (and she was) got a 24g in the right AC and got 2 liters of fluid through it ... amazing! LOL

allnurses Guide · Oct 17, 2011

Had one fellow who said "I don't have any veins left at all". Turned out he had a congenital disease and spent most of his childhood being stuck. He really didn't have anything left peripherally. He told me the only thing he had left is this vein on his inner thigh.

I said, right. He was adamant, so I put a tourniquet on, and placed it on the inner thigh, about half way up from the knee. Oddest IV I've ever placed.

noahsmama · Oct 17, 2011

I love it when they are tatooed (is that a word???) all over and state that they are afraid of needles. REALLY???

It is a word, but it's spelled tattoed. (since you asked...)

apocatastasis · Oct 17, 2011

It is a word, but it's spelled tattoed. (since you asked...)

Actually, it's spelled tattooed. :up:

StrwbryblndRN · Oct 17, 2011

I just recently had blood work done. The nurse asked if my veins were little or rolled. I told I did not know. But have been told that my veins are not agreeable to needles. Did not help that I was a weenie too.

She surmised that they were small and rolled. But I will never admit that. Whoever is sticking will figure it out. Besides, I am too busy making a face from getting stuck.

Editorial Team / Moderator · Oct 17, 2011

Come on over to Firefox, we have a built-in spell check! Please, just don't call them "tats." Ugh.

I got in trouble for doing a boob IV on a true "hard stick" when I was a tech -- we were only supposed to place IVs in extremities. I told my NM (with a straight face) that the mammary area in question was large enough to, in fact, be an extremity. She just about fell over laughing.