What do your ER patients families say or do that irks you?

caroladybelle, BSN, RN · Aug 9, 2005

I've been starting IVs on both adults and children for over 30 years, and yes, even I miss sometimes. So no, I don't do it for fun, I don't do it for "practice", I don't do it to torture patients; I do it because the patient needs it for whatever reason to get well.
It doesn't help when a patient/friend/whoever threatens me before I start the IV. I've heard it so many times it really doesn't bother me, but what does the poor child think when the mom says "only one time"?
Now I do agree that four times is a bit much, but, sadly, sometimes there is no other choice.

I agree fully with this statement.

And while I wouldn't stick someone (especially a child that had been through so much) four times, how exactly do people think we come by superior IV start skills but by at least trying to start an IV on poor veins? The lab does not exactly provide us with "the lousy vein Valerie dummy" for practice.

sjt9721, BSN, RN · Aug 9, 2005

..."the lousy vein Valerie dummy"...

:rotfl:

BabyRN2Be · Aug 9, 2005

..."the lousy vein Valerie dummy"...
:rotfl:

Yeah... she has the ability to speak one sentence: "You gotta butterfly needle you could use?"

elizabells, BSN, RN · Aug 10, 2005

Yeah... she has the ability to speak one sentence: "You gotta butterfly needle you could use?"

What's the deal with butterfly needles? They haven't taught us IV sticks yet. I do know that whenever a phlebotomist tries to use a regular needle on me they go right through my vein and I get a glorious bruise. Butterfly? Always get it on the first try, no problem. Is there something about them that sucks, because everyone seems to complain about them on the boards...

mdslabod · Aug 10, 2005

no reply. thanks

sjt9721, BSN, RN · Aug 10, 2005

What's the deal with butterfly needles? They haven't taught us IV sticks yet. I do know that whenever a phlebotomist tries to use a regular needle on me they go right through my vein and I get a glorious bruise. Butterfly? Always get it on the first try, no problem. Is there something about them that sucks, because everyone seems to complain about them on the boards...

A butterfly needle is great for phelbotomy (drawing blood), but is not ideal for an IV. IV needles have a plastic catheter that is threaded off the needle & into the vein...then the needle is removed & the catheter remains in place. In my practice as an ED nurse, I draw the patient's blood from the IV catheter upon initiating the IV site.

You'll find that phlebotomy and IV starts, although similar, are not identical and require different skills. Some veins will "take" butterfly needles but not IV catheters. That's not much consolation when the patient needs an IV site. Patients don't always realize the difference and I think we get frustrated hearing "use a butterfly" over and over.

Does this help? :)

texas_lvn · Aug 11, 2005

I've been starting IVs on both adults and children for over 30 years, and yes, even I miss sometimes. So no, I don't do it for fun, I don't do it for "practice", I don't do it to torture patients; I do it because the patient needs it for whatever reason to get well.
It doesn't help when a patient/friend/whoever threatens me before I start the IV. I've heard it so many times it really doesn't bother me, but what does the poor child think when the mom says "only one time"?
Now I do agree that four times is a bit much, but, sadly, sometimes there is no other choice.

One can usually tell when a person is hesitant to get a stick. They take the gloves off, feel, put the gloves back on, keep looking, ect. I do not say anything in front of my son. I have enough respect and love for him to always talk about "difficult" things outside of his hearing. I do not lie to my child either, he knows when he will have to have an IV, shot, or blood draw, even spinal taps. All I am saying is if you are sticking my child, and have second thoughts that you may not get it on the first try, get someone else. I realize that the nurses get special training, especially with it being an emergency situation, but I am talking just more than putting an IV in, I am talking about when they draw blood, ect. I am not trying to make anyone mad, but my son has been through enough. And I have to disagree with you that "Now I do agree that four times is a bit much, but, sadly, sometimes there is no other choice" because for ONE person to do this is much. She should have stopped after the second try and got someone else, as it was POLICY to not do anymore than 2 sticks a person, but she continued because SHE did not care about the patient, and wanted credit for the stick. (I found out about the policy from the nurse who stuck #5, and did file a complaint.). I think it is safe to say this is a forum to have fun, so I will not defend my situation anymore. This is a place where we will agree to disagree. Texas

And just because I was unable to reply right away only means that I am busy and can not always get on my computer. I do have a family, job and school.

mom2special3 · Aug 18, 2005

As the triage nurse, I hate this phrase - usually said with great drama in a loud voice the the waiting room. "I have been waiting so long, if I was having a heart attack. I would be dead by now". I always want to reply something like, "Well, you aren't having a heart attack. You have a hangnail and need to wait. Some day I hope you have a heart attack so you can see us save your sorry self".

surgpa · Aug 18, 2005

I only had 2 beers.........
They can only get my IV using a baby needle......
I have been here for 6 hours.....( checked in 25 minutes ago)
Is Dr soandso here (medical director,CMO,etc) we are close family friends......
I have this green frothy discharge.......

I was working as a PA in the ER at Womack Army Hospital a number of years ago. I was driving into work early one morning following an ambulance (no lights or sirens) when it pulled up to the front door. Out jumped a young soldier with his wife from the front seat of the ambulance! I went in and waited while the triage RN talked to him. It seems that the ER doc he saw over the weekend told him to "come back if he wasn't feeling better". Thats not hard to believe, because most providers say something similar.

I pulled him back to my area and asked him why he thought he needed an ambulance to carry him back for an ER visit. He told me (really, no BS) that his car was in the shop and he didn't want to pay for a taxi. He knew "they" would pay for the ambulance and he could go about his business.

For those of you who have spent time in the military, you know that troops go to "sick call" usually Mon-Fri, not to the ER. Unfortunately for this guy, he got to pay $200 for the ambulance ride because I walked him over to the collections folks and told them he had abused the need for an ambulance. Needless to say, he was pissed, but I list that as a score for "our side".

BTW, he was sent back to work about 5 minutes after being seen.

Mike

CritterLover, BSN, RN · Aug 18, 2005

what's the deal with butterfly needles? they haven't taught us iv sticks yet. i do know that whenever a phlebotomist tries to use a regular needle on me they go right through my vein and i get a glorious bruise. butterfly? always get it on the first try, no problem. is there something about them that sucks, because everyone seems to complain about them on the boards...

butterly needles are also way more expensive than a regular vacutainer needle, causing some departements/hospitals either to stock them in very limited quantities, or to not stock them at all. the benefit to using a butterfly, to me, is that you can go in at a very shallow angle, and they are easy to stabelize as you are changing tubes. this is because they have a short piece of tubing between the needle that goes into the skin and the one that goes into the blood tube. with a regular vacutainer needle (what i call a "straight needle"), the hub that holds the needle causes you to need to go in at a higher angle, and is easily jostled when changing tubes.

here is a site with some pictures if you are really interested:

http://www.bd.com/vacutainer/products/venous/#plus_plastic_tubes

elizabells, BSN, RN · Aug 19, 2005

A butterfly needle is great for phelbotomy (drawing blood), but is not ideal for an IV. IV needles have a plastic catheter that is threaded off the needle & into the vein...then the needle is removed & the catheter remains in place. In my practice as an ED nurse, I draw the patient's blood from the IV catheter upon initiating the IV site.
You'll find that phlebotomy and IV starts, although similar, are not identical and require different skills. Some veins will "take" butterfly needles but not IV catheters. That's not much consolation when the patient needs an IV site. Patients don't always realize the difference and I think we get frustrated hearing "use a butterfly" over and over.
Does this help? :)

Ahhhhh, thank you. They don't let us get anywhere near an actual pt with a needle in the first semester, and rightly so!

Patma · Aug 28, 2005

*LOL* Oh yes, the ones that say, "You'll have to use a butterfly needle..."
And..."Wow, looks like you guys aren't that busy right now," or "Gee, it sure seems slow in here"...
And let's not forget..."My doctor told me to come in. I'm supposed to go right back without waiting."
(I could go on for pages but will give others a chance to post!) :chuckle

What's wrong with informing the Nurse that you are a "hard stick"? Over the years, the usual amount of pokes is three to five times. If I know I can make it easier by informing the Nurse where a vein is or using a smaller needle or using a butterfly will help, why would the Nurse get upset with that? I've had IV's in my neck, my ankles and thumbs due to small veins.

One time, I decided not to say anything because it did seem to anger the Nurse, so after seven (7) sticks, she asked me where they usually get a vein. I told her they usually use a smaller needle (22) or a butterfly and stick me in my hand. So, she did exactly that and she got the IV started.

Remember, the poor patient is getting stuck like a pin cushion, so they are trying to be as helpful as possible to avoid numerous sticks!