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What's it like the first time you...

Posted

Specializes in ER/Forensics/Disaster. Has 13 years experience.

Give injections, draw blood, IV's, foley catheters, etc??

What is the hardest to learn? Is it terrifying:uhoh21: ?? The only thing I KNOW I have to learn this semester is the foley catheter. Is that difficult? Does it just slide right in? LOL, I'm terrified I will torture my first patient!

colleennurse, ASN, RN

Specializes in post-op. Has 8 years experience.

It is nerve racking anytime you do something for the 1st time! Foleys are not that bad, it is easy on male patients, cause you can easily see where to insert, females can be a bit more tricky because a lot of time you end up inserting the catheter in the vagina. Plus you have to hold the labia open with one hand and insert with the other, it can be tricky to keep it sterile.

For me the most difficult thing was starting IV's. The 1st time I did one my hand was shaking so bad. But with any nursing skill, once you do it a few times and get it right your confidence goes up and you are not scared anymore. You get excited when you get it! And of course with any new skill you will have someone there helping you and giving you tips. Good luck!

Achoo!, LPN

Specializes in Urgent Care.

My opinion is IV's. Poking someone is one thing, but finding and threading the vein can be tricky in itself- then you add nerves on top of it.

nurseangel47

Specializes in geriatric, hospice, med/surg. Has 26 years experience.

Just try to go over the steps for each procedure the night before clinical and maybe again the morning of if you're awake enough. I always was as I couldn't sleep very well the nights before clinicals! Couldn't get my brain to turn off...wanted to perform to the best of my ability..I think everyone here can relate to that one!

But, really. It DOES take actual practice before getting those clinical skills honed. It DOES get better, not worse, with practice and more practice.

The others are right. Foleys not as difficult to place as ivs.

Some are gifted with getting into veins easily and stay that way. Others are more gifted for finding that wayward spot in females that are difficult at times to cath. In general, if a woman is elderly or has given birth, that little sweet spot to get into with the catheter has gone awanderin' from the place God put it to start with! Usually moves a bit to the one to three oclock position of a clock face, if that helps at all. Of course, it could be anywhere in the general area, you need an extra pair sometimes two extra pairs of helping hands to a)help hold the legs apart and b) hold the flashlight aimed at the anatomical area...but with extra help, you will do just fine.

Takes practice, like I said. You can DO IT!

nurse4theplanet, RN

Specializes in Critical Care, Pediatrics, Geriatrics.

Any new skill performed on an actual pt was nerve racking to me. Doing it on a dummy in skills lab with the nursing instructors looking for the slightest mistake and break in aseptic/sterile technique was horrible, but doing it with them standing there AND having a pt who knew you were a student/crying out in pain over needle stick/questioning you while you were trying to concentrate...that was even worse. But practice makes perfect and once you perform your skills a few times you become more confident and proficient.

Positive self talk is priceless. You can do it.

I had the worst problem with sterile glove application at first because of nervousness and the stupid things sticking together. I almost failed first semester because I couldn't get the darn things on. Now I can slap in on in about 5 seconds flat with no problem. LOL

I was most nervous about inserting foleys in males because I am quite modest myself and reserved...it just made me uncomfortable at first. But after doing them on several females, I prefer to do it on a male. Its alot easier to find the right insertion site!

I've never had a problem getting a vein, but the stupid tape is the worst...sticking to your gloves.

NG tubes are difficult for me. All my attempts have been on pt's that are intubated and sedated so they can't swallow or flex their heads. One guy was a boxer and his septum was so screwed up that we had to go through his mouth instead of his nose. That was easier to me than going through the nose.

Difficult tasks always take a team effort. Don't be afraid to ask for help. Each time you perform a task you get a little better at it. Seek out every opportunity during clinicals to get experience. Do not be meek. It is for your best benefit.

All these things are 10 x harder in school cause your instructor is watching you and you have to be by the book your sooo scared as you do it in practice you'll nerves will ease and you'll get in the flow........foleys are had do to sterility but ivs are hard just cause it does hurt the pt and it can make a mess with blood but soon you'll be a pro and people will ask you to get iv for them :o)

CityKat, BSN, RN

Specializes in Trauma.

The hardest thing, IMO is finding a vein. I've inserted three IV lines and drew blood once. Some people have difficult veins. They are hard to find and the patient may be dehydrated and elderly. Which in that case, you might blow the vein and you may have to start over. However, some people have AMAZINGLY large veins and they're easy. You gain more confidence through them and then when a tough vein appears, you are not nearly as afraid as you were before.

The female foley for me was a little challenging. I'm not allowed to insert male foleys, so I can't tell you about that. My first stick was a little scary, but after the first one, it gets much better. Assessment gets better with practice, practice, practice and patients, patients, patients:)

nurse4theplanet, RN

Specializes in Critical Care, Pediatrics, Geriatrics.

I'm not allowed to insert male foleys, so I can't tell you about that.

why is that?

flygirls2, BSN

Specializes in ER/Forensics/Disaster. Has 13 years experience.

Are IV's and blood draws basically the same thing? I mean by difficulty level-not including the IV fluids or anything-just insertion.

nurse4theplanet, RN

Specializes in Critical Care, Pediatrics, Geriatrics.

IV starts and blood draws are different. Usually when you stick a pt for a blood draw as opposed to obtaining the sample through a peripheral IV or central line, you stick in the AC (nice big vein usually, easy to feel/see). You have to keep a steady hand and avoid blowing the vein as you push your collection tubes into the vacutainer. It's not anymore difficult per say, but to me its different.

Inserting an IV you typically try to find a vein most distal to the pt and work your way up from there. Your angle is different, you have to thread the catheter into the vein and get your tubing connected without getting blood everywhere, and instead of just getting blood return you have to flush to make sure your IV is patent. Like I said, not harder just different.

Where I work, we don't do sticks for blood draw. If the pt has a central line then we draw the blood, if not then a phlebotomist from Lab comes to stick the pt to obtain a specimen. So it's not a skill I use often.

colleennurse, ASN, RN

Specializes in post-op. Has 8 years experience.

I am curious too about not being able to insert foleys on males????

At my facility we have lab do the blood draws for labs, unless of course it is a picc. So I am not sure, but I have to think that starting and IV is more difficult because you have to put the whole catheter of the IV in the vein, whereas with a blood draw, you just need to get in the vein and then you are done once you get your tubes of blood. But you do need to be able to find veins either way :)

Give injections, draw blood, IV's, foley catheters, etc??

What is the hardest to learn? Is it terrifying:uhoh21: ?? The only thing I KNOW I have to learn this semester is the foley catheter. Is that difficult? Does it just slide right in? LOL, I'm terrified I will torture my first patient!

Terrifying?

No, terrifying is being told your 11 year old has leukemia. Terrifying is standing in front of an altar and choosing the man you will live with until the day you die. Terrifying is getting on a plane at O'Hare airport to fly to Nairobi, Kenya, where not a single soul on the entire continent knows you.

Let's keep things in perspective here.

Mudwoman

Specializes in Certified Diabetes Educator. Has 20 years experience.

For me, inserting an NG tube is the hardest thing. The first one I ever did....the patient vomited the end up and out. So, the NG was up her nose and out her mouth. I then started vomiting too and had to have another nurse cut that one off and redo it. I have never forgotten that. On a male, pull the penis up if you have problems getting the cath by the prostate.

cherokeesummer

Specializes in OBGYN, Neonatal.

Give injections, draw blood, IV's, foley catheters, etc??

What is the hardest to learn? Is it terrifying:uhoh21: ?? The only thing I KNOW I have to learn this semester is the foley catheter. Is that difficult? Does it just slide right in? LOL, I'm terrified I will torture my first patient!

I think it is scary the first and second time you do anything but with time I think it gets better. Practice and guidance are what got me where I need to be. I've done a male foley, a female foley and an IV. The male foley was easy but awkward, the female foley was hard, my instructor started a new policy for herself though of having two students so one can hold the labia. It is way too hard to maintain sterility! Of course in the real world having two nurses probably wn't be an option but hey its a help!

The IV I got on my first try and I was so excited...it was GREAT! But I'm sure I will be nervous the next time too!

Imafloat, BSN, RN

Has 13 years experience.

Terrifying?

No, terrifying is being told your 11 year old has leukemia. Terrifying is standing in front of an altar and choosing the man you will live with until the day you die. Terrifying is getting on a plane at O'Hare airport to fly to Nairobi, Kenya, where not a single soul on the entire continent knows you.

Let's keep things in perspective here.

Everyone's experiece and perspectives are all a bit different.

Imafloat, BSN, RN

Has 13 years experience.

I graduated 3 weeks ago and I have never started an IV or drew blood from an adult. I did my practicum in a NICU and I got really good at NG tubes, trach changes, and heel sticks. I am really nervous about doing my first IV, especially on the babies.

I agree that things are more difficult in school when you are getting graded/rated on everything you do.

My first injection was hard for me, I just dreaded breaking someone's skin intentionally. I did it and that was that and now they are no biggie. Before I went to nursing school I thought that injections would be the hardest part of being a nurse...which was before my introduction to MRSA stool.

CityKat, BSN, RN

Specializes in Trauma.

why is that?

According to my clinical instructor in my first semester, it will be the MD to insert them since you run the risk of rupturing an enlarged prostate. Since then, I have heard that numerous nurses insert the male foley. Unfortunately, I was never taught hands on with it, but had to read about it. The hospital where I did my med surge I and II was amazing. But, their protocol is the MD inserts the male foley and the RN's do the female foleys. Recently, my professor for Med Surg II said if the bladder is enlarged, than you can rupture the prostate. Sooo..

that's why. I would love to insert one since I have inserted one on the female. I hate to go into a job with never having seen one done, you know?

I'm hoping for a male insertion next semester in my internship:)

RN 4 U

Specializes in none yet.

I think the hardest thing abut learning to insert a foley is maintaining sterile. You have to be aware of every little thing you do to ensure that the kit stays sterile. Also when you go to insert it you have to remember that 1 hand is the dirty hand which is usually your non-dominant hand when you spread the labia majora or hold the penis and you have to let that stay in the position until the dominant hand inserts the catheter. then and only then can you let your non dominant hand go. If i were you i would practice the principles of sterile technique b/c this is the key that determines if you will pass or fail your praticum or prevent an infection to a patient in the hospital.

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