When did you become competent with starting an IV and blood draws

[Blackheartednurse]

Ok so I'm a new nurse with one week and a half into orientation and yesterday I had my second unsuccesfull attempt in starting an IV...My preceptor must be really thinking I'm slow to learn...I feel I will never learn able to feel the right vein or find it..I really regret I didnt get IV certified or phlebotomy certified prior to starting my first job in a hospital setting..It is worth to mention that we do not have any IV team or phlebotomist,we are responsible for our blood draws and starting/changing IVs..I was really curious as to how long did it take for the nurses to feel comfortable with locating and puncturing veins,any words of wisdom,advice,tips..I trying to sign up for a phlebotomy workshop at the end of this month..I'm under a high level of stress,I work on a cardiac step down unit (telemetry)..I came to this floor without prior hospital experience..I love my floor,my coworkers,patients and even most of the doctors..I also like cardiac specialization-I find it interesting and dont imagine myself going into med-surg now (which I wanted for my first nursing job)...I worry a lot since everything is basically new to me and on top of that I have to deal with a lot of new information,a lot of new nursing procedures.

[DeLana_RN, BSN, RN]

Although I did dialysis for years (with 16-gauge needles, but fistulas that were easily seen or felt), I just can't seem to get the hang of IV starts and even blood draws on the stepdown unit I now work. Unfortunatley, my workload just doesn't usually allow for the luxury of practicing - on my own, or other nurses' pts - so I have become quite good at delegating (lab draws) or asking IV team for help (stick two bandages on the pt, we're supposed to try it ourselves twice ).

I really wish I had the chance to practice these skills, but the paperwork we have to do - which cannot be delegated - just makes it very challenging to learn a new skill that requires time...

I keep hoping for a "good day"...

DeLana

[HollyHobby]

IV starting is simply a matter of practice. If you work in an area where you get to do it often, you'll become proficient faster. I was lucky to start out in an ICU where most of our patients were comatose: you don't feel nearly as terrible if you miss an IV on a person who is unconscious.

A lot of people here have given good advice. I especially agree with the suggestion that you observe other nurses starting IV's or doing lab draws and asking their advice. If the patient is conscious, I suggest you pose as the other nurse's "helper"; act like you're there to hand her the tape or whatever, so the patient doesn't realize you're there for the learning experience.

Here's my personal trick. Since most of our patients are elderly folks whose veins "blow" if you just look at them the wrong way, I've found that I'm much more likely to get the IV if I don't use a tourniquet at all. I usually use the tourniquet to make the veins pop out so I can select the best one, but then when I actually start the IV I do it without the tourniquet.

If your patient is an IV drug user, ask him/her where to stick. They know.

Finally, take your time choosing a vein. It never hurts to look.