Aug 24, 2001
I personally love the IV team. It frees me up to do other things while they find a vein and stick em. At our hospital most, not all, of the IV team will hook up a patients antibiotic or IV line if it is all set up in the room for them. Which is nice.
I don't expent them to do patient care for me. I figure they did their time on bedside nursing and are now IV team and they dont have to help me. It is nice of them if they want to do it, but it is not in their job description, at least at my hospital.
Specializes in Med-Surg Nursing.
Aug 25, 2001
For the past eight months, I have worked at a hospital that doesn't have an IV team. I worked for 3 years at a hospital that does have an IV team and let me tell you, how I miss that.
I am having a difficult time learning to start IV's. It is not an easy skill to learn. It does make my day a little harder especially when you go to hang an IV antibiotic at the beginning of your shift and you find that the site is no good and therefore have to re-start the IV. How I long for the days when I could pick up the phone, dial the operator and have her page the IV team who would then come in about a half hour or longer when they were really busy to re-start the IV.
No, the IV team where I used to work never did anything like give a pt a bedpan as it ws not in their job description and they inserted PICC lines on day shift when there were more IV Team nurses scheduled.
So, if anyone can give me any tips, I could sure use it!
Specializes in ER, Hospice, CCU, PCU.
I guess because I have worked most of my life in ER's I find as much use for them as I do EKG techs. It's a whole lot faster just to do it yourself.
canoehead, BSN, RN
Specializes in ER.
Has 30 years experience.
No use for them- I can start 90% of my IV's within 5 minutes, and it would take that much time to call them and get them here.
Also no use for respiratory techs, nurses are qualified to do the same things, minus vents, and we have a holistic view of the patient and can prioritize based on that- plus we are used to working together. Where I work the RT's are trying to get nurses to take over their duties for the night shift- including vents. If we are good enough when they don't want to be woken up why not transfer their budget to us and let us cover the whole day.
Specializes in Leadership/Critical Care/Surgery/Seniors.
Has 34 years experience.
IV teams have been a thing of the past for well over 10-15 years in most places here. I personally prefer to do them myself as well. IV teams were abolished due to budget constraints.
The RT issue is another issue altogether. Our facility will be moving to 24 hr. coverage in a few weeks. Up til now, nurses manage all the respiratory care on nights, including the vents. I personally am looking forward to the 24 hour coverage. I look at RT's being a valuable member of our team.
Dec 6, 2001
It saddens me that anyone would consider another member of the health care team to be 'useless'. Hooray for those of you that are proficient in placing peripheral IV's. For every one of you, there are 10 who can't stick, won't stick, or don't stick. PLEASE - share your talents by teaching your co-workers your tips and secrets. Remember, it is the patient that matters. As for the IV Team that "sits in the cafeteria for hours waiting for calls", that sounds like crappy management. If your facility has an IV Team, rejoice and be grateful. We are not a dying speciality, and patients love us!
In the military our CNA's or med techs start our IVs. I usually give them 1-2 tries or do it from the beginning if it seems like a difficult stick. But I love doing IV sticks especially the hard ones. A little trick a CRNA taught me is to go in slow, get your flash then turn the bevel down after its in the vein and as you advance putting the cath tip just a little toward the surface. Makes it harder to go through the back wall in small veins. This works for me very well.
As nurses I think we should all be proficient in IV sticks. You never know when you may need to drop in one quickly.
Dec 7, 2001
A couple of hints... Try the anticub.. I know most of the other nurses will hate you.. But it's a big vein and it will boost your confidence and you will get to feel the "pop" and then you can go on to smaller veins... Remember that it's not so much the "seeing" as the ''feeling".. The ones you can see are sometimes tough..both physically and literally to get... Hot pack an arm..And by all means tell the patient you are glad that everyone else has trouble getting an IV in them just as you finish taping that sucker down and starting the fluid....
Dec 19, 2001
when I graduated from school, I was scared to death to start IV's!I would always call the float nurse to put one in if I needed it. After a while, I realized if I never do them, I would never be good at it! I started decreasing my calls to the float nurse and put them in my self. The more I did, the better I became. I still call the float nurse to put one in if I am busy, but if they are unavailable, I don't freak out cause I can do it myself:)
Also, if the IV nurses wanted to put pt's on the bsc and do other nursing duties, they would not be on the IV team! I think it is great to have a nursing job where you are not stuck at the bedside all of the time, everybody needs a break! Especially if you have been a floor nurse for years and just need a change.
Feb 12, 2002
hi, my comment is that.....if you want to be a pro in setting IV, i suggest you should try with your own colleagues. my colleague had once put an IV line in my very own vein when i was having my night shift in the AE. we should learn that first with our colleague and when it comes to the patient, don't ever feel pity to them because you know you can do it. sometimes we need to put that sense of empathy aside for awhile..know what i mean?
Specializes in Med-Surg, Long Term Care.
I love-love-LOVE the IV team at our hospital! The last place I worked was phasing out the IV team and we had to start our own. Because I worked part time, I NEVER got good at starting IV's. Part of the problem was that on the Med-Surg unit, with 6 to 7 patients to care for on 3-11 shift, no aides, covering LPN's, often no Unit Clerk, etc., I never felt I could take the time needed to get a good stick. As much as I tried to be calm and focused, I was rarely succesful. PLUS, so many patients were elderly with bad veins, mastectomy patients with only one useable arm, for example-- I hated missing a stick because I knew it meant one less site available.
The IV team are the experts at IV placement and I am so thankful to have them!
Bobbi gave very good advice. Another tip is to let gravity work for you-allow the arm to hang dependent for a minute or two, over the edge of the bed. Then, put your tourniquet on before lifting the arm to search for veins.
The most difficult folks, by far, are the grossly obese. You can't see a vein, and you can't palpate one. My experience is to try to smooth the adipose tissue horizontally across the ac, looking and feeling for a vein. For some reason, that worked well for me.
Another one is to remove a person's watch. Usually there is a medial radial vein that the watch band covers and protects from tanning, etc.
In elders, don't be misled by their large, prominent veins. They ysually are plaqued and sclerotic. Try a 20 or 22 in the hands, wrists, and forearms.
In babies, look at the dorsum of their little hands. Again, you may have to run a thumb horizontally across their pudgy little hands to push the adipose tissue aside. Another way is to put the medial aspect of their ankle against the palm of your hand. Then, with the other hand, flex the outer aspect of the foot and ankle downward, and the veins on the dorsal aspect of the foot become evident. Depepnding upon the age of the child, do not use too big an angiocath. Start with a 22 or 24. For neonates, a 26 may be necessary. We used to keep those on the Pedi Crash Cart.
I was never a fan of IV teams-always had to wait on them. Working in ER, it is much easier to just get your vein, draw labs, plug in your solution, get your EKG, and etc.
In the last hospital I worked in, the ER nurses were called to start difficult IV's on the floor.
NurseDennie, BSN, RN
I got to be very good at starting IV's. In neuro, you get to practice on the old, dried-up population. Another thing is to use a BP cuff instead of a tourniquet, and sometimes nothing at all in the elderly. If you have it too tight, those older veins just blow.
I worked in a hospital with an IV team from 6a to 6p. They are the BEST. Never, never sitting in the caffeteria waiting on a call - they get in the office early, set up their supplies and that's often their ONLY break during the day. We were supposed to get all the IV's in that we possibly could, and only call them if we'd tried and couldn't, if we were afraid that our trying would ruin the only site available, or if the patient specifically asked. But you know a lot of people just got soooo busy and called for IV team so she could carry on with everything else.
Incredible bunch of nurses. Once I was in the cafeteria on my lunchbreak and heard a code called at the main elevator. I ran there, and an IV nurse had been closer and that IV was IN there before more than a couple of other people even were close.
Another time, one of my patients was going bad, and I only had a 20 gauge IV in him. IV nurse came in and asked if I wanted a bigger site - "I saw people running and I thought you might need me."
Why in the world would you want people like that putting people on bedpans??? And I don't think the IV nurses should hook people up to setups at the bedside - It would take too much of their time to look for THAT order and check the tubing, etc., etc., etc... Let them do what they are incredibly good at.
Feb 14, 2002
Well, it's now February and I must say that I have greatly improved my IV skills. I had an experienced RN watch me and she then told me what I ws doing wrong. Since then I have gotten most of my IV starts! What a relief! It's just something that takes time, practice and patience! Thanks to everyone for thier helpful hints!
Feb 24, 2002
I have worked as a travling nurse with and without Iv nurses. Are they a god send NO. Yes while everyone is not mr/ms supernurse with i.v.'s it takes practice and confidence to do it. I was taught in the Navy and was told one rule of thumb. After doing 100 your an expert. Its a degration of nursing as a whole as new nurses will not get a chance to try I.V.'s they will let the iv team do it for them and allow them to limit thier abilities as a nurse.
Are they helpful? depends. The few who i have met were nurses who help 10 to 15 years of senoirity at the hospital and let me tell you they wouldnt lift a finger to do ANYTHING outside of thier job discription... I had one tell me they wouldnt start a Iv on a patient with chest pain until they had a written order by the md ont he chart....
are they useful.... well they reasons for Iv team were to decrease med reactions from infiltrated Iv's, perpheral infections and complications from iv thearpy. But instead of challanging the floor nurses with training and encouragin better performance or giving them the staffing they need to do te job properly they created the Iv nurse who removed the iv from the scope of practice of the nurse. Its common everywhere in the US to remove skills from the scope of practice in order to increase the care given to the patient .....and its a bad practice
Specializes in Everything except surgery.
Has 27 years experience.
Ok...here is a something I haven't seen mention yet. I showed another newbie IV starter this trick, which I'm sure most of the experienced IV starters had used or know of.
Just as someone has already pointed out...have someone with poor viens...warm the area. If starting in the arm start at the hand and work up. If you do a AC put it on a arm board, or prepare to run in the room frequently for a beeping pump. In an emergency....yeah go for the AC. Another site can be started when there is more time, and that one capped off until time to change sites. Ok ...here's the trick that has rarely ever failed for me. Hook up a syringe of NS...when you get a flash..push NS and push the cath forward slowly. It's called "floating" it in. The nurse I showed this to...listen to someone else...and started trying to start without "floating" it in, and would miss everytime. When she would "float"...she never missed. I rarely use "floating", anymore...except when I have someone who is dehydrated. The b/p cuff is an excellent way to try also...and remember to lower the arm. I have worked in many different areas where I had to be quick starting IVs, and I rarely had to stick more than once.
But even so...I LOVE having the IV teams where ever I go. In places where they weren't I noticed a lot more pts. with outdated sites, infiltrations, and outdated tubing. They also help in hospitals where the RN is the only one who can change CL sites.
I think every nurse should be able to start a line...and I believe it should be part of the orientaion process. In some hospitals it is. Like it has been said...being good at it takes practice...and some people will always be better than others at it...as in any skill. But don't let that frighten you away from increasing your skills. I don't mind starting an IV for anyone who asks....but what I don't like is the ones who ALWAYS ask, and haven't tried for themselves yet!
Apr 27, 2002
I know that this is an old thread, but I just thought of another IV technique I learned on my own.
You know those people with very large, engorged veins that seem to pop as soon as you get the IV in. I found that using no tournaquet at all works really well with these people (as long as the vein is not sclerotis). The IV slides right in and you don't have the back pressure of blood leak around the site of insertion.
If the patient insists that you must uses a tounaquet, then put it on very loose. Works like a dream.
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