You're TERRIBLE at IV starts?? omg!

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Are there any nurses that aren't the greatest at starting IVs? If so, how many years have you been a nurse, and who do you get to help you start IVs?

I'm ok at them, but MAN.. today at the endoscopy center I was only able to get one started!! :p I blew one vein, and the other one rolled on me (I just started there PRN). I thought I was pretty good at getting them, but apparently not. Oh well, I need the practice. For some reason I have it in my head that all nurses are good at starting IVs... don't know why I think that, lol.

and to repeat what previous posters have said - ask the patient! when i was practicing needle sticks/blood draws i volunteered to let students stick me who had been paired up with partners that didn't have "good veins." i REALLY don't like being stuck, but i have veins that can be seen across the room and for the purpose of my classmates getting the skill checked off, i volunteered my arm. i would show them before we went in for the test where to stick me and it never failed. if they hadn't been able to succeed on someone else, they succeeded with me. i even marked a dot on my arm with a pen for one guy who HAD to get a successful stick and as he was getting ready i reminded him, "on the dot." i knew where he'd be successful bc it was the spot others have ALWAYS been successful.

Specializes in ICU/CCU, Med Surg.
this amazes me. i'd be jumping at the chance to start an IV as to not lose that skill. same with blood draws. so often nurses will ask phlebotomy or the CNA to come and draw blood - not bc they don't have time and it's a delegateable task, but bc they don't know how. not that they'd ever admit it.

Er, I don't think it's that we don't know *how* but rather, the pt is a difficult stick for reasons mentioned above (dehydration, veins rolling, etc.)

I often jump at the chance at starting an IV, but after 2 sticks I prefer to not let the pt suffer from my awkward fumbling, and oh, Bed 3 is desatting to the low 70s sorry gotta go bye....!

Er, I don't think it's that we don't know *how* but rather, the pt is a difficult stick for reasons mentioned above (dehydration, veins rolling, etc.)

I often jump at the chance at starting an IV, but after 2 sticks I prefer to not let the pt suffer from my awkward fumbling, and oh, Bed 3 is desatting to the low 70s sorry gotta go bye....!

right, but if a patient is difficult to stick for all of those reasons to the point that a nurse has trouble - they're going to be difficult to stick for the person who has had, what, a few days training? after 2 sticks if the CNA or the lab can't get it - they're going to call for help, and their "help" is the person who is "above" them which would normally be the nurse. if the nurse can't get it, what're they gonna do, call the doctor? i'd love to be a fly on the wall after that page.

i guess i'm old school. i think a nurse should know how to change a patient's bed, but i've met more than one who didn't know what a chux pad even was - and a few who couldn't draw blood. to me - those are the basics. if someone is working "under you" then you should be able to step in and do anything they're capable of doing. :twocents:

Specializes in ICU/CCU, Med Surg.
right, but if a patient is difficult to stick for all of those reasons to the point that a nurse has trouble - they're going to be difficult to stick for the person who has had, what, a few days training? after 2 sticks if the CNA or the lab can't get it - they're going to call for help, and their "help" is the person who is "above" them which would normally be the nurse. if the nurse can't get it, what're they gonna do, call the doctor? i'd love to be a fly on the wall after that page.

i guess i'm old school. i think a nurse should know how to change a patient's bed, but i've met more than one who didn't know what a chux pad even was - and a few who couldn't draw blood. to me - those are the basics. if someone is working "under you" then you should be able to step in and do anything they're capable of doing. :twocents:

I wonder where you work...

When I call the lab to finally come do the draw, it's after I've tried twice and another nurse has tried at least twice. CNAs are not allowed to do lab draws, at least in the state where I live. Are you in the UK? Canada, Eh? The RN always does blood draws, unless it's specified that phlebotomy will do it. And I'd give more credit to phlebotomists...they're trained beyond a "few days" (I think...right?) and are *invaluable* to RNs.

Sorry - I've had the shift from hell and am new at nursing. My mental status is....meh.

I wonder where you work...

When I call the lab to finally come do the draw, it's after I've tried twice and another nurse has tried at least twice. CNAs are not allowed to do lab draws, at least in the state where I live. Are you in the UK? Canada, Eh? The RN always does blood draws, unless it's specified that phlebotomy will do it. And I'd give more credit to phlebotomists...they're trained beyond a "few days" (I think...right?) and are *invaluable* to RNs.

Sorry - I've had the shift from hell and am new at nursing. My mental status is....meh.

they are actually a "step above" a CNA (i guess you could say) because the CNA's can take a class which consists of about 15 hours training in order to be allowed to draw blood. they are given a new title and a bit of a pay raise. i won't say the exact title bc it will give away too much info. about my specific location - but they are NOT certified phlebotomists. they can only do draws at our facility - so if they quit and went somewhere else they wouldn't be able to carry that title or training with them. so, yes, in a nutshell they are CNA's who take a 3 day class/15 hours and are called on to do the blood draws.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
it amazed and still does amaze me that so many nurses can't draw blood from a patient when someone who takes a short class is able to do so.
I've never, ever drawn blood by way of venipuncture. The only time I ever draw blood is when the patient has a PICC line.

Therefore, the person with less education who has taken a short training class (but performs 50 venipunctures on a routine day) is going to be better at drawing blood than me since they always do it and I never do it. Practice makes perfect. :)

One of our IV therapy people shared a piece of advice with me last week. I had an old pt who was a difficult stick and actually accessed his vein but then the vein blew. She told me it's not always a good idea to use a tourniquet esp with people like him with fragile veins. It can cause them to blow more easily.

Specializes in Peds and PICU.

I have some days where I can draw blood from a rock. Other days, a vein could be looking at me, waving, saying, "Here I am!! Stick a needle in me!!" And I'll still miss it! Its always exciting when you get an IV that others tried 345789 times to get and, I hate to say it, but it almost makes me feel better when I miss an IV and then a more senior nurse tries and misses!

Specializes in Cardiovascular, ER.

I am not sure if this will help or not... since I was usually pretty sucky at IV's, I would always go for the 22g. My ER preceptor had told me that they are actually more difficult to thread than bigger guages.. Are they? I don't know, but now I only go in with 18 or 20g and have had more luck so far. They do seem easier to get. I don't seem to hit as many valves for some reason (usually the reason I would not get them in the past - would get a flash, then could not thread the cath).

Specializes in Med-Surg, Psych, Tele, ICU.

I always listen to the patient, if they have a preference of where to be stuck, or state that one site is easier to access than another. I agree with above poster regarding not using a tourniquet on older patients. When I was getting IV certified (1995), our instructor told us that with larger or edematous patients it was crucial to know your anatomy, and to "press out" where you knew the vein would be. She would use her thumbs, and press down on the area...and voila, the vein was there.

Specializes in tele, oncology.

We've got some nurses on my floor that have been working acute care for 10+ years who can't get a 22 into a pt with three tries that I can get a 20 or 18 in on the first try. Likewise we have people who can't get Foleys into women, sink a NG correctly, etc. I think sometimes there's just skills that for whatever reason people are not so hot with. But I have to give props to those who keep on trying to get better, even if they're years into it.

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