General Forums >> Ask A Nurse >> Starting IVs
Starting IVs
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| Posted about 5 years ago I always talk myself out of starting and IV, I find I get it when I'm positive. The only thing is sometimes I just can't get positive that I'll hit it. In clinicals I take pts that I'll get to work on and the Dr dcs the IV. I did a rotation in Icu thinking cool I'll get to start them there, but...there weren't that many sticks and if I didn't get it the ICU nurses didn't get them either. I guess I'll get the practice when I hit the floor running. I've always worked at hospitals that have the IV teams so that hasn't helped in gaining skills. Please don't pay any attention to my misspelled words or typos. Sorry I'll try harder next time. |
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| Posted about 5 years ago I find all these tips very interesting. I myself feel like I stink at starating IV's even after 2 1/2 years. I work nights so we don't very often get an opportunity to start them unless one goes bad or the patient has pulled them out. New admissions we get at night already have one that was started in the ED. The patients we have usually are very hard sticks. Oncology patients which have no veins, of course alot of them have PAC's. Dialysis patients which you're limited to one arm d/t shunts, and most dialysis patients are extremely hard sticks. and alot of women with mastectomies which makes it limited to one arm. Along with the 80 & 90 year old patients. I usually will try once and then get one of my co-workers to try. WE don't have an IV team. If no one on the floor can get the stick we call the nursing supervisor. |
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| Posted about 5 years ago Most of the hospitals I"ve worked are small rural hospitals. You either learn to do it yourself, or it doesn't get done. Starting IVs is not that big a deal. People get way too worked up over it. It IS a real skill that has to be acquired with practice, and some of the devices on the market can challenge you to subtly change your technique because of the way the device works (my experience is it takes me 2 sticks to figure out what I need to change to use the device). There are LOTS of tricks to finding veins. Warm compresses on the arm are one. There are new devices that highlight deep or hidden veins. But most of the "hard sticks" I've seen nurses complain about come simply from making basic mistakes. The biggest is not advancing the tip of the needle further into the vein once you get the "flash" of blood. This is the most nerve wracking part of starting an IV, especially on a child or elderly person, because you can go all the way through the vein and potentially lose the site. But you have to get the tip of the angiocath into the vein before you can advance it. Using too large or too small an angiocath is another problem. Too big, and you could blow the vein, or hit a valve you can't get past--and in some situations you NEED a large bore IV. Use too small an angiocath, and the vein can collapse, especially in dehydrated patients. It takes a lot of clinical judgement to know what size to use. But the ONLY way to learn is by doing it. All nurses should develop and practice this skill, even in hospitals that have IV teams. Sometimes the IV team is busy and you need a line right then and there. You can't always wait for the luxury. But I do like having them in one respect: when I worked in the ER we did all our own sticks. But if I missed after two tries, I'd call the IV team instead of another ER nurse. It was a better utilization of resources, unless the situation was life threatening. |
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| Posted about 5 years ago I had a co-worker ask me if I wanted to try and start and IV last night. She had tried twice without success. Of all people she asked me. I thought about what I had read on here and went in with a postive I can do this. It was a very hard stick but I got it on the first try WOO HOO!!
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628 posts back to top |
| Posted about 5 years ago Congradulations! See? You CAN do it! :D |
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| Posted about 5 years ago Like most of you, I have had hit and miss experiences. I can only say that I hope to get enought experience to go into it with confidence. From everyone's postings it seems to be a combination of skill, confidence and positive attitude addressing sometimes difficult situations. I know that I had a older patient who was dehydrated that I couldn't get a start on, my clinical instructor did not get him that day either, I only stuck once and the vein (which the instructor also thought was our best bet) collapsed. An ER nurse finally got it with a different size cath. Again like all have said the size of the cath, the skill of the nurse and the condition of the patient can all have an impact. |
