I have a gift for starting IV's after 30 years and being PICC certified I guess I should, my husband says I can put an IV in a nat! Not that I would but I have trained many nurses in IV therapy. Most nurses get nervous when they prepare to stick a patient, fearful they will miss the vein, and once the patient looks at the needle the vein will fall and disappear. Once you get your tourni on and the vein is visable apply pressure to the vein for a few seconds with your alcohol swab remove and go directly into the vein, this tricks the vein into thinking everything is okay lol it works, or you can do the 2 step method if you have a vein that keeps falling, stick the skin right next to the vein, wait a second the vein will return to the surface and then go in for the kill.

 Also if you use a little skin prep on the skin around the IV site, it helps protect the skin but MOST important it holds on your tape so you do not need a pound of tape to keep it secured.

AbusyRN2go says ...

 I have a gift for starting IV's after 30 years and being PICC certified I guess I should, my husband says I can put an IV in a nat! Not that I would but I have trained many nurses in IV therapy. Most nurses get nervous when they prepare to stick a patient, fearful they will miss the vein, and once the patient looks at the needle the vein will fall and disappear. Once you get your tourni on and the vein is visable apply pressure to the vein for a few seconds with your alcohol swab remove and go directly into the vein, this tricks the vein into thinking everything is okay lol it works, or you can do the 2 step method if you have a vein that keeps falling, stick the skin right next to the vein, wait a second the vein will return to the surface and then go in for the kill.

That is great advice, you sound like you are a great fisher. I never thought of doing that when I was a phelbotomy tech. I know that this is different, from the regular venipunctures, but every experience helps. Thanks's I will remember this when I become IV certified.

 Yes warmth always helps the veins to rise, but be careful you need to get the IV in quickly while the vein is warm or it falls fast too, AND remember if you use warmth that the patient will bleed alittle more as well, so apply gentle pressure for an extra minute or two.

On overweight patients and IV drug users putting a second tourni on helps.  I learned this working in an ER.  Along with the alcohol pad trick.  Great to see things out there!

The advantage of a PICC line is you can draw labs from them as long as it is a true PICC, if it is only a midline which is what is used mostly then you can not draw fro it, PICC lines are not commonly used in labor and delivery.

Thanks for the great tips. Knock on wood I have been getting my IVs stated in 1 stick since implementing the suggestions! Not to mention the boost it has given my confidence starting IVs now. Thanks again!

 AS you begin to feel more confident with IV placement you will learn how to finesse a vein into submission and not give up if you do not immediately get a flash, if you give the vein a few seconds to recover and even release and re=apply your tournequit you can get the vein without sticking your patient again, I call it finessing the vein, once you get your confidence you too will be able to finesse your own patient's veins into submission.!

lilbit7623 says ...

Thanks for the imformation, I am working on getting my IV certification this term in school and quite frankly Im a little nervous that I may mess it up, and on top of that, I go in a few weeks to a local hospital to try to get some sticks and hopefully the patients are going to let a student do it.....lol

If you worked with me, I would let you practice on my veins, which I have done a few times now. Ask nurses that you work with if they have anybody that you can practice on. My patients were usually willing to let a new nurse try, knowing that someone was right there to help out. One COPD patient was a HORRIBLE iv start - his veins were the product of long-term steroids. You could not use a tourniquet on him. I saw him every few months on our unit. He was always willing to let somebody practice on him.

When I draw a lab especially from a new IV site, I always make sure I draw a 'rainbow' instead of just one tube.  It's been my experience that usually if the doc just orders a bmp/cmp they wind up adding the cbc (or vice versa) while I'm in drawing it.  Also if the pt is on bloodthinners, it's always good to add the blue top as well.

I think practice is what really makes you better at starting IVs. Im a new nurse and when I was starting out on the floor I was so nervous about  starting IVs. After a short time I became so much more confident and comfortable and for new nurse I must say Im not bad. I would start 3 or 4 IVs every night and it wasn't long before I was feeling much better and now its not a big deal anymore.

I have been a nurse for 1.5yrs. I was not nervous when I was sticking the patient. I got nervous and started shaking after I got the flashback! I could not stop shaking after I poked them. Now, other nurses find me to start their IVs and the shaking has left the building!!! I actually enjoy doing them. If the patient will allow I would poke them all night long LOL!!

In regard to collecting labs as you start your IV, it works great with children and adults. However, infants' veins are too small and collapse. Nine times out of ten the nurse will lose their IV and have to start over in addition to sticking the patient again to finish getting labs. I have been a NICU nurse for 9 years and have been called to the ER numerous times to start an IV, only to learn that the ER nurse lost the IV while trying to collect labs! Please don't pull back on PIVs in infants :-)

AbusyRN2go says ...

i have been a nursing student for 4 years now. i am a student from the philippines and, well, you know how it is living in a developing country.. as a student i have tried and successfully inserted peripheral IV lines. 29 out of 30 actually yeah i keep counts and records...but  hush** that is without a license to IV therapy.. well you can picture the setting of a third world tertiary level hospital.. luckily.. because of the few nurses licensed to prick someone..many of the students get the chance to do so.some fail.. and a few succeed.. ^_^ 

These are wonderful!  Every one of them.  I've been IV certified on the ambulance for a number of years, but an RN for a few months.  On night shift, it never fails that i have to start an IV on somebody with next-to-nothing for veins.  Every word on this thread will be taken to heart.

One of my co-workers taught me that thumb and finger veins work well if you have one with horrible valves - you get flash but can't advance to save your life.  The veins are straighter and there's no valves in the digits.  (granted, that's last-ditch because the pigtail is always in the way and you have to splint the daylights out of it)