Nurses and intravenous catheters (IVs) seem to go hand in hand. Yes, yes, I know nurses are not the only health care professionals that place and start IVs, but we do the majority of it. My sincere apologies to all the out-of-hospital EMS personnel.
Oh, and as a side note to all the TV fanatics out there: Physicians RARELY start peripheral IVs. In fact, in my short tenure doing this job, I’ve seen ONE physician start one.
Even though my IV skills had a pretty rough start, I thought I’d share some tried and true tips to help increase your chances of success.
Know your anatomy
- This is a simple yet vitally important rule. Don’t go rooting around for that “magic” vein. Know where to look and what you are looking for. Most cephalic forearm veins are overlooked, while the median anticubital vein is usually abused. Remember, the ventral side of the forearm is sometimes a gold mine!
Trust your gut
- After your initial survey, if you know in your gut that you’re going into it blindly, stop what you are doing and ask for help. Ask for assistance or simply hand the task off to someone who is more experienced. There is no shame in knowing your limits, but don’t be afraid to fail, either.
Stick to your own routine
- For some reason, every nurse thinks his or her way of prepping the vein, applying the tourniquet and exposing the vein is the best way. Ehhhh. Wrong answer! Once you develop your skill, be sure to follow your own routine. Your routine will ensure you do it the right way, each time, every time.
Hone your skills of palpation and touch
- This seems to be a dying art these days. Just because you can’t see the vein doesn’t mean it’s not there. Be sure to practice your palpation skills. Practice and sharpen this skill by closing your eyes and palpating a known large exposed vein on a well-hydrated patient. When you see “that” patient with the good veins, be sure to palpate the veins with your eyes closed. Do it over and over again until you can recognize what the vein should feel like. Don’t ever rely on just your sight.
Don’t forget there’s a patient attached to that vein!
- Once again, we nurses get so focused on the task that we forget there is a human being on the other side of that vein. Just because the dorsal hand veins are prominent does not mean you ignore the forearm! You are inevitably causing pain to your patient–be sure to empathize and make every attempt to increase their comfort level.Â I haven’t met a patient yet who actually likes being stuck with a needle!
Starting an IV is a skill like all others–practice makes perfect. It also follow our mantra, “If you don’t use it, you lose it.” Don’t handicap your practice as a nurse by letting your IV skills lapse. It’s better to try and fail than to never try at all!