I recently talked about the major differences between the simulation lab and the real thing. It brought back a wonderfully entertaining, yet terrifying 1st for me. Everyone remembers their first IV cannulation don’t they? Who could forget that?!
The diploma program I was allowed you 3 tries during your senior practicum experience. Of course it was supervised by your instructor and sometimes with a fellow RN preceptor. It was kind of a hit-or-miss experience, like all other 1st’s, literally (heh heh).
My first experience is what I call ‘combat’ training. Learning to adapt to the worst possible environment so that most other situations would seem tolerable, and dare I say easy. We introduced ourselves and explained to the patient what we were there to do. Explained the circumstances, as well as informed the patient that it was the Physician’s order to place a peripheral IV. She expressed her concern that she didn’t like IV’s and that she was a tad fearful of needles (who isn’t?)
We did the standard operating procedures of getting consent, asking and answering any and all questions. Verifying the correct patient, correct site, and allergies, any contraindications, therapies, treatments, etc. We dotted all our I’s and crossed all our T’s.
That’s when it happened.
As I’m setting up my stage to insert my IV (remembering all my steps from the simulation lab) and the patient begins to cry. Not just tear up, but cry uncontrollably. The type of cry that takes over you’re whole body. She started doing what I call the ‘hiccup-cry’. She almost started to hyperventilate.
She stated that lying in bed on her back was not helping her. She needed to sit up at the side of the bed. It’s what would make her comfortable.
We of course accommodate her. I continue with my set up.
The crying continues to a low roar.
Tourniquet in place.
Potential IV site found. Cleansed the area.
More hiccupping.. More crying.. Shuffling in seat.
Reassured the patient, emotional support given.
At this point, if the IV was not a necessity, I probably would have walked away. The patient explained that regardless of who would be inserting the IV, she would be acting the same. She was scared. She envisioned this 3 foot long hypodermic needle piercing through her arm. She was very courteous, but still very tearful.
So. Here I am. Days away from being a graduate nurse. Starting my first real IV on a real patient.
She is tearful and fidgety. She’s sitting up at the side of the bed. And she is not looking anywhere near where I am working.
All I can think is “This is NOT what the textbooks show you.” “This was not how the sim-lab was”.
In the end, I got the IV in on the first try. No complications. In fact the patient thanked me for trying my best to comfort her, and she admitted, “that didn’t hurt at all?!”.
Oh, wait, did I mention she was not of the Caucasian race?
A great adventure I must tell you. A great adventure. I always like to share that with fellow nurses who are either learning how to start IV’s or are sharing their IV stories.
How about you? Any good IV starting stories?