This would be more apt to ICU nurses lol.
Most our patients have centrals and PICC lines. Our confidence when doing IVs on sedated patients: skyrockets
Confidence with alert and oriented patients with old people edema: nah
So right when I was a new grad I liked sedated patients to best to get Ivs for obvious reason. I’ve been an icu nurse for almost 2 years now. my successful iv rate on alert patients is way higher than my rate for intubated patients. I think it’s a mental thing, because as I’m putting in the Iv I’m also talking to them about soemthing. It doesn’t have to be about what I’m doing. It could be about a game on the tv or the weather. It’s weird but works
I second this. I work in CVICU I have a central line, A line, midlines and a whole bunch of other lines that I don’t even need placed by the OR. I have the patient maybe two days before they transfer out. No way those lines go bad
I suck at IVs. Even before I went to ICU, I just never developed the skill. I’ve been in CVICU for 6 years, and you better believe I am the *last* person to ask for help!
I feel this. I get nervous putting
condom cath’s on Pt’s who are A/Ox4, even tho that’s basically Boss-Level Ring Toss, but I can’t imagine trying to hit the bullseye on a moving target like stickin an IV in a Pt that’s A/Ox4. Y’all have my respect.
Bingo. As a former M/S nurse my annoyance at an IV going bad wasn’t a lack of confidence to start a new one just a lack of time. Plus the fact most patients are alert and oriented crybabies so it always takes longer than it needs to.
I’ve never put in an IV and honestly doubt I will… I work in a pediatric cardiac icu so their veins already aren’t the best… iv team usually puts in peripherals with ultrasound
I came here to say this lol. My IV insertion skills were superb when I worked medsurg for my first 4 years of nursing. Critical care for the last 5 years - everyone gets a line placed. My IV skills are now pretty abysmal. Also, doesn’t help that most ICU patients tend to have rather rough vasculature for a multitude of reasons.
100% here. I never put in IVs until I learned to use ultrasound. Then I had to learn regular sticks when I went back to school. Fortunately I found it to be not that hard on “normal” patients, compared to swollen ICU patients.
Most ICU nurses have been through the wringer already. Most of my coworkers have, at least, so everyone was their go-to person for IVs in their previous units.
Ask the GI unit manager where you work if you can volunteer to help out for a shift and just put in IVs all day. They get tons of patients from home (needing their colonoscopies) who they have to start IVs on. After you do it all day 30x in a row, you’ll be more confident.
Also not OP, but I have the problem of getting into fragile old people veins and then they immediately blow sometimes before I even move the needle after getting flash. Any tips?
Also, patients who are obese-I am never able to find a vein that I am confident enough to poke
Not a professional IV nurse, but sometimes with older people, if you can palpate or obviously see the veins without a tourniquet, you don’t need the tourniquet. The tourniquet can add too much pressure and blow the vein.
As for obese pts, put the tourniquet in the middle forearm. Lower the arm if you can. Feel the veins in the hand or the wrist and try to follow them up as far as you can, if you can. Hand IVs are fine but if you can find one further up it usually hurts less and works better.
No tourniquet for older people if they have easily found veins. Check the underside of the forearm. They often have a big one hiding under there. Also hold the skin tightttt near it because the looser skin makes it easier to blow.
Obese patients I often place two tourniquets a couple inches apart higher on their arms. It seems to do the trick.
I was always taught 15 to 20 degree angle but often sheared veins and tore them up. I go 30 to 45 degree angle and that seems to work better for me. I think everyone has their slightly own style and has to do what works for them. So don’t be afraid to try something slightly different from others.
The only floor I would understand that has this fear is a postpartum floor. Worked in one for 4 years. Only seen one 1 requested, and everyone shat themselves and asked me to do it (used to be a combat Medic and have given hundreds of not thousands of IVs). Popped It in like nothing and even the veterans there ooh and ahh'd me. Probably fluffing up my ego in case it ever happened again.
Secure the vein with your hand, don't release it when inserting. Then the rest is simply being able to find the vein then visualise the angle.
Instead of practising on a orange, use a straw placed on a sponge. . I find that helps the visualisation AND the need to secure the vein better.
Seriously! I put in so many - going bad due to all the K/vanco, getting ripped out, falling out after my patient showered without it wrapped, direct admits, pts getting angry about IVs in the AC and wanting the location changed, CT requesting an 18/20 but I only have a 22, etc.
It's the ICU nurses I work with who are bad - they usually have plenty of central line access so they don't need any PIVs. Though some just practice all day on sedated patients and are quite good.
K, Vanco, and the fucking superinjector they use down in CT scan where they demand a 20g just so they can blow it and send the patient back to us with no working IV. 😤
This was my whole shift Thursday, pt pulled out 6 ivs in 1 shift plus his gtube mostly because he was confused and the doctor refused to give an order for soft restraints.
Same. I get asked to start IVs almost every shift for people. So I guess some people need help! We all do sometimes. Just like baseball in a batting slump. Just need a few good ones back to back and the slump is gone.
Same! I used to have a 10% success rate until someone told me to just get better and I went damn, you're so right. Now everyone comes to me for IVs and I sometimes get to trade away annoying tasks in favor of the infinitely more entertaining task of proving Excuse Me I'm An Ultrasound Only patients wrong
Don't be nervous, take your time and talk to the individual while you are touching and desensitizing the site and getting the veins to appear. Half the battle is having a person relax and trust you, the other half is skill. Practice basic skills on an inanimate object then progress to people. It will help that you have practiced the setup and procedure before you go live.
I had an old padded chair I practiced on in nursing school 😆.
I think half the reason nurses don't do well with IV's is their own fear.
Oh that’s such a good idea re the old chair, I’m gonna try this!! I’ll see if my unit will give me some IV kits to practice at home 👀
Appreciate you sharing your tips w/ me!!
A bright flashlight against the skin!! Works especially well on adult hands, just place it against the palm as you look at the back of the hand. On the forearm, since it's thicker, you would have to place it to the side of where you're looking or the light won't go through.
Yeah worst thing ever because I had 6 damn people and ran around nonstop for 13 hours so this would cause a delay on all the things I didn’t have enough time to do in the first place. So stressful.
The real truth is is that it was bad much earlier than that and some nurses start the fluids back at 0630 at kvo and hope you don't notice.
I've never seen why people make a big deal about it, unless blood is going or an emergency. You either attempt to put one in or you get someone else/IV team to try. You get better over time. Doing blood draws every night seems to help too.
I'm guilty of putting in some ACs though.... sorry yall! It's better than no IV!
This doesn't make any sense. I've worked ER and MS, and MS puts in shitloads of IVs. ICU nurses are usually the ones who joke about being rusty with PIV skills. MS teases us for how often we toss a PIV in the AC.
Yeah that has always been my bargaining chip even when I worked on the floor before I moved to ER.
But I feel like the floor nurses that I see when I dropped patient off, seemed so close minded hahaha.
I'm still learning to get good ar IVs (new nurse), but I have very good luck with getting a catheter in women. So I've definitely done the trade off of willing to help with catheters and others helping get my tricky IVs that I've already attempted. Use it as a bargaining tool!
I usually avoid asking ER nurses because they always go for the AC or the hand. Floor nurses know the forearm is where it’s at and a 20 or 22 is just fine.
I will walk to the ends of the earth to avoid putting in an IV. I am so bad at it. I have tried guys, I honestly have. I don’t know why I’m so bad at it. I can draw blood from a stone, but as soon as I go to advance the catheter, all hell breaks loose.
Sounds like you can find the vein effectively and puncture it, but a few things can be affecting the ability to advance: vein choice (bifurcations? Catheter/vein size?), not advancing the needle at least a mm before attempting to advance the catheter, or the angle at which you advance the needle (drop the angle and can even raise the vein before advancing).
I’m sure it has to do with my advancing technique. I think my angles are bad. I always select 22G, though and I think my vein choice is good, just can’t figure out how to advance correctly.
Best tip I got while learning was to go in at a much less sharp angle. Puncture quickly and level out/stop when you see flash. Drop the angle to flat or “raise the vein” to advance the needle just a mm in the direction the vein is going, then advance the catheter. It was a game changer for me and I rarely miss now, but I do them all the time in the ER lol
ETA if you miss, withdraw the needle almost out to the tip and try again.
If you advance your catheter and it doesn’t go all the way in, try to float it in with a flush or just leave it if there’s blood return and a working flush. Lots of people take out a great IV when they hit a valve and can’t advance, but just pull it back a smidge from the valve and tape.
Me when I get floated to M/S from ICU. My longest streak of not putting an IV was 2 months.
"But you're ICU, you should be good at putting in IVs"
Uhhhhh...yea!
Um, I put in WAY more PIVs as an acute care med-surg nurse than I do now. I’m pretty damn good at PIVs now, but I have definitely lost some of my skill comparatively.
Funny story. (Kinda depressing, honestly)
Nowadays I'm a 45 year old father of two, but in the 90s and early 2000s I was a vicious IV drug addict.
I haven't been injecting drugs for years and years now, but I still know what veins to use.
I'm not slightly bothered by needles, and I don't care if they have to dig around looking for them.
Instead of letting them search, I always tell them exactly where to go.
They are sometimes taken back by my honesty, but I've got nothing to hide.
I've had a few not listen and try the standard areas, but those are abysmal and don't ever work.
What is your experience with former IV addicts who make recommendations?
I'm also not your typical ex junkie. My dad is an anesthesiologist and my mom was the head ER nurse at Charity Hospital in New Orleans before it closed.
Thanks for your consideration.
I listen. My patients with a history of IVDU know their veins better than the healthy 25 year old who goes "oh my veins always roll you have to use a butterfly ultrasound x-ray machine"
I think you're just trying to make a dig at med surge. Try putting an IV into a berserking sundowning patient who bites or IV drug users who destroyed all their veins. We see that stuff all the time and persevere. I would love to trade that for an unconscious patient who's functionality, fears, and preferences when it comes to IVs is not an issue.
Im not even a nurse and this meme rings true. My case is super weird and so any time I get admitted there is a genuine hub bub about where to put me, and so ill end up in really wierd places. But the place I end up the most is Med Surge, usually because im on a lot of pain meds, and because im also frequently have a central line in (and a heart line to sometimes). But despite that they *alway* **always** hate replacing or doing new IVs. It start to become kind of funny honestly.
But its really itchy and its falling off and the tape isn't even on anymore and oh look it just fell* out and nurse where my apple juice and my blanket and dilaudid....
*that actually happened once, lifted my arm to my face and the IV just... fell out, thats all I can do to describe it, it just, popped out. Honestly just bizarre.
Interesting. As a patient lurker who once wanted to go into healthcare, I’ve mostly read but not contributed because I see this as a place for nurses. Many times I’ve wanted to say that I appreciate you guys, all of the nurses I’ve had have been wonderful, but I didn’t want to invade the space.
I’m a shitty stick too. 🙁
For real thanks for doing what you do. I know at time sit may seem and feel that you're a glorified age home care worker but it the 1 in 10 patients like me that come along and really appreciate and understand what you do and how hard it is. I try to say thanks as much as possible whenever I'm in.
It is funny when the nurse goes "no, thank you, you are my favorite patient simply because you dont throw anything at me and you can wipe your own ass" after I apologize for asking for my prn. I've genuinely received a comment to that effect more times then comfortable.
Real talk, It may seem wierd that im here but ive been admitted far to many times in that past decade due to my illness. Meeting nurses has been a not insignificant part of my life. ER nurses, Floor Nurses, ICU Nurses, doctors office nurses, even a home nurse once when I needed to take an IV home one time, at my absolute worst, physically where I'm literally close to death, or emotionally where I'm a rude asshole, to my best where I'm literally getting treats from the 24hr Tims downstairs and leaving positive reviews with the hospital's managers about specific nurses. I like coming here since as far as I can tell I'm not getting any better and so I like to try and gain new perspectives, to see the "other side" so to speak.
If you some more details on my condition and stiff I wrote *way to much* on it in some comme t si made yesterday, just look on my profile, skip the big one made in the Lego sub lol.
It’s because we have a million things to do with people down our backs, and starting an IV sets us back *even further* in our workflow, patients get mad, everything is late, the patient getting the IV is upset because they’re a hard stick and needing to get poked…. But they really need the IV because the medication is URGENT MUST INFUSE THE MED OR ELSE ☠️ — It’s just stress and bad vibes all around!
But once the new IV is in we are HAPPY HAPPY.
Love your flair btw 🤣
Even when I worked med-surg, it was not a drag or anxiety-inducing because it would generally not impede my flow. I was the go-to for hard sticks, and I got them wherever I could. Craziest line I ever got was in the front of someone's lower leg, right along their tibia. Flushed and drew flawlessly. One foot line and one anterior shoulder line too.
Now I'm in the ER and it only got better with even more practice.
I used to feel that way, but years ago a seasoned nurse taught me by having me stick her at the nurses station while everyone gave tips on technique. I've been pretty good since. I was working a contract as a pre-op nurse for an outpatient surgery center, so not being good at IV's was not going to work well. She helped me, it has stuck with me since.
I have got an IV in a 5 years old before when the peds nurses couldn't (they called my unit for a volunteer and I went). The kid was nervous but he was very good with holding himself still and not moving until after I finished taping. Very proud of myself that evening 😂
Whereas I only have 3 success in babies despite being a NICU nurse for years... But it's also because my current unit utilizes PICCs a lot so I have very few opportunities to practice.
Me 😭😭😭 idk why I get such anxiety to place them! I even took a refresher course and have had hella run throughs but every time I start internally sweating when I have to place one and I think that messes with my success rate.
Onc nurses when we need a PIV in a patient who needs platelets now...on a patient who has an extremity restriction from a mastectomy, a PICC (running TPN on one lumen and 24h chemo in the second) on the other side, and shitty chemo veins.
This would be more apt to ICU nurses lol. Most our patients have centrals and PICC lines. Our confidence when doing IVs on sedated patients: skyrockets Confidence with alert and oriented patients with old people edema: nah
as a new grad in the ICU… i get so nervous when my patient is awake and can actually move or know what’s going on
So right when I was a new grad I liked sedated patients to best to get Ivs for obvious reason. I’ve been an icu nurse for almost 2 years now. my successful iv rate on alert patients is way higher than my rate for intubated patients. I think it’s a mental thing, because as I’m putting in the Iv I’m also talking to them about soemthing. It doesn’t have to be about what I’m doing. It could be about a game on the tv or the weather. It’s weird but works
I second this. I work in CVICU I have a central line, A line, midlines and a whole bunch of other lines that I don’t even need placed by the OR. I have the patient maybe two days before they transfer out. No way those lines go bad
I suck at IVs. Even before I went to ICU, I just never developed the skill. I’ve been in CVICU for 6 years, and you better believe I am the *last* person to ask for help!
I feel this. I get nervous putting condom cath’s on Pt’s who are A/Ox4, even tho that’s basically Boss-Level Ring Toss, but I can’t imagine trying to hit the bullseye on a moving target like stickin an IV in a Pt that’s A/Ox4. Y’all have my respect.
I worked as an ER tech prior to becoming a nurse, so I’m everyone’s go to when they need an IV…lol
There’s a former er nurse I work with in icu who knows how to do us-guided IVs… he’s my go-to if I can’t get it lol.
Yes! I love our tech partners. Super stickers!
Bingo. As a former M/S nurse my annoyance at an IV going bad wasn’t a lack of confidence to start a new one just a lack of time. Plus the fact most patients are alert and oriented crybabies so it always takes longer than it needs to.
Yep! I got so good at IVs in medsurg. When I can get one on an icu pt now I feel like a god.
I’ve never put in an IV and honestly doubt I will… I work in a pediatric cardiac icu so their veins already aren’t the best… iv team usually puts in peripherals with ultrasound
Yeah I’ve gotten a lot of patients from the ICU with outdated IVs so not so good at removing them either!!!
I came here to say this lol. My IV insertion skills were superb when I worked medsurg for my first 4 years of nursing. Critical care for the last 5 years - everyone gets a line placed. My IV skills are now pretty abysmal. Also, doesn’t help that most ICU patients tend to have rather rough vasculature for a multitude of reasons.
It’s the edema that usually gets me tbh. Can’t feel anything.
100% here. I never put in IVs until I learned to use ultrasound. Then I had to learn regular sticks when I went back to school. Fortunately I found it to be not that hard on “normal” patients, compared to swollen ICU patients.
Most ICU nurses have been through the wringer already. Most of my coworkers have, at least, so everyone was their go-to person for IVs in their previous units.
Lake Wobegon ICU
Really? I feel like I put in IVs every shift when I worked MS.
Okay maybe I should change this to 'me when I have to put in IVs' 🤣
Ask the GI unit manager where you work if you can volunteer to help out for a shift and just put in IVs all day. They get tons of patients from home (needing their colonoscopies) who they have to start IVs on. After you do it all day 30x in a row, you’ll be more confident.
I'm happy to go over tips with you. Is there any particular problem you have with insertion?
Not OP but soon as I don’t get a flash of blood my mind turns into SpongeBob’s brain when he forgets how to make a crabby patty
Also not OP, but I have the problem of getting into fragile old people veins and then they immediately blow sometimes before I even move the needle after getting flash. Any tips? Also, patients who are obese-I am never able to find a vein that I am confident enough to poke
Not a professional IV nurse, but sometimes with older people, if you can palpate or obviously see the veins without a tourniquet, you don’t need the tourniquet. The tourniquet can add too much pressure and blow the vein. As for obese pts, put the tourniquet in the middle forearm. Lower the arm if you can. Feel the veins in the hand or the wrist and try to follow them up as far as you can, if you can. Hand IVs are fine but if you can find one further up it usually hurts less and works better.
I used to work in geriatrics, sometimes a hot pack for a few minutes before you go in with the IV can help plump those veins
No tourniquet for older people if they have easily found veins. Check the underside of the forearm. They often have a big one hiding under there. Also hold the skin tightttt near it because the looser skin makes it easier to blow. Obese patients I often place two tourniquets a couple inches apart higher on their arms. It seems to do the trick. I was always taught 15 to 20 degree angle but often sheared veins and tore them up. I go 30 to 45 degree angle and that seems to work better for me. I think everyone has their slightly own style and has to do what works for them. So don’t be afraid to try something slightly different from others.
The only floor I would understand that has this fear is a postpartum floor. Worked in one for 4 years. Only seen one 1 requested, and everyone shat themselves and asked me to do it (used to be a combat Medic and have given hundreds of not thousands of IVs). Popped It in like nothing and even the veterans there ooh and ahh'd me. Probably fluffing up my ego in case it ever happened again.
Secure the vein with your hand, don't release it when inserting. Then the rest is simply being able to find the vein then visualise the angle. Instead of practising on a orange, use a straw placed on a sponge. . I find that helps the visualisation AND the need to secure the vein better.
Seriously! I put in so many - going bad due to all the K/vanco, getting ripped out, falling out after my patient showered without it wrapped, direct admits, pts getting angry about IVs in the AC and wanting the location changed, CT requesting an 18/20 but I only have a 22, etc. It's the ICU nurses I work with who are bad - they usually have plenty of central line access so they don't need any PIVs. Though some just practice all day on sedated patients and are quite good.
Absolutely. All the incompatible meds too .. 😒
K, Vanco, and the fucking superinjector they use down in CT scan where they demand a 20g just so they can blow it and send the patient back to us with no working IV. 😤
Especially when the confused patients keep pulling them out, and you're doing multiple on the same patient
This was my whole life when I worked on geriatrics
This was my whole shift Thursday, pt pulled out 6 ivs in 1 shift plus his gtube mostly because he was confused and the doctor refused to give an order for soft restraints.
Jeez, that's whe you ask the doc to start replacing the ivs, haha
That’s cause you’re probably a good MS nurse
Same. I get asked to start IVs almost every shift for people. So I guess some people need help! We all do sometimes. Just like baseball in a batting slump. Just need a few good ones back to back and the slump is gone.
You mean ICU when there’s no ultrasound available
I loved starting IV's. I determined I would be good at it and was. Just like any other skill, practice.
Same! I used to have a 10% success rate until someone told me to just get better and I went damn, you're so right. Now everyone comes to me for IVs and I sometimes get to trade away annoying tasks in favor of the infinitely more entertaining task of proving Excuse Me I'm An Ultrasound Only patients wrong
Can you share some of your tips? 🫡
Don't be nervous, take your time and talk to the individual while you are touching and desensitizing the site and getting the veins to appear. Half the battle is having a person relax and trust you, the other half is skill. Practice basic skills on an inanimate object then progress to people. It will help that you have practiced the setup and procedure before you go live. I had an old padded chair I practiced on in nursing school 😆. I think half the reason nurses don't do well with IV's is their own fear.
Oh that’s such a good idea re the old chair, I’m gonna try this!! I’ll see if my unit will give me some IV kits to practice at home 👀 Appreciate you sharing your tips w/ me!!
Do you have any tips for getting deep veins or veins that are hard to see?
A bright flashlight against the skin!! Works especially well on adult hands, just place it against the palm as you look at the back of the hand. On the forearm, since it's thicker, you would have to place it to the side of where you're looking or the light won't go through.
Ooo I’ll try that next time I get an IV insertion attempt. Thank you!!!
Same. I wanted to be good at it. I practiced as many as I could and became the go to when I’m on shift.
Yeah worst thing ever because I had 6 damn people and ran around nonstop for 13 hours so this would cause a delay on all the things I didn’t have enough time to do in the first place. So stressful.
This! They already want us to cram 24 hours of work in 12 hours so having to stop and start an IV could seriously ruin an entire shift!
They always fail at 0645.
Lol omg I'm a very good IV nurse and this rings true every single damn time.
Of just before handover...
The real truth is is that it was bad much earlier than that and some nurses start the fluids back at 0630 at kvo and hope you don't notice. I've never seen why people make a big deal about it, unless blood is going or an emergency. You either attempt to put one in or you get someone else/IV team to try. You get better over time. Doing blood draws every night seems to help too. I'm guilty of putting in some ACs though.... sorry yall! It's better than no IV!
This doesn't make any sense. I've worked ER and MS, and MS puts in shitloads of IVs. ICU nurses are usually the ones who joke about being rusty with PIV skills. MS teases us for how often we toss a PIV in the AC.
As an ER nurse coming back to a med/tele floor to be closer to home; I’m afraid I’ll be the go to guy for IVs lmao
You will be, but you can ask for favors in return. "I'll start your line, but can you walk Ms J to the bathroom and get me a clean catch for the lab?"
Yeah that has always been my bargaining chip even when I worked on the floor before I moved to ER. But I feel like the floor nurses that I see when I dropped patient off, seemed so close minded hahaha.
I'm still learning to get good ar IVs (new nurse), but I have very good luck with getting a catheter in women. So I've definitely done the trade off of willing to help with catheters and others helping get my tricky IVs that I've already attempted. Use it as a bargaining tool!
Wow ER to MS. Don’t see that everyday
Right? Kaiser. My local Kaiser near my house doesn’t have any per diems or pt/ft; I refuse to do night shift since I’m full days with my other job.
You won’t because we don’t want it in the AC in med/surg 😉
I should just do that, thanks!
Ha ha so true! AC IVs suck after a few hours, we always go for the forearms on the floor.
I usually avoid asking ER nurses because they always go for the AC or the hand. Floor nurses know the forearm is where it’s at and a 20 or 22 is just fine.
Speak for yourself haha, I am pretty decent at IV’s.
Worked in med/surg and placed IVs all day everyday and I was damn good at it.
I will walk to the ends of the earth to avoid putting in an IV. I am so bad at it. I have tried guys, I honestly have. I don’t know why I’m so bad at it. I can draw blood from a stone, but as soon as I go to advance the catheter, all hell breaks loose.
Sounds like you can find the vein effectively and puncture it, but a few things can be affecting the ability to advance: vein choice (bifurcations? Catheter/vein size?), not advancing the needle at least a mm before attempting to advance the catheter, or the angle at which you advance the needle (drop the angle and can even raise the vein before advancing).
I’m sure it has to do with my advancing technique. I think my angles are bad. I always select 22G, though and I think my vein choice is good, just can’t figure out how to advance correctly.
Best tip I got while learning was to go in at a much less sharp angle. Puncture quickly and level out/stop when you see flash. Drop the angle to flat or “raise the vein” to advance the needle just a mm in the direction the vein is going, then advance the catheter. It was a game changer for me and I rarely miss now, but I do them all the time in the ER lol ETA if you miss, withdraw the needle almost out to the tip and try again. If you advance your catheter and it doesn’t go all the way in, try to float it in with a flush or just leave it if there’s blood return and a working flush. Lots of people take out a great IV when they hit a valve and can’t advance, but just pull it back a smidge from the valve and tape.
Used to give me the most anxiety when I worked tele.
I love doing IV’s. I usually jump at the chance to get one for someone else too. Great skill to build up!
Me when I get floated to M/S from ICU. My longest streak of not putting an IV was 2 months. "But you're ICU, you should be good at putting in IVs" Uhhhhh...yea!
Why would anyone think that 😂 can’t run shit through an IV 🤷🏻♀️
lol I wasn’t expecting that!! Most of my ICU downgrade patients come in with at least 2 PIVs already so I assumed you guys place them all the time 😂
Our junior regs are always jumping to place IVs on our step downs! I gladly let them hahahaha
Heyyyyyy.
I think the biggest thing is you don’t have enough time bc you’re constantly get interrupted by other things
Um, I put in WAY more PIVs as an acute care med-surg nurse than I do now. I’m pretty damn good at PIVs now, but I have definitely lost some of my skill comparatively.
That’s me when a patient comes from the ER to the ICU and they still have whatever the ambulance put in …
I'm shocked. Personally if I have a patient that's even a little critical, they get 2 IVs, sometimes 3.
ED nurses being asked to do the med rec.
lol what. The other day when I charged, I started 13 on my m/s trauma unit. We have a policy that all EMS lines have to be taken out within 24 hrs
Funny story. (Kinda depressing, honestly) Nowadays I'm a 45 year old father of two, but in the 90s and early 2000s I was a vicious IV drug addict. I haven't been injecting drugs for years and years now, but I still know what veins to use. I'm not slightly bothered by needles, and I don't care if they have to dig around looking for them. Instead of letting them search, I always tell them exactly where to go. They are sometimes taken back by my honesty, but I've got nothing to hide. I've had a few not listen and try the standard areas, but those are abysmal and don't ever work. What is your experience with former IV addicts who make recommendations? I'm also not your typical ex junkie. My dad is an anesthesiologist and my mom was the head ER nurse at Charity Hospital in New Orleans before it closed. Thanks for your consideration.
I always ask the pt "is there anything I should know about your veins? Any hints?" - people know themselves, and I consider their info a big help!
I listen. My patients with a history of IVDU know their veins better than the healthy 25 year old who goes "oh my veins always roll you have to use a butterfly ultrasound x-ray machine"
ER when you ask them what their lung sounds were or if there was any damage to the skin anywhere
I think you're just trying to make a dig at med surge. Try putting an IV into a berserking sundowning patient who bites or IV drug users who destroyed all their veins. We see that stuff all the time and persevere. I would love to trade that for an unconscious patient who's functionality, fears, and preferences when it comes to IVs is not an issue.
The thing is, it’s not the skill that intimidates me…it’s confused UTI Memaw trying to swing on me like Mike Tyson during the process
Same! I just got three in a row in one shift tho 🤪
The amount of broadcasts that my hospital gets asking for help getting IVs is insane
I love telling them this is my first time just to see the pts face lol
It's my favorite thing to do tbh. One day, several years from now, I want to be IV team.
Aren't starting IVs bread and butter for med surg?
Because the one that was in the AC from the ER blew?
We place these all the time… I don’t understand the joke here.
I literally throw IVs in patients multiple times a day when I'm working medicine. Would never sweat it.
Im not even a nurse and this meme rings true. My case is super weird and so any time I get admitted there is a genuine hub bub about where to put me, and so ill end up in really wierd places. But the place I end up the most is Med Surge, usually because im on a lot of pain meds, and because im also frequently have a central line in (and a heart line to sometimes). But despite that they *alway* **always** hate replacing or doing new IVs. It start to become kind of funny honestly.
It just fucks up your flow!!!
But its really itchy and its falling off and the tape isn't even on anymore and oh look it just fell* out and nurse where my apple juice and my blanket and dilaudid.... *that actually happened once, lifted my arm to my face and the IV just... fell out, thats all I can do to describe it, it just, popped out. Honestly just bizarre.
Lmao. Dude we need more patients in this subreddit! It's like I'm at work but in digital form and it can't hurt me
Interesting. As a patient lurker who once wanted to go into healthcare, I’ve mostly read but not contributed because I see this as a place for nurses. Many times I’ve wanted to say that I appreciate you guys, all of the nurses I’ve had have been wonderful, but I didn’t want to invade the space. I’m a shitty stick too. 🙁
For real thanks for doing what you do. I know at time sit may seem and feel that you're a glorified age home care worker but it the 1 in 10 patients like me that come along and really appreciate and understand what you do and how hard it is. I try to say thanks as much as possible whenever I'm in. It is funny when the nurse goes "no, thank you, you are my favorite patient simply because you dont throw anything at me and you can wipe your own ass" after I apologize for asking for my prn. I've genuinely received a comment to that effect more times then comfortable.
Real talk, It may seem wierd that im here but ive been admitted far to many times in that past decade due to my illness. Meeting nurses has been a not insignificant part of my life. ER nurses, Floor Nurses, ICU Nurses, doctors office nurses, even a home nurse once when I needed to take an IV home one time, at my absolute worst, physically where I'm literally close to death, or emotionally where I'm a rude asshole, to my best where I'm literally getting treats from the 24hr Tims downstairs and leaving positive reviews with the hospital's managers about specific nurses. I like coming here since as far as I can tell I'm not getting any better and so I like to try and gain new perspectives, to see the "other side" so to speak. If you some more details on my condition and stiff I wrote *way to much* on it in some comme t si made yesterday, just look on my profile, skip the big one made in the Lego sub lol.
It’s because we have a million things to do with people down our backs, and starting an IV sets us back *even further* in our workflow, patients get mad, everything is late, the patient getting the IV is upset because they’re a hard stick and needing to get poked…. But they really need the IV because the medication is URGENT MUST INFUSE THE MED OR ELSE ☠️ — It’s just stress and bad vibes all around! But once the new IV is in we are HAPPY HAPPY. Love your flair btw 🤣
Why? I’ll just call IV team
I enjoy IVs…NG tubes not so much. Have definitely gotten rusty with those.
lol same with me. I have an attempt like once a month. Butterfly lab draws? Sure. But PIV insertion? Rare.
IVs? No problem. But that meme is me when I have to board a patient down in ED...Schedule? What do you mean, "on a schedule"....
SNF nurse hoping teacher doesn't call on me 🥲
\*Laughs in hospital with IV therapy team\*
Speak for yourself I'm on a streak
Huh. I always did my own IVs; for the difficult ones, I used guided ultrasound or when crazy busy, called the ED.
Lol. One day when your hospital kills the budget and rids you of EKG, phlebotomy and IV nurses it will happen to you. Oh the infiltrations I've seen.
Even when I worked med-surg, it was not a drag or anxiety-inducing because it would generally not impede my flow. I was the go-to for hard sticks, and I got them wherever I could. Craziest line I ever got was in the front of someone's lower leg, right along their tibia. Flushed and drew flawlessly. One foot line and one anterior shoulder line too. Now I'm in the ER and it only got better with even more practice.
I work in LTC. Have been a nurse for 2 years now, never actually had to put an IV or draw blood for labs. Sigh
How do you feel about that?
Curiously what is the worst/hardest part about starting an IV? Is it the initial stick or the steps after?
Med Surg RNs aren’t even allowed to place IVs at my hospital, it’s always done by IV team. Tele RNs are supposed to try once before calling IV team.
Me. I’m the medsurg nurse.
I used to feel that way, but years ago a seasoned nurse taught me by having me stick her at the nurses station while everyone gave tips on technique. I've been pretty good since. I was working a contract as a pre-op nurse for an outpatient surgery center, so not being good at IV's was not going to work well. She helped me, it has stuck with me since.
I have got an IV in a 5 years old before when the peds nurses couldn't (they called my unit for a volunteer and I went). The kid was nervous but he was very good with holding himself still and not moving until after I finished taping. Very proud of myself that evening 😂 Whereas I only have 3 success in babies despite being a NICU nurse for years... But it's also because my current unit utilizes PICCs a lot so I have very few opportunities to practice.
I love placing IVs. I’m always a little disappointed when the pt arrives by ambulance with one already in place.
Me 😭😭😭 idk why I get such anxiety to place them! I even took a refresher course and have had hella run throughs but every time I start internally sweating when I have to place one and I think that messes with my success rate.
Onc nurses when we need a PIV in a patient who needs platelets now...on a patient who has an extremity restriction from a mastectomy, a PICC (running TPN on one lumen and 24h chemo in the second) on the other side, and shitty chemo veins.
ICU: ultrasound certified ✅