I know a lot about IVs. I know how they are supposed to go in, preferred places to look (and not look), patient preferred insertion sites, and so much more. Unfortunately, I am intimately aware of what it is like to fail to obtain access on a patient too.
IV insertion is hands down my achilles heel in my nursing practice. It is a damn shame too. I can communicate well with the patient, comfort them, educate, make them laughs with jokes, and then the second they need a new IV it all boils down to, “you can do it on the first try, right?”
The floor I work on is a general surgery floor (bowel, breast, OB-GYN, hernias, thyroid procedures, etc). The patients arrive on the floor with IV access and it is good for four days, unless it has a complication. It might not seem like much, but four days is a long time on a surgical unit. Sometimes patients have come and gone before they need a second IV.
I often don’t get a lot of opportunities to place IVs. Either someone else is around when it needs changing, it’s the beginning of the shift and the charge nurse changes it, the patient no longer needs it, or we can extend it 24 hours because the patient is going home tomorrow. I need to actively seek out more opportunities to get regular practice at placing them.
I have nothing against teamwork, but we have all been in situations where everyone is busy. It is a helpless feeling which heightens my insecurity. Asking for help with IVs is the one thing I routinely need. I’d rather be the guy nurses from another units seek out to help them with hard IV sticks.
This past weekend, I needed an IV in a 90-year-old patient. They had that thin translucent skin with bulging veins that rolled and disappeared depending on how they moved, and they were always moving. I didn’t even use a tourniquet, the vein would just explode. I ended up getting a 20 gauge needle in their hand so we could continue with IV antibiotics.
I played it cool, dressed the site, anchored the extension tubing, then signed and dated everything. I picked up the IV starter kit and walked out of the room. I gently placed the kit down then started fist pumping and doing karate kicks to celebrate (don’t question my methods) ending a several month spell of IV impotence. It felt good. I like feeling good.