Nurses and paramedics....IV starting tips!!!?

I am a new LPN with IV cetification. I enjoy starting IV's but don't feel like I am as good as the professionals around me. I know that everyone misses sometimes (except the liars). In my new job I am in occupational medicine, where we do blood draws on chemical plant employees(same procedure as IV start), sometimes up to 50 a day. Sometimes I have good days when I am really in the zone, and sometimes it seems like I have to double stick every third person. I had a man pass out on me yesterday (men are wimps around needles). and by the time last day on this particular site job came around(one week job) the other plant employees had spread the word that people were getting stuck "5 or 6 times" (I would never do this!) which made me feel incompetent, which I am not. I know people expect perfection from healthcare employees. Are there any "old tricks" to help me dilate the vein or things I can say to reassure a grumpy patient? THANKS!

Just want to add that as a former EMT-B, I have much respect for paramedics and all prehospital care employees. I know how hard yall' work for such little pay (thats why I went to nursing school) and ZERO recognition. I think 99% of all paramedics are very intelligent, hard working people with a passion for their job. Just know that not all nurses disrespect you and some of us understand how hard your job is! Thank you for busting your @$$ out there!

Take your time looking for the right vein. Going after a small, crooked, tiny or deep vein is more likely to lead to failure.

"Beating the hell out of a vein", as another answerer put it, causes a localized release of histamine, which causes vasodilation. It's very helpful in many cases to tap or flick the vein a few times to make it dilate.

Everybody has good and bad days. I've started tens of thousands of IV's and sometimes I feel like I couldn't hit anything. (I have to perservere until I get it, though) If your patients complain, ask why they didn't bring good veins with them. :)

Blood draws are different than IV starts (I think IVs are easier) Sometimes you get into the vein, and the vein wall gets sucked up against the needle, and you won't get any blood out.

When you are having a bad day, just be thankful that you aren't having to stick neonates or 90 year olds.

I'm sure you do a great job. Don't let others' negative attitudes get you down.

Visualize what you are doing and picture in your head the tip of the needle going in the vein. If you get a flash but still feel resistance on the the catheter think about why. Are you at too steep of an angle? Are you at a valve? Many times the needle goes in, but the catheter is still outside the vein. There is an answer to every problem. Make sure you like the vein before you try. Beat the hell out of the vein so it sticks out. It hurts a lot less to smack the vein than it does to get stuck. Good luck and don't get discouraged.

First off thank you for all your positive comments about us Medics. When it comes to starting IVs I have found that it is better to relie on your sense of touch rather than your sense of sight when it comes to finding a good vein. Many times you can feel GREAT veins that you can barely, not at all see. Secondly, always start low and work your way up the arm when looking for a vein. Remember that if you blow the persons AC then any IV below the elbow on that arm is pretty much out. Secondly after you get flash, advance the needle another 2mm or so. Many times people blow great veins by not doing this. By doing so puts the end of the catheter inside the vein. Lastly once you have gotten flash and advanced another 2mm, LAY THE IV DOWN on the arm before you advance the catheter. By not doing so you can accidentally pull the the needle out without the catheter going all the way in the patients vein. That is about all the words of wisdom I got. Good Luck!

I never figured out why people beat the hell out of the vein...that just doesn't seem to work well.

Several things that can work well. For small veins, sometimes applying a hot pack can help the vein dilate. Using a smaller needle or a butterfly needle can help, too. Tie the tourniquet, and allow the veins to fill for a minute or so before attempting a stick...having the patient pump their fist a few times can help, too.

It's completely normal to miss a few times, and even having to stick a patient 5 or 6 times doesn't mean that your incompetent. We all have "off" days, and some patients can be downright uncooperative.

Hope this helps....