You know you’re a nurse when you get extremely high upon seeing a good vein and hit it at the first shot and get depressingly low when even after several attempts you still fail at inserting an IV line. Yeah, every nurse who has an IV therapy license has experienced these at least once. Yes, finding a good vein might be difficult for some, and even harder for others. However, the fear of failing at insertion of IV cannula must not stop the nurse from trying to start an IV line, as this is part of her duties as a nurse. Below are some tips that would help in smoother IV insertion:
Feel, don’t just look.
There are nurses who would just go for the most visible veins, but often these veins are very close to the surface and will blow easily, deeper veins are often stronger, less fragile veins. Try to palpate veins with your fingers tips and feel around for a springy feeling vein. It might feel like pressing down on an under inflated balloon, it will "bounce" a little under your fingers. Select the largest vein that you can find. Once you have a found a nice big, bouncy vein follow it up about an inch or two and make sure it feels pretty much the same all the way up.
Use solid traction: Anchor well
Once you’ve found your site, try placing a thumb a few inches distal to the site and pull traction. During this time, the patient should feel a firm pressure. Finding a spare digit to help advance the catheter off the needle can be hard with one hand busy pulling back on the skin. However, this should not be an excuse to let go of traction at the moment of advance. Maintain that traction till the catheter is fully advanced.
Don’t go too deep
Instead, use a shallow angle. The closer the needle approximates the actual angle of the vein, the easier it will be to land the tip inside the vein where you want it.
The catheter goes forward. The needle does not go back
Once you’ve achieved proper needle placement and you’re ready to advance the catheter make sure that the hand holding the needle does not move. Instead, the catheter needs to advance forward off the needle and the needle does not move backward out of the catheter.
Learn from your mistakes
Yeah, you might not get it right for the first few tries as an IV therapy nurse. But don’t let that put you down and shy from IV insertions. Learn from them. If it happens with the same patient, learn what you can from the failed IV attempt, but once you drop that failed needle in the sharps box, forget about it. Put things in the past and don’t let them affect your next attempt. Who knows, you might get it right this time.
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