Something To Consider When You Need An IV

“You only get one shot at this.”

If you ever want to place unwarranted stress on a new nurse about to insert an IV in you, go ahead and say this. And if that doesn’t work, “You better be an expert” has a lovely way of raising the anxiety level as well.

Because really, who doesn’t want a nervous wreck taking care of them in the acute care setting? 

As much as I wish every nurse exited nursing school as an IV expert (and would stop calling me from other departments to come place IVs for them), sadly that’s not the case. It takes practice. Lots of practice. Do you want to know how many IVs I started in nursing school? Probably not, but I’ll tell you anyway. One. And it wasn’t even on a patient. It was on another nursing student. (And I blew the vein.) 

So when I started as a new grad nurse, you better believe I prayed to God every morning nobody would ever need an IV. That all my patient’s IVs would be inserted and last forever, never minding the fact we were supposed to exchange IVs out for new ones every three days. Or maybe it was four. I wouldn’t know since it was a policy I chose to ignore. (Don’t worry—the policy has changed since then. Probably because nurses kept ignoring it.)

But as it turned out, heartfelt prayers and complete lack of regard to policy wasn’t enough to carry me through my entire nursing career. It didn’t even carry me through orientation. I had to accept the fact I needed to learn how to place IVs. And I had to accept the fact I might not be very good at it for a while—one of the reasons I grabbed a more experienced nurse by the scrubs one evening and pleaded, “Help me!”

Thankfully this nurse did. She talked me through every step. “Place the tourniquet. You do know what a tourniquet is, right?”

Yes. I wasn’t completely useless. Well, until I saw the flash of blood and said, “What do I do? I don’t know what to do!” (I might have been a little bit useless.)

The nurse literally had to place her fingers over mine and thread the catheter into the vein, retract the needle, and hook the extension loop to the end. She may have even had to pop the tourniquet for me. I don’t remember. All I remember is the euphoria of placing my first IV—“I did it!”—and the patient rolling his eyes and mumbling, “Sure you did.” 

It didn’t occur to me at the time how much grace and humility that patient extended in allowing this obviously bumbling nurse the opportunity to, let’s face it, “practice” on him. How many of us ever want to go into the hospital and let a new nurse or resident “practice” on us? 

I’d wager to say none of us. 

And yet, that’s what it takes to be honest. When I started off, I missed a lot more IVs than I hit. Sometimes I felt like I was playing baseball. If I can just have a .203 IV starting average, maybe they’ll renew my contract for next year.

Thankfully over time I learned a few tips and tricks that helped. The biggest tip? Keep practicing. Even when you’re not sure you’ll get it, you try. Why? Because that’s the only way you get better. And someday you may be in a situation where the patient needs an IV now and all those patients you practiced on before helped prepare you for now. 

Like the patient I missed an IV on years ago on the burn unit. I could feel my face flushing with embarrassment. Why am I so bad at this? Everybody knows patients judge a nurse by their IV starting skills. I just knew this patient was judging me. Thinking about how he’d drawn the short end of the stick that day getting me as his nurse. “Sorry,” I said, head hanging down, shoulders drooping. “I’m just not getting it.” 

My patient didn’t say a word. He simply reached out and patted my hand. My patient, with third degree burns from the waist down, in more pain than I could imagine, was consoling me. The nurse. 

Such grace. 

Years and who knows how many patients later, a rapid response call rang out through the paging system. Another nurse and I arrived to the scene to discover blood pouring out of a patient’s mouth. He needed surgery. He needed a blood transfusion. But first, guess what.

He needed an IV.

“Here—” Someone shoved an IV start kit into my hands. Thank God for all those years of practice. (And thank God this patient had great veins.) During the chaos—nurses climbing onto the bed to get suction set up, others on the phone notifying surgery, calling family, requesting blood from blood bank—I didn’t say anything to the patient. I put the tourniquet on and stuck him with the IV. He looked down at his arm, then looked up at me. We met each other’s gaze briefly. “Sorry,” I said.

Not because I’d missed, but because the patient was going through a real crummy situation, and sometimes as a nurse the only thing you can do is say sorry—after you get the IV. 

He nodded. Then a few minutes later he was rushed to surgery.

Nobody wants to be the “guinea pig” and nobody wants to feel like they’re getting “practiced on”. But keep in mind there’s a lot of patients who are going to follow you in that young nurse’s career. Be one of the patients who extends grace. You never know whose life that nurse may be trying to save down the road. It might even be yours.