Keep Missing Veins When Starting IVs? | Nurse, Phlebotomist Venipuncture Tips
HTML-код
- Опубликовано: 11 июн 2024
- Keep missing veins when starting an IV or drawing blood? This is a common problem that nurses, phlebotomists, and other healthcare professionals face, especially when they don't have a lot of experience starting IVs on patients.
However, even nurses or phlebotomists with decades of experience can and do still miss veins from time to time, especially when the patient doesn't have visible veins due to illness (heart failure, kidney failure, dehydration, etc.), drug use, obesity, and more.
If you keep missing veins or work with a patient population that typically has few veins to use, there are several things you can try to help you increase your chances of a successful stick on the first try.
In this video, Nurse Sarah offers her insights into what to do when you miss a vein, tips on how to find veins on difficult patients, and more.
#venipuncture
#missveins
#veins
#nursing
Website: www.registerednursern.com/
More Videos: • Dopamine IV Drip Calcu...
Nursing Gear: teespring.com/stores/register...
Instagram: / registerednursern_com
Facebook: / registerednurserns
Twitter: / nursesrn
Popular Playlists:
NCLEX Reviews: • NCLEX Study Strategies
Fluid & Electrolytes: • Fluid and Electrolytes...
Nursing Skills: • Nursing Skills Videos
Hey, everyone! Thanks so much for watching. Don't forget:
*Stop Rolling Veins*: ruclips.net/video/MbG_1-_mnoo/видео.html
*IV Series*: ruclips.net/video/MbG_1-_mnoo/видео.html
Nursing Skills: ruclips.net/video/JmfABHbL-HM/видео.html
NCLEX Reviews: ruclips.net/video/nyBV18sHNSg/видео.html
Nursing Gear: teespring.com/stores/registerednursern
Instagram: instagram.com/registerednursern_com/
Facebook: facebook.com/RegisteredNurseRNs
Twitter: twitter.com/NursesRN
Could you please make a video about Partogram?? 🙏🏻
Could you please make a video about birth injuries? 🙏
Could you please do an updated video about school supplies a day what to expect on the first day of school, since we are in a pandemic? Thanks!
I am a retired RN (BSN) also a CRNI, who worked in ICU/CCU and home IV therapy for almost 50 years. I also taught IV certification courses at a college. Too frequently I saw nurses using sight instead of knowing anatomy and them using their sense of touch. Trust touch, veins bounce. Picture in your mind a soft tube (slightly larger than spaghetti) filled with moving liquid. Image the depth too. Dilatation with heat is a great idea.Use gravity too. Don’t avoid practicing, you definitely will improve with repeated practice.
@ Catherine Somerville As a frequent patient over the past couple of months I've had more than my share of IV infiltrations which really hurt. It truly is a skill to get IV insertion just right and is one of among many which the nursing staff spend many hours perfecting and as a frequent patient I really appreciate the many hours of training and practice that they put into their work.
Good tips!
Thank you for sharing your experience, Ms. Somervillle. I'm studying to be a phlebotomy technician. Your analogy with spaghetti is helpful to understand veins better.
Very true. Er nurse here I never go by sight. If i cant touch i am not fishing unless i got to.
Wow taking care for patient with sickle cell anemia is a real struggle getting a vein...but it gives me good experience taking care of them, as well as with the elderly...my colleagues will often call me when they cannot insert peripheral line and do blind shot, and always take a good shot😘
I’ve been a phlebotomist for only 2 months and have been missing patients. Here I am still learning
People ask me you are so good at starting IVs what’s your secret? I always respond… don’t be afraid to fail. You will fail a lot; but if you learn from your mistakes you will get better. Pick up in the ER if you can. Learn the venous anatomy if the upper extremities. Start an IV on every patient you encounter. You will fail. People will not like you. In due time you will be the nurse that rarely misses a vein.
EXPERIENCE!!
It also helps if your patients are relaxed about it. I was a CNA for years and saw way too many new nurses panic because the patient was becoming agitated or impatient. I’ve also had a few surgeries and hospitalizations that required IVs. After my lithium overdose I had to get like, 6 vials drawn every couple hours for the first 36 hours in ICU. I was afraid of needles before but after that I don’t give a single fuck. So if a brand new nurse takes 10 tries it’s not even going to phase me. I’m a student at a research university with a hospital, medical school, and nursing school, so I’m happy to let newbies practice.
Why do patients or patients’ families think that watching over you, putting pressure on you or being mean to you when you’re trying to do a procedure will make you do a better job? Sheesh 🙄 so unnecessary
I refuse to complete a procedure in front of the family. I always ask them to leave. Don't care if they get annoyed.
I hate when they do that!
Well try the family and your mentor over over you, yelling at you. Its a recipe for disaster.
Its worse when a family member is in the medical field and they think they know everything.
@@bdogg20101 lol. So true
These are awesome tips! I’m a mobile phlebotomist and 90% of my patients are geriatric, critical care, or other hard stick patents. Whenever I need to pull out and try again for missing a vein I calmly and factually say “I’m not getting anything yet, would you be willing to let me try one more time?” instead of being apologetic or anything about their veins being ‘bad’. It’s not their fault if their veins are small, and I know that I’m human and can’t be 100% perfect even if I try my best.
Great response, you aren't over apologizing but at same time ,not blaming patient. Just the facts. And politely requesting to try again. From a retired RN
I’m a brand new nurse. I’m trying to be THE IV queen on my unit 💪🏼
Me too girl!👊🏽
Great attitude!
All the best
Good for you! Practice practice practice
I would be the future IV queen in my unit and I’m only 17 and used to doing IVs 4x a week
Im crying... felt like this is a sign. I was on the verge of giving up on doing iv cannulations and blood collections because i always missed a vein. 😭 thank you.
Don't give up. Practice. First practice finding the vein with a tourniquet. If you have friends and family that you can practice on, that can help too.
There could be a multitude of reasons to miss a vein. Is there a specific reason why your missing?
Tourniquet placement, you don't want it too loose, yet you don't want to cut off the circulation.
Your positioning is important too. Have to adjust your body to the perfect position for the site you choose. Or if you can adjust the arm or bed.
I found that using the elastic tourniquets can help more than the disposable tourniquets. But now with covid, that may not be an option.
Warming up the site brings more blood flow to the area. It will help.
And even gravity helps, especially with veins on the hand.
If you are using the hand, having then grab on to the edge of the table or a small ball and tilt the hand downwards.
For some patients, they could be hard to stick because they are dehydrated. That is why it's important for the patients to stay hydrated.
For some patients they could have limited veins and/or for those that need frequent blood draws or IV access, their veins could be very hard to get.
Like for me, I have really good veins. But after 2 years of going to the cancer center, my veins are shot. Luckily for my port. Makes life so much easier. Better than getting stuck 4 times trying to find my veins.
Love all of your IV videos!! I have to do about 20 IVs every day at work for sedation procedures and for a good month when I first started I kept missing veins and gave up for a bit! I started to shy away from even attempting IVs and would get others to do it for me. You're tips have helped so much and now I have improved my IV skills sooo much!! I get successful IVs all the time now and don't let myself get discouraged anymore if I miss! Just gotta keep at it! Thank you again! ♥️
This gave me hope! Just starting out and i have hits and misses but lately felt like its been more misses than anything. So im literally researching ways to improve my skill and i am so happy she has a video! 😁
This is me, and when she described what i shouldn’t do when i miss a vein, both situations i have done 😩
I've been an RN for over 17 years and I still miss veins. I'm usually pretty good though. I will sometimes take a blanket from the warmer and wrap it around their whole arm, wait five minutes or so and then try and stick them. It's works! Thanks for sharing! ; ) 💕
Been a RN for 3 months and this was a skill I really wanted to learn. I asked my leadership to spend a few hours in the ER just practicing. Now I'm the go-to guy in my step down unit. It does get easier.
Hello I am a Nurse Extern at my local hospital and a nursing student. As extern we get to practice our skills while also working. I was having so much trouble with IV sticks. Missing veins, blowing veins, rolling veins, and even a patient who wouldn't set still. I sat down and found this video. Well after watching it i later got to attempt another IV stick. Got it on the first try. Really a boost in confidence. Thanks for the material.
You're a life saver to every nursing students😭😘💝
Ohhh you will be the queen then........try hard....👍
Nurses too 😊
registered nurse here and i STILL look to her videos for guidance!💕
Literally. Failed 5 times to draw blood volunteer veins for my practical because I kept missing them. Actually being over apologizing and didn't want to try for the other arm (scared of hurting her arm again) but she said just carry on. Man,she actually calmly asked me to try again when I lost all my confidence 😭 This video helps me to not give up 🥺
I’m a retired nurse and even though I know I won’t be doing these procedures again, I still want to keep my knowledge current. As I grow older, I will have more healthcare encounters and I want to be able to partner with my care givers.
Hello Donna, nice 2 know, u care
I have about 15 sticks under my belt and every time I miss one I am hard on myself and I feel I miss more after I miss the first one. Trying to work on my confidence. Thank you for the video
When I train I tell people not to LOOK for a vein because the better ones aren't visible, they're under dermis fat pad. They're "squishy, springy" as you said, but they aren't blue they look for. So I tell them to practice at home - without needles - on anyone willing to sit for them, to close their eyes and run their fingers over the arm to find veins by FEEL, not sight. When they do this off and on for a day, they eventually find vessels comfortably by feel rather than sight. Plus they get over anxiety building during tourniquet application of "what if this goes wrong?", because it can't without needles in play. They tend to find good veins at home, then again in class, approach shallow into a flash, then smoothly level off. A bigger vessel by feel gives them more room in the lumen to get it right the first time. Much moreso than the tiny blue surface venules.
Sometimes ... they'll point out a tendon by mistake, which can also be felt through skin, which of course can never be canulated. But the feel is different. A vein is spongy and pliable like pressing on the skin of a balloon, while a tendon feels like a hard strap under the skin and won't lightly compress under their fingers like veins will. Again practice on the fly with just a tourniquet at home with family, friends or with other students, gives them the feel and confidence they usually don't have with unfamiliar variations in surface anatomy. It's one less thing to worry about in class when they do it again with a needle.
The other tip is when pulling skin taut, don't put the thumb on the feeding vessel. Since blood flows from wrist to elbow, even with a tourniquet this inadvertently shuts off the flow to the access site, causing it to go oval or collapsing outright. Pressing harder won't make this situation better. They'd be surprised how many staff make this error simply because they're concentrating so hard on insertion. Instead, they need to pull the skin taut by pinning EITHER SIDE of the vessel, but not pressing ON the vessel. I had a nurse miss my veins four times before surgery before I said, "OK. Now let me talk you through it." He got it during the tutorial to both our reliefs.
I am a struggling new phlebotomist and this video really helped me. Thank you!
Honestly you should be a teacher, we honestly don’t have enough that students are able to grasp the concept from so quickly Btw I LOVE watching your videos :) thank you for making these!
What do you mean - she is a teacher hahah
Thank you so much :) you helped me a lot to understand the Med-Surg Nursing 😍😍😍
I PASSED MY BOARD EXAM YESTERDAY. I'M ALREADY A REGISTERED NURSE!!
- REI FROM PHILIPPINES
CONGRATULATIONS! YOU'RE GOING TO BE AMAZING! I just got my ATT I'm about to sign up to take my NCLEX TOO!
Sarah I'm running out of words to express my gratitude towards you🙏 you're helping us so much to learn new knowledge everyday..you made my nursing so interesting that I found boring at a time ..Thankew so much Sarah ..God bless you more and keep making more videos❤️❤️❤️
At first I thought I will never be able to start an IV on my own but after watching RUclips videos on IV cannulation including yours, I got to start one successfully. Thank you!
I just recently got out of the hospital after having had a heart attack, followed by cardiac bypass surgery , followed by a 3 week stay in a rehab. Moreover, I have been a long time blood donor having donated nearly 15 gallons of blood. I have seen a lot of needle sticks and IV insertions. For the most part the nurse / philbotomist was successful but there have been some exceptions. Due to my long time blood donations I have developed scar tissue within the veins and some of my veins will roll. It takes both practice and skill to deal with inserting a needle correctly and some of the most skilled nurses have trouble with this while a number of philibotomists do a great job
Thank you!!! I have not done this yet.....I'm so grateful for you and Ben and all the helpful information over the years! God bless you!!!! : )
Your story about the family really reminded me why I love the covid restrictions in my ED.
I am a new phlebotomist at a very busy "hub" hospital and find that if I miss the first stick, my second guessing and self confidence lend to me missing my secon/final attempt. Your videos have been very helpful and I can't wait to try your approaches. Thank you so much for making these videos
Thanks for the tips and encouragement!! I get such anxiety about this and it's one of the simpler things a nurse does!!
Thank you. Great to have you helping us. Such a nice skill bank to share.
Thank you so much for these tips and being so encouraging. I'm learning to do IVs and it's always disheartening when you miss, especially for a beginner.
I have to do IVs in my ward and it's been 5 days but most of my attempts are not successful. I feel really bad and colleague makes me feel inferior about not being able to do them. I am glad i got this video in my recomrecommendation, i hope i am able to do them.
I just passed my NCLEX RN and you just gave me so much confidence. I can do it 💪🏽 i loveeee your videos
New nurse here. I had a bad night the other night and missed every one.
We all have those days. But every day is a new day. The main thing is to know why we missed and learn from that.
Fighting! Good luck for you!
I appreciate this video, I missed the first two veins I tried to hit in nursing school and was devastated. Somehow youtube knew and suggested this video to me 😂. I feel much better knowing I am not the only one.
I'll be graduating the RN program soon and I want to be in the ED so I'll be doing a lot a IV insertions. This has been helpful. Thank you
I missed today and beat myself up about it. I appreciate your video to know that we all miss sometimes but the best thing to do is try again with confidence.
I have sickle cell , so most times I’m getting stuck more that 2x. Love all the points in this video. I hate when nurses don’t listen to me and choose to go else where and miss 🙄. I understand that it’s probably not the easiest thing to start an IV. I’m a nursing student and dreading learning how to start IV.
I know what you mean. I been going to the cancer center every week for 2 years and I tell the nurse which veins are good and which one they should not use. Some nurses I guess they have the attitude that they know better. But who knows their body better than the patient.
Some times I would get stuck 4-5 times a visit. Them Just trying to get IV access.
Don't dread IV's. The one thing I learned in nursing school and phlebotomy school is not to be scared. If you are scared, your more likely to miss. Be confident and go step by step. Practice. Practice, practice.
@B K oh my goodness 😫 I hate that! Yeaa I appreciate the ones who listen definitely!
@B K thank you I will , I’m still gaining confidence as I go along , working on it !
@@bdogg20101 I know the feeling as I've been hospitalized four times so far since november 2021 and as a result my veins especially on my left arm are tapped out. Last time I was in there in late december the nurse botched another IV resulting in a painful infiltration but what I really dreaded was the ultrasound IV during admits one and three. I swear when I saw the nurse wheeling out that ultrasound monitor I knew there was gonna be major pain.
Thanks for your words and explanations.
You're a life saver!! LITERALLY
Hey Sarah. Would love to find out whether you have videos on pre and post operative care. BTW thank you so much your videos are really helpful.
You teach so well, thank you
Thank you so much sarah for your explanation, it makes so easy to understand. Would you please make more videos on hematology disorder like leukemia and kymphoma. Please
You're just so great, I keep missing veins, thus video really gave me a boost of confidence. Love your energy
This video made me feel a little better about IVs
Your videos are very helpful! 🙏🏽🙌🏽
Thank you. This is useful information for prehospital healthcare providers (ie: EMTs) as well.
Any recommendations for alternatives to vein-finders? We don't see those often outside the hospital setting. Most of us get pretty good at finding them the old-fashioned way, but more tools in the toolbox is always welcome.
I am loving the new look and sound! The makeup and the more personable tone is very fitting for you You! You have grown so much and I appreciate all the hard work you do for making these videos! You are amazing. 💟
Thank you NURSE SARA your videos helps a lot before I took the Philippine NURSING LICENSURE EXAMINATION I've watched your videos and guess what I've passed my examination thanks to your videos very informative..
Thank you so much. I really love the way to teach.
Thank you for this!
You're so amazing.
I'm going to start studying phlebotomy soon and I've seen a few of your videos now an they're so helpful!!
Thank you so much for the tips and advice!
Great content. Thank you.
Excellent teaching !
Thank you very much!
You’re awesome great IV advice 👏👏👏
You are amazing! Thanks a lot for that.
Thanks so much for this great and motivating Video.
I'd never considered that I might be putting too much pressure on the vein (as demonstrated by the water balloon). Makes sense, I will have to try easing back on my next attempt.
Im working in the homecare settings. I usually travel for a home visit, usually its difficult to insert to a geriatric and obese patient, what i learned to do is to always bring a hot compress to dilate the vein before starting the procedure. I prefer to apply this principle to avoid hustle and delaying the next patient, becoz of the travel time by the patients line up..
It is also very important for the patient to hydrate
Helps the veins pop out more.
Love you sarahhh....you are my role model.
You rock! 🎸Thanks for the content! 🙏
hi Sarah, i just wanted u to know i passed our local nursing board exam on friday. Thank you so much for your videos.. it helped me passed the board. 😁🙏❤️
Proud of you congrats
Love the video thank you so much. I really thought this is not my thing. that I am never going to learn this. thank so much for the tips. I will practice and not give up.
thank you again. i will continue to practise
Thx for thsess vids thses literly helps me
I am an incredibly easy stick. I've had a dozen or more IVs and while I it's annoying after it's in because it's always in the way, it has never hurt. Today had someone start an IV in my hand and it felt like she was forcing the needle through flesh and bone into my hand. It was excruciating. She put the tourniquet about 2" above my wrist, a first, didn't look anywhere other my hand, and spent forever rubbing and smacking my hand to find a vein. I have nearly clear skin and my veins are extremely visible and prominent. You can see them with zero effort. I tried to make suggestions of where I've had several successful IVs and she shot daggers at me. So she stopped on my left hand and told me she had to stop because I couldn't tolerate it, which really pissed me off. Then insisted on trying in my right hand, which I REALLY DID NOT WANT, but both nurses said there was no reason to say no because I would still be able to use it. I kept saying I've had a lot of IVs I know what it's like. They would not listen. So she proceeded to put an IV in my right hand about 1/4" above the bend of my wrist and I could not bend my wrist even slightly with terrible pain. She did not ask me if it was ok when she was done she just left. I was not dehydrated. I actually had to pee the whole time and then had to go without being able to use my right hand at all. Plus I didn't really want to use a hand with an IV to wipe anyway. Well my hospital gown fell in the toilet after I peed and then dripped toilet water all over my thighs and abdomen when I tried to hold it up with my one available hand. It was just a mess and the nurses treated me like a complete whiner as soon as I said that first IV hurt. I was smiling and joking and perfectly happy until today IV happened. She missed that first vein entirely but just kept forcing. It didn't even bleed after and pain was radiating up and down my hand into my arm. Don't be that person who takes it out on a patient when you mess up. The new IV HURT the whole time and still hurts hours later. It was wrong and no one would offer to redo it. It was a short procedure so I can see why but quit gaslighting patients
Great video and tips❤thank u
Thank you❤
Please keep teaching us you are amazing
Thank you
Thank you for explaining its sometimes 2 tries per nurse as it’s not always the cause. I have hard veins and many nurses won’t try more than twice when the policy said they can go again as limited staff if I consented and she told me it would be torture if she did it Again and I didn’t get a needed test but will be getting it soon anyways as it was needed. Now it’s delayed
Thank you ☺️
Best technique
Excellent 🥰
I really love your videos
Thanks, I loved your video, but I need to ask. Can you recommend a specific vein light? They usually have mixed reviews.
Impressive personality with knowledge.
After watching this i have a confidence that i can do
I pray I’m able to be super awesome all the time to help others
I want to buy an ultrasound machine, because starting ivs on npo patients is stressful
ivs are my favorite skill.
All the way from Tanzania 💪
Thumbs up for the information and for your helper 🙂
good work ♥️
As a new grad keep missing all the time 💀 I need to try these tips
I am horrible at IV starts. Thanks for the advise
First two weeks of working as an ER doctor and I only get patients in severe shock, no peripheral pulses, getting the IV catheterization in first attempt is really tough, there will be no veins to palpate, legs are mostly cyanosed.
Great video , from a hard stick
I'm a medical student and I have been admitted to a clinic once , the nurse who was supposed to start the IV was so nervous as she couldn't spot my veins because I have freakishly small veins on my hands and my darker complexion made it even harder for the nurse to to find a vein ( back in china there aren't a lot of dark skinned patients daily on the clinic) . She got it on her 3rd try. She was so sweet and sorry.
Hi, thank you so much for your videos, they’re amazing, especially the IV insertion ones. I don’t know why, my biggest problem when trying to attempt IV insertions are that I’m having a hard time feeling the veins, especially the ones that you cannot see. I know and I understand that in general to be successful with IVs, the more practice and the more that you do is what usually matters.
But do you think that may also have to do with my fingers / hands being less sensitive to touch? I’m someone who tends to be washing my hands quite often, usually more than others. Do you think starting to use a hand cream or something, especially for nourishment and / or sensitive fingers / hands would help? I know it’s not going to do wonders for my IV insertions, but do you think it’ll help at me at least with my sensitive fingers / hands in general?
Hoping for a timely response, your response matters, thank you so much for your time, much much appreciated!
I'm from Pakistan. I learn a lot from your video. I'm 2nd year student generic BSN.
Thank you, I’ve been doing IVs for 6+ months now as a new to practice RN in the emergency department. I still have days where I miss and it sucks having to call for help lol cause it slows down our care so much. I think the main issue is maybe not sliding the needle in far enough. Sometimes I immediately get a flashback and other times I have to palpate on top of the vein while guiding the needle in. I never shy away from trying! I want to get better and even though I have resources and a strong team but I also want to be better for myself. Thanks for your tips!
YES, the part about asking the patient, please please do that yall. I have been to the hospital 100+ times, and I know my body! When they don't listen to me, guess what happens, I get stuck by a needle 10 times before everyone gets frustrated and they need to get an ultrasound, vein finder doesn't work on me
TY for the balloon analogy! I had an instructor in my clinicals try to tell me to take the tourniquet off (during my first stick ever) b/c he was afraid I'd blow the vein, but he did NOT explain it like that. Since then, every single nurse I've worked with insists on it being on and I have a feeling I've blown several veins (and watched others do so as well) for that reason! I once went into a room while I was insanely busy during the height of COVID and plopped an IV in a guy w/o any tourniquet whatsoever b/c his vein was so obvious. It was the easiest stick I've ever done and he said it was the least painful IV he'd ever gotten! I just realized why!
You are the most amazing person in the world u even better than my teacher
Nice video 😊
You´re totally AWESOME! Love U!!!
Love her!
Thank you so much for your great video
Watching from Kenya🇰🇪🇰🇪🇰🇪.... Thanks for the insight. I actually missed a vein on two pts today i felt so disoriented and disappointed.
Aaaaargh!!! I made it worse by trying to apologize. I missed 5 times on one😭😭
But I also managed on 3 patients. Practice practice makes perfect.
I think it's just all about confidence and the angle. Also make sure you tie the tourniquet in a easy way to unfasten.... I noticed I was missing when trying to untie
Stumbling across this video gave me hope,felt like quitting already cos I missed two patient Ivs today, and have done successful ones this past weeks without no stress and no one supervision, have been wailing cos I feel the patient won’t ever let me attend to them…
I've heard nurses say "sorry...I can't seem to find it...could I try again?"
I love your video but I am in love with your hair too❤