@Dwayne The Coke Johnson hands are worse, more likely to fall out, however yes ACF creates the beeping sometimes very dependable and depends on size of the vein.
I listen to the patient who was a difficult stick she directed me however I did not see a vein, I trusted her, Lo and behold I got backflip and we were in! Haha
@@klow4491 when I was in a coma I was immobile but I could still feel Nd hear... When I got able to use my right hand apparently I was. Conscious giving thumbs up and thumbs down answersrs but I just wanted to go back into my coma (brain hurtyflipping off the nurses working on me I do remember one saying" oh he didn't like that" just some advice for you wonderful nurses out there, I now know. Were following instructions but then I didn't want to wake up no matter the yelling/pinches temp prods etc... Again BRAIN HURTY (ANEURYSM) HEMORRHAGAL stroke
I am a hard stick and I always tells the nurses "do this vein, the others are too difficult". They take that as a challenge, then go for the hard ones. They miss every time.
Tell them “you are not allowed to stick me anywhere but here” I’m a paramedic and we need consent to do anything in the medics field. Don’t let them tell u otherwise just stick to that sentance
They miss not once,not twice, not three times,NOT FOUR TIMES,BUT FIVE. plus the girl didn’t even remove the needle,just wiggled it around. Threw up,got really sick. Turns out it wasn’t clean.
I just failed the Nclex exam.😭😭😓 I cannot begin to articulate the level of embarrassment and heartache I'm feeling. 😥 I'm confident that I will be a good nurse . I just need to get past this, move on and persevere
After using uworld twice and failing, I never knew I could ever pass the NCLEX but today I am very happy, I just passed my NCLEX on my third attempt with a great help for Mrs Catherina..
Really, you'll know her Too? I even thought I was the only one she has helped walk through the fears and falls of Nclex Exam,Mrs Catherina Alison has brought me out of the trenches and to a better living, I encourage repeat test taker to work with her.
I had one nurse who wouldn't stop poking me until another nurse intervened. I never had a vein blowout before 🥵 Two nurses in black showed up and inserted the IV like no big thing. Angels 🙌
one of my worst experiences ended up with blown veins on BOTH ARMS! and an IV on my hand. probably ended up with 8-10 sticks between left/right arm and left hand! now i have a hickman which is amazing since i have basically no IV access
When I was in the hospital, I told them that I was a hard stick, at first many took that as a challenge until they realized it was a warning not a challenge, they brought vein scanning tools and people who supposed to have experience with the hard sticks but it was up to "magic Maggie"( a rotating nurse) to save the day
Those two angels used to poke patients numerous times when they were just a beginner. At times people need to understand all those professional nurses used to learn things step by step before.
AEMT and ER Tech: Alcohol preps can help dilate the veins too and double tourniqueting can help make the veins “pop” more. Sometime for elderly patients inflating a BP cuff and using that as a tourniquet can help as it is a more circumferential pressure! Also, look on the thumb side of the wrist and back side of the forearm for hidden veins that like to pop as well! Happy poking!
The warm glove trick has yet to actually fail me. Make it hot water and always monitor with the patient and on the skin to make sure you're staying safe. That tourniquet wasn't nearly tight enough, though. xDD Just a heads-up to those people watching who haven't dealt with it much. She was probably just doing a demonstration versus an actual poke.
I had to have surgery a few years ago, and despite thinking I was well hydrated (didn't know I was hypovolemic at the time, with anemia and stretchy, rolling veins), no amount of slapping, hot packs, hot water gloves, and even dopplers helped. I had to be stuck 12 times with blood running down my arm. There will always be a patient where some trick will fail. You need to be able to do it without special tricks, or you end with pissed pincushion patients. They had to call in someone from RRT to stick me.
@@limalicious I never said anything about there not being patients out there in which it wouldn't work, just that it hadn't failed me, yet. This isn't to say that I haven't failed to poke someone...I just knew that no amount of heat or other skill was going to make it easier. Sometimes, it just takes a different person. Also, IVs are much harder to put in than just doing a veinipuncture. This comment was unnecessary, really. It's okay to ask for a different person or technique, but please don't be telling us how to do our jobs. We hate having someone turn into a pincushion as much as they hate being one and are fully aware that tricks will not always work.
When I was in the ER, they were trying to give me an IV, they kept switching which arm they were poking, and fished in my left arm for 5 minutes. They legit had to pull out the ultrasound. Thankfully, I'm used to IVs from when I was hospitalized as a kid, so I wasn't too bothered by it. I think I was mostly upset at the fact I couldn't go back to school because they were taking so long, lol. The bruises after were crazy, bro
I literally just donated my blood yesterday. I gave compliment to my nurse as she is so quick and skillful, that even big needle like that didn't even feel hurt. She's so happy and proud ❤
Also, nurses gotta be more confident in placing lines in heavily tattooed areas! Trust us.... a quick pinch or two or even three is worth giving our other arm a break! Lol
Tell that to a person with severe anxiety concerning needles or any piece of equipment that is stuck inside the skin. Good for you that you can't feel it or simply don't care.
The reason we won’t go for tattooed areas is because we cannot see what is happening (hematoma aka bruise forming) when the skin has been tattooed It’s mostly for patient safety, but I definitely understand what you’re saying It really all depends on the veins (bc if you’ve got a really juicy, viable vein it makes it easier to justify sticking tattooed skin when there are no other options)
I’m a hard stick and my advice is to always ask the patient if they have a preference for where they want the IV, I always get people wanting to put it on the inside of my elbow and I have to tell them that my hand veins work so much better. Also forget the warm blanket/whatever and get a real heat pack, most places I get an IV at have them, although I think the hot water in the glove trick would work fine as well. I’ve also never had someone pull the skin back on the opposite side of the arm, I don’t generally look at what they’re doing but it usually feels like they’re anchoring with their thumb, but do whatever works.
Don't be scared to use a tight tourniquet!!!! A few seconds of tight can make all the difference in giving you a nice plump target! Put that tourniquet on clothing if the patient has fragile skin. But don't be scared to make it a little tight!
I once told the nurse you can’t find my vein in one of my arms, and she insisted she could. Stuck me over 4 times. Tried the other arm only once. Then moved to my hands. The other nurse came over and said she was needed elsewhere, she took over and instantly found my vein one time. Bruh. These nurses sometimes just don’t give 😂
At my hospital they use a different kind of tourniquet. It is more of a strap, with a clasp that is very easy to loosen or tighten. They have different color coded sizes, so it is easy to grab the right one from the cart.
There is pinching problem with those. I used one on myself when doing hemodialysis at home. Don't think I could have used one like shown here with just one hand. Those are likely single use which has its upsides.
Had to get anesthesia once when i was younger. The nurse was having a hard time finding a vein, and me being terrified of going under wasn't helping things. She started slapping my arm to get a vein and was loudly telling me to calm down. This method looks so much better than that mess.
Whenever possible I think these things should be done especially for people with bad veins. But I will say, I have terrible veins, and getting an IV can be borderline traumatic but anytime I've been in an ambulance, the EMTs get it first try every time even when we're moving. I don't know what kind of sorcery they're using but I wish everyone had it.
@@shannonrickard8605 paramedic here: we land because it’s a challenge and if I miss then I’ll have one of the old guys at my station say “son when I was your age I was able to throw IVs using my left pinky and ring finger while upside down and using my other hand to get a BP palp all the while doing 85 mph down a gravel road and the shocks were already blown on the truck”. A bit of an exaggeration on my part but yea the old guys will always challenge us young guys on our skills. Keeps the job fun and keeps us good
That’s such a shame though, because that little extra bit of due care and preventative measure, is the difference of someone like myself as a patient who has a record of 23 attempts to find a vein on me. I’m always mind blown if they can stick me under four times at best. I’ve had thousands of vena puncture, I’ve met THREE nurses who “babied me” a little and got the vein first go.
I am a doctor and I did so so many IV as a house surgeons. My trick is don't look, just feel. Try to feel the veins with bare hands. And next step try with gloves on. Only insert if you can feel a vein in a cannular length. This trick even helped me with two gloves on in covid era.
I’ve had neonatal nurses struggle with my veins, an anesthesiologist left frustrated. Now I can only go to one specific hospital in my city if I need a blood draw or IV catheter placed, because they have an ultrasound in their phlebotomy lab.
I just got my first IV and my nurse was so impressed cause i was the chillest patient all of her shift, but i decided to watch her draw my blood and she gor nervous. ❤ you C
Something else that helps is having the right size gloves. Dexterity is a huge factor when giving obtaining IV access (make sure that you don't have a half inch of extra glove on your fingertips; gloves that are too tight can make it difficult as well).
I am a drug free IV user since April 2017. I always have to tell the nurses where to stick me for blood tests because my arms are messed up and I have always been hard to stick. Most of the time, they listen and stick me in the back of the hand as I'm requesting. But sometimes they stick me in my arms anyway and also leave the turniquet on for too long so I get ugly bruises and bumps. I love the nurses who actually listen to me ❤ My body always starts shaking when they draw my blood, and I have to explain it to them.. I assume it's a natural response from the body when you have been an IV user, even if you have been clean for a long time 😕
My worst was having a nurse try to get my IV started with me severely dehydrated and suffering vertigo. Not only was the world shaking, my girl tried every option in both arms before letting someone else do a perfect insertion into my hand. Anyway, I volunteer for the local phlebotomy and nursing classes now because they can’t do me any worse. 😂😂 They’re all so scared of sticking their first real person and it’s sweet. ❤
Mature person here with several nurses in family. When especially doing older patients please put tourniquet over a sleeve edging. It doesn't take extra effort, of course if in serious emergencies. This keeps skin from bruising and pinching even with doing flat like she suggest. Both important. If at all possible. Thanks from a patients view. Nurses are the BEST!!!
Im a phleb and IV certified too… also gloves that fit properly is great because if not you’ll feel glove and not a vein. Sometimes bending the arm helps and 3 finger unspoken rule is so slept on too !! IYKYK ! Also pull that tourniquet i rather they feel that then having dig and you should always anchor vein especially ones that move or roll . Also palpate that vein !! Lol you will never feel anything by just giving a soft rub . So veins are deep !
I feel like anchoring this way would make it very difficult to get a vein, especially on older people. However I'm in the lab so I'm not sure if there are other ways you guys do it. I always anchor on the bottom.
When I had to get fluids from when I was in the hospital with Covid, they didn't bother putting a warm compress and the liquid was coldddd. My arm was hurting so bad. One nurse kept telling me to put my mask on even though I was actively vomiting. The next year I was getting infusions and the nurse was so nice. Made sure I was comfortable and let me use as many warm compresses as I needed. They definitely help!
Work in an area with auto blood pressure monitors? Turn the "venipuncture" mode on and use that instead of a tourniquet. Sometimes you may need both. Love that feature!
I’m someone who can’t hold IVs (I have literally blown a central line) I’ve had 2 port-a-caths (1 had a manufactured leak & I contracted MRSA from a contaminated OR for the 2nd…as a bonus, during both surgeries I experienced Anesthesia Awareness & felt EVERYTHING) Was supposed to get a 3rd, but I backed out of the surgery last minute, but I did get a Groshong Catheter which my son, then 4, accidentally pulled out when he tripped on my tubing. For some reason, heat doesn’t work on me. We’ve tried every hack from what you mentioned plus heated blankets, hand warmers & even washcloths dipped in near boiling water. What does work on me is ice. It’s insane how fast they pop up. My hardest stick happened on the OR table after the anesthesiologist couldn’t get a line (it was at Stanford when they had anesthesiologists start surgical IVs not nurses) I ended up having 9 people trying for an IV on every limb, all at the same time. 30 minutes & almost 50 sticks later, my surgeon decided to use gas instead as the surgery was supposed to be quick. I’m beyond thrilled that more hospitals are using ultrasound. Now it’s one & done!!!
Another great trick is if you're having trouble with IVs and blood draws talk to either a pediatric or NICU nurse. They are pros at them since they have to when with much smaller veins on squirmy patients with as little pain or discomfort as possible. I once got poked like 8 times for a blood draw by I'm guessing am intern, they called up a pediatric nurse and she got it first try plus I barely even felt it.
I’m an extremely difficult stick. One time it took over 18 hours and 31 attempts. I was so poorly with a stomach bug so very dehydrated. In the ambulance/A&E it took over 18 hours and 31 attempts before they got one in for fluids etc and it only lasted a day so they did my first midline as I was there for over 3 weeks. In A&E they tried multiple areas, multiple nurses & doctors, an anaesthetist tried and finally a nurse got one in using an ultrasound machine.
As a phlebotomist for many years. Put turnoquite around the gown. People with frame skin tolerate it much better. Even healthy skin. Warm water in a glove and for obese patients you can use a blood pressure cuff.
i hate the tourniquet bc they always have it roll and pinch my skin and it just always hurts, especially bc they take FOREVER trying to get my vein and then have to change arms, or stick me again somewhere else in the same arm 😭
I am a very difficult stick, which means sometimes I end up with a lot of bruises after blood draws. The warm cloth often helps.They also use the "baby" needles on me most of the time. I'm not sure if they mean the pediatric needles or what but they always refer to them as that.
The "baby needles" are often the butterfly needles, with a handle on each side. They're smaller and easier to use. And also, to minimize bruising they should release the turniquet right away after the blood starts going into the tube (sometimes they can't, if you have a slower "flow"). And never have the turniquet on for longer than 1 minute 😊
In nicu and newborn babies break heel warmers and wrap around arms and feet if Uv line will not be placed. ensure to hold traction as well cause the veins are small so they need to be held into place. make sure you have your arm board, stocking and tap ready and a second pair of hands is always helpful if available. For nicu labs or pku heel warmers to both feet and use lancet make sure good pressure and hold for a sec, then squeeze, scoop and allow blood cap refill to happen and gravity trick works well and repeat until lab tubes have been filled to appropriate line. Invert up and down at least 5 times to prevent coagulation for lab draw. For pku ensure all your circles are filled appropriately.
You know i use to feel the same exact way when I first started out as a RN at age 20. I was just scared, started in the er to get my skills and there were only 5 nurses who would do baby and ped Iv’s . I relocated and decided to face my fear straight in the face and started working at children’s er I had amazing mentors and extra help which gave me the courage and confidence and to see how fast babies and peds responded to treatment was a huge eye opener for me and I began to truly love working with babies and peds. I relocated again and went onto a maternal float pool so work areas was nicu, nursery, peds, labor and delivery and post partum and worked there for about 7 years and truly loved it but I was ready for growth and understanding of how the hospital worked so I went into case management and now I work with a insurance company for risk case management. My heart is with babies, peds and moms. And the minute you care for them that fear goes away a immense love pushes you through for the patient and the family. When I had kids of my own it definitely pulled at my heart strings a little harder and my moto was I will care for you like I would for my kids and it worked so well! I would say working med surge/icu or with the elderly is such a super power as well and hands down the most difficult floor for your body. People are just so sick now at earlier ages it’s heart breaking! I am 37 now and work from home mon-Friday where there is min stress, I do miss my patients and coworkers but can’t complain! My outlet is my family and arts and crafts 1000%% definitely find one if you don’t have one!!
Yes anchor the vein below where you are going to stick the needle. Listen to your patients because they do know their body. For the people getting a needle put in them let them know that others I've had better luck with with this vein (point to the vein), then tell them what to do but what others have done. That usually works better with me as a phlebotomist.
The fact that I’m seeing so many comments that don’t know about hot packing both disappoints and yet doesn’t surprise me, nursing school doesn’t teach half the things you actually need to know for clinical practice, also be aware your facility may not allow for hot packing (can be a safety concern) but usually if you ask your patients and tell them what you are doing tell them the potential risks and to notify you of discomfort they’re usually really good about letting you do it because they’d rather have one stick with minimal discomfort.
Lay the alcohol prep on the site you think you want. Tap the site firmly, once, remove the prep as you tap. The vein you chose (or perhaps a better one) will rise to the surface of the skin. The clean as usual.
My best tip was that I need to feel always feel. Most people at the beginning only want to use the veins they see. And try to use the tiny ones just because they see it. Then find a good balance between seeing and feeling. Also look if there is blood on the tip and very slowly pull out the needle an aspirate gently because often your needle is to deep in. I was very bad at that and got better. If you can do that you can lay down an i.v.
I have thin veins and the other day a nurse just stuck it in the veins on my hand, she said it hurts more but it wasn’t painful. Good thing that the veins on my hands are thicker.
Def listen to your pt especially if they're difficult. Also. May I suggest a PCT course? We went over all of this in less than a week! Then again it's not something we administer, mostly monitor. Depending on state.
Confidence plays a huge role cuz even if you know the technique and you doubt your knowledge or your own hands you will mess up every time. I did my first IV not long ago and the patient told me she didn’t feel any discomfort. I do need to build up my confidence but trusting oneself plays a huge role
The tourniquet always makes me nauseous when I get my blood drawn 😭 like, yeah feeling my thick blood being sucked out through a thin needle also doesn't feel great, but the tourniquet makes it 100x worse
No matter how much training you have, you will miss an IV from time to time because of the patients medical condition. Plays a roll in the ability to obtain an IV site. It's not just the skill of the practitioner
Don’t stick an IV right in the elbow crease. Every time the patient bends their arm, they’ll set the IV alarm off. Happened on my fourth delivery. So annoying. In the end another nurse just turned my IV drip off because she was fed up with coming in every two minutes. 😳
My veins are very visible, but there's one on my left arm that is particularly easy to get to. I am also right handed so I try to tell my nurses to do that arm. Some are assholes and take that as me trying to do their job. For some reason with me after doing bloodwork I can't use that arm without pain or numbness for like three hours after (this has always been a thing) so I really despise the ones who don't listen, I wish as a kid I had spoken up to those ones who didn't listen. Now I know better to tell them and if they don't listen, don't give that arm.
My veins are very small and somehow, almost every time, the nurse or tech will miss 1-2 times… One tech, granted she was new, but she was terrible! She stuck my left arm once and then my right arm twice… she must have hit a nerve because never had I felt so much pain from an IV. When my arm trembled from the sheer amount of pain and I inhaled sharply, she told me to calm down 🤦🏻♀️ She FINALLY called in a senior nurse and she did it in go. The times a nurse has done that I can count on one hand!
Also, please listen to your patients. I have exactly one good vein in my arm, even though I look like I have several. Trust me, I know how it goes if you don’t believe me and neither of us wants that.
I always point nurses to my best veins but half the time they don't listen. When they listen they get it the 1st-3rd time depending on skill,if they don't listen they puncture through veins and three other people have to try. I have veins that are hard to get and most roll or don't show no matter how hydrated I am. My veins can also be blown easily if there's too much force or the wrong angle
some people are old with rolling veins, you got to plant those veins using your first finger above the insertion site and your thumb to pull down on the vein tk help hold it in place, that way when you gk to stick your needle in the vein will attempt to roll a little but will stop because your fingers planted the vein in place and then push needle a little further and bam.....flush
No one ever gets my blood drawn in the first try. I've had possibly every area done on me; the inner elbow, the back of hand, the side of wrist. The worst was when I was to be tested for dengue the nurse straight up gave up and nicked my finger with the needle for diabetes and told me to squeeze the blood out into a small test tube. That wasn't a pleasant experience. Sometimes I get so tired of being poked and prodded that I just want to tell the nurses to just slice my wrist or something, at least they'll definitely get their blood then 😭
Also, if someone says do not use a particular spot respect that. Do not take it as a challenge or worse, m stick that spot anyway while they are under anesthesia. Apparently they decided they wanted a “backup” IV. Just like I warned it would, the IV infiltrated in less than a day. They didn’t even use the IV, since the other one worked just fine. But the flushes made it hurt like hell and swell up for a month. Next time I am writing on my hands in sharpie “I do not consent to IVs here”. Apparently me saying “hard no” multiple times and finally pulling my hand away from the nurses who kept arguing with me was not a clear enough lack of consent.
Please keep posting, my son who is terminal tells us stories of how bad they stick him repeatedly cause they can't get a vein. I just sent this to him because he doesn't feel he should tell them how to do their job better.
I remember a nurse repeatedly digging in the same spot over and over again I was internally screaming in pain I think after the 4th or 5th time it went numb and she KEPT at it I was going into premature labor that nurse had no rights to touch another patient
I'm very hard to cannulate and now have a permanent one in, but i remember the anaesthetist telling me that people seem to think slapping/tapping the area will bring a vein to the surface but actually stroking the area is better... Didn't work for me, he had to get his special machine and use my foot, but i always tell the next poor nurse that seems to think she will find a vein in me to try that! Bless their hearts as they never manage it even though i warn them it's probably best not to try and just get the experts 🤷 You'd think they'd listen to their patients more but apparently we don't know our own bodies - they are lucky i don't mind blood or needles! 🤣
Don't ever get cancer then. 😄 Or pancreatitis. When I got that I had a needle in my hand 24 hours a day for three days giving me all my nutrition and liquid. No food or water by mouth. I got this because I dragged my feet getting my gall bladder out because general anesthetics are what I had a phobia about.
Im a phleb and I ask my patients to not look at the needle and give them the alcohol swam so they can smell it, also take deep breaths. So far it has worked. I tell them once I’m in the vein (I get it first try 99% of the time) they won’t feel a thing cuz only the first pinch hurts a bit and sometimes they don’t even feel it. I know it’s something psychological because getting blood drawn does not hurt at all but i understand
@@maggie0285 the needle doesn’t stay inside your vein, only the plastic, blue, flexible tube she loosened at the beginning. The needle is only used to find the vein to guide the tube inside :) also the needle doesn’t go all the way in cuz as soon as you get a flush of blood you insert the little plastic tube and remove the needle :)
Nurses don't really have an issue finding my veins. They really like this one in particular. Also I don't know why but I don't bruise after they remove the needle. I have no bruises showing where they put it in. Only a little scab
As a "difficult stick" I would suggest to listen to your patient, they may have dealt with the difficulties and may be able to offer legit tips
I'm that patient. I roll up like a G asking for butterfly needles and tell them where to stick me. I like my hand the best
@Dwayne The Coke Johnson you sound ignorant for suggesting violence for this.
@Dwayne The Coke Johnson hands are worse, more likely to fall out, however yes ACF creates the beeping sometimes very dependable and depends on size of the vein.
I listen to the patient who was a difficult stick she directed me however I did not see a vein, I trusted her, Lo and behold I got backflip and we were in! Haha
@@klow4491 when I was in a coma I was immobile but I could still feel Nd hear... When I got able to use my right hand apparently I was. Conscious giving thumbs up and thumbs down answersrs but I just wanted to go back into my coma (brain hurtyflipping off the nurses working on me I do remember one saying" oh he didn't like that" just some advice for you wonderful nurses out there, I now know. Were following instructions but then I didn't want to wake up no matter the yelling/pinches temp prods etc... Again BRAIN HURTY (ANEURYSM) HEMORRHAGAL stroke
I am a hard stick and I always tells the nurses "do this vein, the others are too difficult". They take that as a challenge, then go for the hard ones. They miss every time.
Tell them “you are not allowed to stick me anywhere but here” I’m a paramedic and we need consent to do anything in the medics field. Don’t let them tell u otherwise just stick to that sentance
I just tell them I throw up when I get my blood drawn and they don't wanna deal with that so they're more careful with me
I started telling them directly that its a rolling vein. They get the hint that no matter how hard they try to go straight into the vein, it'll move.
They miss not once,not twice, not three times,NOT FOUR TIMES,BUT FIVE. plus the girl didn’t even remove the needle,just wiggled it around. Threw up,got really sick. Turns out it wasn’t clean.
Omg SAME
I just failed the Nclex exam.😭😭😓 I cannot begin to articulate the level of embarrassment and heartache I'm feeling. 😥 I'm confident that I will be a good nurse . I just need to get past this, move on and persevere
Well I've taken the exams for the second time now and still didn't succeed, i wonder how those who succeeded did it🥺😭
I failed 3 times, i lost money to reviews that never helped but the major thing is that I've not lost hope
Nclex test is really frustrating, I can't believe I failed again after studying so much🥺🥺😓😭😭
After using uworld twice and failing, I never knew I could ever pass the NCLEX but today I am very happy, I just passed my NCLEX on my third attempt with a great help for Mrs Catherina..
Really, you'll know her Too? I even thought I was the only one she has helped walk through the fears and falls of Nclex Exam,Mrs Catherina Alison has brought me out of the trenches and to a better living, I encourage repeat test taker to work with her.
I had one nurse who wouldn't stop poking me until another nurse intervened. I never had a vein blowout before 🥵 Two nurses in black showed up and inserted the IV like no big thing. Angels 🙌
It is soooo painful i start to go onto a panic
Technically, two sticks max. Then call IV nurse.
one of my worst experiences ended up with blown veins on BOTH ARMS! and an IV on my hand. probably ended up with 8-10 sticks between left/right arm and left hand! now i have a hickman which is amazing since i have basically no IV access
When I was in the hospital, I told them that I was a hard stick, at first many took that as a challenge until they realized it was a warning not a challenge, they brought vein scanning tools and people who supposed to have experience with the hard sticks but it was up to "magic Maggie"( a rotating nurse) to save the day
Those two angels used to poke patients numerous times when they were just a beginner. At times people need to understand all those professional nurses used to learn things step by step before.
Nothing better than a nurse who is good at this and I always let them know how much I appreciate their skill.
AEMT and ER Tech: Alcohol preps can help dilate the veins too and double tourniqueting can help make the veins “pop” more. Sometime for elderly patients inflating a BP cuff and using that as a tourniquet can help as it is a more circumferential pressure!
Also, look on the thumb side of the wrist and back side of the forearm for hidden veins that like to pop as well! Happy poking!
The warm glove trick has yet to actually fail me. Make it hot water and always monitor with the patient and on the skin to make sure you're staying safe.
That tourniquet wasn't nearly tight enough, though. xDD Just a heads-up to those people watching who haven't dealt with it much. She was probably just doing a demonstration versus an actual poke.
I had to have surgery a few years ago, and despite thinking I was well hydrated (didn't know I was hypovolemic at the time, with anemia and stretchy, rolling veins), no amount of slapping, hot packs, hot water gloves, and even dopplers helped. I had to be stuck 12 times with blood running down my arm. There will always be a patient where some trick will fail. You need to be able to do it without special tricks, or you end with pissed pincushion patients.
They had to call in someone from RRT to stick me.
@@limalicious I never said anything about there not being patients out there in which it wouldn't work, just that it hadn't failed me, yet. This isn't to say that I haven't failed to poke someone...I just knew that no amount of heat or other skill was going to make it easier. Sometimes, it just takes a different person. Also, IVs are much harder to put in than just doing a veinipuncture.
This comment was unnecessary, really. It's okay to ask for a different person or technique, but please don't be telling us how to do our jobs. We hate having someone turn into a pincushion as much as they hate being one and are fully aware that tricks will not always work.
When I was in the ER, they were trying to give me an IV, they kept switching which arm they were poking, and fished in my left arm for 5 minutes. They legit had to pull out the ultrasound. Thankfully, I'm used to IVs from when I was hospitalized as a kid, so I wasn't too bothered by it. I think I was mostly upset at the fact I couldn't go back to school because they were taking so long, lol. The bruises after were crazy, bro
As a former IV user, the warmer you are the better. A hot shower works the best but anything you can do to stay warm!
I literally just donated my blood yesterday. I gave compliment to my nurse as she is so quick and skillful, that even big needle like that didn't even feel hurt. She's so happy and proud ❤
I always use a washcloth or pillowcase under the tourniquet. Hurts less, fewer skin tears, can tighten a bit more.
Also, nurses gotta be more confident in placing lines in heavily tattooed areas! Trust us.... a quick pinch or two or even three is worth giving our other arm a break! Lol
Tell that to a person with severe anxiety concerning needles or any piece of equipment that is stuck inside the skin. Good for you that you can't feel it or simply don't care.
Go by feel, not by sight. Some of those veins like to hide pretty deep!
@@platinum_inkI think you nay have misunderstood the point of the original comment
The reason we won’t go for tattooed areas is because we cannot see what is happening (hematoma aka bruise forming) when the skin has been tattooed
It’s mostly for patient safety, but I definitely understand what you’re saying
It really all depends on the veins (bc if you’ve got a really juicy, viable vein it makes it easier to justify sticking tattooed skin when there are no other options)
I’m a hard stick and my advice is to always ask the patient if they have a preference for where they want the IV, I always get people wanting to put it on the inside of my elbow and I have to tell them that my hand veins work so much better. Also forget the warm blanket/whatever and get a real heat pack, most places I get an IV at have them, although I think the hot water in the glove trick would work fine as well. I’ve also never had someone pull the skin back on the opposite side of the arm, I don’t generally look at what they’re doing but it usually feels like they’re anchoring with their thumb, but do whatever works.
Don't be scared to use a tight tourniquet!!!! A few seconds of tight can make all the difference in giving you a nice plump target! Put that tourniquet on clothing if the patient has fragile skin. But don't be scared to make it a little tight!
I once told the nurse you can’t find my vein in one of my arms, and she insisted she could. Stuck me over 4 times. Tried the other arm only once. Then moved to my hands. The other nurse came over and said she was needed elsewhere, she took over and instantly found my vein one time. Bruh. These nurses sometimes just don’t give 😂
Very helpful and I think this is great for nurses learning techniques as well as any medical professionals in the field!
At my hospital they use a different kind of tourniquet. It is more of a strap, with a clasp that is very easy to loosen or tighten. They have different color coded sizes, so it is easy to grab the right one from the cart.
There is pinching problem with those. I used one on myself when doing hemodialysis at home. Don't think I could have used one like shown here with just one hand. Those are likely single use which has its upsides.
Had to get anesthesia once when i was younger. The nurse was having a hard time finding a vein, and me being terrified of going under wasn't helping things. She started slapping my arm to get a vein and was loudly telling me to calm down. This method looks so much better than that mess.
Whenever I’m starting IVs or drawing blood and I get the flashback it’s such a huge dopamine hit lol idk why
It’s so satisfying. There’s nothing more embarrassing than not being able to find a vein AND there’s family members in the room.
wish i had the same flashbacks as you. mines more of a trigger. 01-09-2021 We Do Recover 💜
Emts everywhere “Yall got time for all that?”
I just did my nurse preceptorship in the ED and that was my first thought 😂
Aint nobody got time for that
Whenever possible I think these things should be done especially for people with bad veins. But I will say, I have terrible veins, and getting an IV can be borderline traumatic but anytime I've been in an ambulance, the EMTs get it first try every time even when we're moving. I don't know what kind of sorcery they're using but I wish everyone had it.
@@shannonrickard8605 paramedic here: we land because it’s a challenge and if I miss then I’ll have one of the old guys at my station say “son when I was your age I was able to throw IVs using my left pinky and ring finger while upside down and using my other hand to get a BP palp all the while doing 85 mph down a gravel road and the shocks were already blown on the truck”. A bit of an exaggeration on my part but yea the old guys will always challenge us young guys on our skills. Keeps the job fun and keeps us good
I just got out of the hospital and NO ONE who put in the IV was this thoughtful! 😢
Unfortunately nurses are way overworked and don’t have time to warm a blanket, cloth or fill a glove before administering an IV.
The blankets should be in a warmer already. Find a glove? They should be in the room.
That’s such a shame though, because that little extra bit of due care and preventative measure, is the difference of someone like myself as a patient who has a record of 23 attempts to find a vein on me.
I’m always mind blown if they can stick me under four times at best.
I’ve had thousands of vena puncture, I’ve met THREE nurses who “babied me” a little and got the vein first go.
@@mo-whack6790our unit doesn't have a blanket warmer and many units no longer have them. But gloves AND a sink should be in every room .
I am a doctor and I did so so many IV as a house surgeons. My trick is don't look, just feel. Try to feel the veins with bare hands. And next step try with gloves on. Only insert if you can feel a vein in a cannular length. This trick even helped me with two gloves on in covid era.
I’ve had neonatal nurses struggle with my veins, an anesthesiologist left frustrated. Now I can only go to one specific hospital in my city if I need a blood draw or IV catheter placed, because they have an ultrasound in their phlebotomy lab.
Not the computer saying learn-ned😂😂😂
I just got my first IV and my nurse was so impressed cause i was the chillest patient all of her shift, but i decided to watch her draw my blood and she gor nervous. ❤ you C
Also good to place tourniquet over the tee shirt instead of directly on skin. Less pinching and skin trauma.
Something else that helps is having the right size gloves. Dexterity is a huge factor when giving obtaining IV access (make sure that you don't have a half inch of extra glove on your fingertips; gloves that are too tight can make it difficult as well).
For those here for the wrong reasons.. Recovery is possible ❤
I am a drug free IV user since April 2017. I always have to tell the nurses where to stick me for blood tests because my arms are messed up and I have always been hard to stick. Most of the time, they listen and stick me in the back of the hand as I'm requesting. But sometimes they stick me in my arms anyway and also leave the turniquet on for too long so I get ugly bruises and bumps. I love the nurses who actually listen to me ❤ My body always starts shaking when they draw my blood, and I have to explain it to them.. I assume it's a natural response from the body when you have been an IV user, even if you have been clean for a long time 😕
This is very informative!!
My worst was having a nurse try to get my IV started with me severely dehydrated and suffering vertigo. Not only was the world shaking, my girl tried every option in both arms before letting someone else do a perfect insertion into my hand.
Anyway, I volunteer for the local phlebotomy and nursing classes now because they can’t do me any worse. 😂😂
They’re all so scared of sticking their first real person and it’s sweet. ❤
Mature person here with several nurses in family. When especially doing older patients please put tourniquet over a sleeve edging. It doesn't take extra effort, of course if in serious emergencies. This keeps skin from bruising and pinching even with doing flat like she suggest. Both important. If at all possible. Thanks from a patients view. Nurses are the BEST!!!
I used to have to get my blood drawn monthly for a medication I was on and the nurses ALWAYS pinched me with the tourniquet
Im a phleb and IV certified too… also gloves that fit properly is great because if not you’ll feel glove and not a vein. Sometimes bending the arm helps and 3 finger unspoken rule is so slept on too !! IYKYK ! Also pull that tourniquet i rather they feel that then having dig and you should always anchor vein especially ones that move or roll . Also palpate that vein !! Lol you will never feel anything by just giving a soft rub . So veins are deep !
Use a blood pressure cuff, upside down as a tourniquet, used that on the elderly, worked great.
I feel like anchoring this way would make it very difficult to get a vein, especially on older people. However I'm in the lab so I'm not sure if there are other ways you guys do it. I always anchor on the bottom.
Hey they have a special light u can put over veins and it showed u the whole vein. They are called vein lights. It's super helpful when ur learning ❤
When I had to get fluids from when I was in the hospital with Covid, they didn't bother putting a warm compress and the liquid was coldddd. My arm was hurting so bad. One nurse kept telling me to put my mask on even though I was actively vomiting.
The next year I was getting infusions and the nurse was so nice. Made sure I was comfortable and let me use as many warm compresses as I needed. They definitely help!
Ooh makes me miss starting IVs, good tips!
Work in an area with auto blood pressure monitors? Turn the "venipuncture" mode on and use that instead of a tourniquet. Sometimes you may need both. Love that feature!
I remembered the times I have had ivs and/or gotten my blood drawn while watching. Felt like I had those in all over again.
They looooove my veins. Mine pop right up!!
I’m someone who can’t hold IVs (I have literally blown a central line) I’ve had 2 port-a-caths (1 had a manufactured leak & I contracted MRSA from a contaminated OR for the 2nd…as a bonus, during both surgeries I experienced Anesthesia Awareness & felt EVERYTHING) Was supposed to get a 3rd, but I backed out of the surgery last minute, but I did get a Groshong Catheter which my son, then 4, accidentally pulled out when he tripped on my tubing. For some reason, heat doesn’t work on me. We’ve tried every hack from what you mentioned plus heated blankets, hand warmers & even washcloths dipped in near boiling water. What does work on me is ice. It’s insane how fast they pop up. My hardest stick happened on the OR table after the anesthesiologist couldn’t get a line (it was at Stanford when they had anesthesiologists start surgical IVs not nurses) I ended up having 9 people trying for an IV on every limb, all at the same time. 30 minutes & almost 50 sticks later, my surgeon decided to use gas instead as the surgery was supposed to be quick. I’m beyond thrilled that more hospitals are using ultrasound. Now it’s one & done!!!
Another great trick is if you're having trouble with IVs and blood draws talk to either a pediatric or NICU nurse. They are pros at them since they have to when with much smaller veins on squirmy patients with as little pain or discomfort as possible. I once got poked like 8 times for a blood draw by I'm guessing am intern, they called up a pediatric nurse and she got it first try plus I barely even felt it.
I’m an extremely difficult stick. One time it took over 18 hours and 31 attempts. I was so poorly with a stomach bug so very dehydrated. In the ambulance/A&E it took over 18 hours and 31 attempts before they got one in for fluids etc and it only lasted a day so they did my first midline as I was there for over 3 weeks. In A&E they tried multiple areas, multiple nurses & doctors, an anaesthetist tried and finally a nurse got one in using an ultrasound machine.
As a phlebotomist for many years. Put turnoquite around the gown. People with frame skin tolerate it much better. Even healthy skin. Warm water in a glove and for obese patients you can use a blood pressure cuff.
I'm a hard stick in one arm. Thankfully most nurses listen, a few it takes them finding out. I've had one give up and use back of my hand for a line
The best nurse I had doing IVs on me would try once, and if it didn't work she would use a blood pressure cuff... never failed!
i hate the tourniquet bc they always have it roll and pinch my skin and it just always hurts, especially bc they take FOREVER trying to get my vein and then have to change arms, or stick me again somewhere else in the same arm 😭
I am a very difficult stick, which means sometimes I end up with a lot of bruises after blood draws. The warm cloth often helps.They also use the "baby" needles on me most of the time. I'm not sure if they mean the pediatric needles or what but they always refer to them as that.
The "baby needles" are often the butterfly needles, with a handle on each side. They're smaller and easier to use. And also, to minimize bruising they should release the turniquet right away after the blood starts going into the tube (sometimes they can't, if you have a slower "flow"). And never have the turniquet on for longer than 1 minute 😊
In nicu and newborn babies break heel warmers and wrap around arms and feet if Uv line will not be placed. ensure to hold traction as well cause the veins are small so they need to be held into place. make sure you have your arm board, stocking and tap ready and a second pair of hands is always helpful if available. For nicu labs or pku heel warmers to both feet and use lancet make sure good pressure and hold for a sec, then squeeze, scoop and allow blood cap refill to happen and gravity trick works well and repeat until lab tubes have been filled to appropriate line. Invert up and down at least 5 times to prevent coagulation for lab draw. For pku ensure all your circles are filled appropriately.
You know i use to feel the same exact way when I first started out as a RN at age 20. I was just scared, started in the er to get my skills and there were only 5 nurses who would do baby and ped Iv’s . I relocated and decided to face my fear straight in the face and started working at children’s er I had amazing mentors and extra help which gave me the courage and confidence and to see how fast babies and peds responded to treatment was a huge eye opener for me and I began to truly love working with babies and peds. I relocated again and went onto a maternal float pool so work areas was nicu, nursery, peds, labor and delivery and post partum and worked there for about 7 years and truly loved it but I was ready for growth and understanding of how the hospital worked so I went into case management and now I work with a insurance company for risk case management. My heart is with babies, peds and moms. And the minute you care for them that fear goes away a immense love pushes you through for the patient and the family. When I had kids of my own it definitely pulled at my heart strings a little harder and my moto was I will care for you like I would for my kids and it worked so well! I would say working med surge/icu or with the elderly is such a super power as well and hands down the most difficult floor for your body. People are just so sick now at earlier ages it’s heart breaking! I am 37 now and work from home mon-Friday where there is min stress, I do miss my patients and coworkers but can’t complain! My outlet is my family and arts and crafts 1000%% definitely find one if you don’t have one!!
You need downward pressure sometimes. Just make it low enough it doesn't get in the way
This is very helpful. I’m saving this. Thank you.
Yes anchor the vein below where you are going to stick the needle. Listen to your patients because they do know their body. For the people getting a needle put in them let them know that others I've had better luck with with this vein (point to the vein), then tell them what to do but what others have done. That usually works better with me as a phlebotomist.
The fact that I’m seeing so many comments that don’t know about hot packing both disappoints and yet doesn’t surprise me, nursing school doesn’t teach half the things you actually need to know for clinical practice, also be aware your facility may not allow for hot packing (can be a safety concern) but usually if you ask your patients and tell them what you are doing tell them the potential risks and to notify you of discomfort they’re usually really good about letting you do it because they’d rather have one stick with minimal discomfort.
Lay the alcohol prep on the site you think you want. Tap the site firmly, once, remove the prep as you tap. The vein you chose (or perhaps a better one) will rise to the surface of the skin. The clean as usual.
My best tip was that I need to feel always feel. Most people at the beginning only want to use the veins they see. And try to use the tiny ones just because they see it. Then find a good balance between seeing and feeling. Also look if there is blood on the tip and very slowly pull out the needle an aspirate gently because often your needle is to deep in. I was very bad at that and got better. If you can do that you can lay down an i.v.
This was one of the first thing my mentor told me when I started my job at the hospital
I have thin veins and the other day a nurse just stuck it in the veins on my hand, she said it hurts more but it wasn’t painful. Good thing that the veins on my hands are thicker.
Blood pressure cuffs work a million xs better and never start in the middle of the arm.
Def listen to your pt especially if they're difficult. Also. May I suggest a PCT course? We went over all of this in less than a week! Then again it's not something we administer, mostly monitor. Depending on state.
Confidence plays a huge role cuz even if you know the technique and you doubt your knowledge or your own hands you will mess up every time. I did my first IV not long ago and the patient told me she didn’t feel any discomfort. I do need to build up my confidence but trusting oneself plays a huge role
Inflate BP cuff midway between systolic and diastolic pressure instead of tourniquet.
I once took 35 blood samples in a day , took me 3 hours in total .
Work was horrible but atleast I'm an expert (almost) now .
my mom is training to be one soo thank you this helped her a lot
The tourniquet always makes me nauseous when I get my blood drawn 😭 like, yeah feeling my thick blood being sucked out through a thin needle also doesn't feel great, but the tourniquet makes it 100x worse
an extended Phlebotomy class should be mandatory for all nurses but unfortunately it is not. I recommend it, it is very useful.
No matter how much training you have, you will miss an IV from time to time because of the patients medical condition.
Plays a roll in the ability to obtain an IV site. It's not just the skill of the practitioner
Don’t stick an IV right in the elbow crease. Every time the patient bends their arm, they’ll set the IV alarm off. Happened on my fourth delivery. So annoying. In the end another nurse just turned my IV drip off because she was fed up with coming in every two minutes. 😳
Had a surgery a month ago and have never had a problem with my blood draw until that particular nurse. Hands are still sore and bruised never again..
warm water on the OPPOSITE side works great too!
My veins are very visible, but there's one on my left arm that is particularly easy to get to. I am also right handed so I try to tell my nurses to do that arm. Some are assholes and take that as me trying to do their job. For some reason with me after doing bloodwork I can't use that arm without pain or numbness for like three hours after (this has always been a thing) so I really despise the ones who don't listen, I wish as a kid I had spoken up to those ones who didn't listen. Now I know better to tell them and if they don't listen, don't give that arm.
My veins are very small and somehow, almost every time, the nurse or tech will miss 1-2 times… One tech, granted she was new, but she was terrible! She stuck my left arm once and then my right arm twice… she must have hit a nerve because never had I felt so much pain from an IV. When my arm trembled from the sheer amount of pain and I inhaled sharply, she told me to calm down 🤦🏻♀️ She FINALLY called in a senior nurse and she did it in go. The times a nurse has done that I can count on one hand!
Also, please listen to your patients. I have exactly one good vein in my arm, even though I look like I have several. Trust me, I know how it goes if you don’t believe me and neither of us wants that.
I always point nurses to my best veins but half the time they don't listen. When they listen they get it the 1st-3rd time depending on skill,if they don't listen they puncture through veins and three other people have to try. I have veins that are hard to get and most roll or don't show no matter how hydrated I am. My veins can also be blown easily if there's too much force or the wrong angle
really helpful. thank you for your useful content. I'd love to see part 2, please.
thanks in advance 😊 bless you.
This is why I love having a port.
In california all 3 of these methods are not supported by CLSI. This is why we have 1 time use internet heat pouches
some people are old with rolling veins, you got to plant those veins using your first finger above the insertion site and your thumb to pull down on the vein tk help hold it in place, that way when you gk to stick your needle in the vein will attempt to roll a little but will stop because your fingers planted the vein in place and then push needle a little further and bam.....flush
Going to school to hopefully become a phlebotomist. These vids are incredibly helpful, I'd like to see more 👍
You forgot, ‘swift insertion’ to minimize needle stick pain.
DONT PUT THE BAND DIRECTLY ON THE SKIN. Use their sleeve or a cloth and tie the band around that so it doesn’t hurt
As a very Old phlebotomy nurse, yes, heat is your friend starting a IV
im a difficult stick too. i show them the 2 i know are there and say "this one has the most success"
No one ever gets my blood drawn in the first try. I've had possibly every area done on me; the inner elbow, the back of hand, the side of wrist. The worst was when I was to be tested for dengue the nurse straight up gave up and nicked my finger with the needle for diabetes and told me to squeeze the blood out into a small test tube. That wasn't a pleasant experience. Sometimes I get so tired of being poked and prodded that I just want to tell the nurses to just slice my wrist or something, at least they'll definitely get their blood then 😭
Yeah I struggle to even find gloves, I just bring my own box, I couldn't dream of having the time or access to warm water 😅
Used to be a phlebotomist, this trick works wonders
Also, if someone says do not use a particular spot respect that. Do not take it as a challenge or worse, m stick that spot anyway while they are under anesthesia. Apparently they decided they wanted a “backup” IV. Just like I warned it would, the IV infiltrated in less than a day. They didn’t even use the IV, since the other one worked just fine. But the flushes made it hurt like hell and swell up for a month.
Next time I am writing on my hands in sharpie “I do not consent to IVs here”. Apparently me saying “hard no” multiple times and finally pulling my hand away from the nurses who kept arguing with me was not a clear enough lack of consent.
trying to watch these types of videos to get over my needle phobia since i want to become a paramedic 😅😅
Lord please allow me to become a nurse, I am trying and will continue to give my all.
I’m phlebotomist working in Hospital
Lab now❤ soon gonna pursue my nursing ❤️💪🙏
Great advice!
Please keep posting, my son who is terminal tells us stories of how bad they stick him repeatedly cause they can't get a vein. I just sent this to him because he doesn't feel he should tell them how to do their job better.
Love this so much!!!
I remember a nurse repeatedly digging in the same spot over and over again I was internally screaming in pain I think after the 4th or 5th time it went numb and she KEPT at it I was going into premature labor that nurse had no rights to touch another patient
I'm very hard to cannulate and now have a permanent one in, but i remember the anaesthetist telling me that people seem to think slapping/tapping the area will bring a vein to the surface but actually stroking the area is better... Didn't work for me, he had to get his special machine and use my foot, but i always tell the next poor nurse that seems to think she will find a vein in me to try that! Bless their hearts as they never manage it even though i warn them it's probably best not to try and just get the experts 🤷
You'd think they'd listen to their patients more but apparently we don't know our own bodies - they are lucky i don't mind blood or needles! 🤣
I have a really bad needle phobia. I didn't know it was so bad that I start breathing faster and tensing up just by seeing one in a video until now!
My husband is the same way. Any time he has to get blood work done I have to go with him because he will faint if there's nothing to distract him
Don't ever get cancer then. 😄 Or pancreatitis. When I got that I had a needle in my hand 24 hours a day for three days giving me all my nutrition and liquid. No food or water by mouth. I got this because I dragged my feet getting my gall bladder out because general anesthetics are what I had a phobia about.
Needles use to not bother me now they do. That needle is long and sits inside your vein!
Im a phleb and I ask my patients to not look at the needle and give them the alcohol swam so they can smell it, also take deep breaths. So far it has worked. I tell them once I’m in the vein (I get it first try 99% of the time) they won’t feel a thing cuz only the first pinch hurts a bit and sometimes they don’t even feel it. I know it’s something psychological because getting blood drawn does not hurt at all but i understand
@@maggie0285 the needle doesn’t stay inside your vein, only the plastic, blue, flexible tube she loosened at the beginning. The needle is only used to find the vein to guide the tube inside :) also the needle doesn’t go all the way in cuz as soon as you get a flush of blood you insert the little plastic tube and remove the needle :)
I need to save this for when im super dehydrated from vomiting
This has worked for me many years with glove filled with hot water . Much easier stick when this is done.
3rd semester nursing student here. I've only had 2 nurses who were able to stick me with zero pain. I want to learn how they did it!!
Nurses don't really have an issue finding my veins. They really like this one in particular. Also I don't know why but I don't bruise after they remove the needle. I have no bruises showing where they put it in. Only a little scab