Accountable Healthcare - Often Overlooked IV Tips For Nurses
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July 8, 2021

Often Overlooked IV Tips For Nurses

Whether you’re fresh out of nursing school or have inserted hundreds of IVs, IV insertion can be a challenge. Here are the top often overlooked IV tips for nurses to help you get it the first time, every time.

IV insertion is a basic skill nursing students learn early on and nurses perform nearly every day. Yet, several factors come into play so that the process of starting an IV is almost never the same twice. 

Some days you’ll “hit the mark” on the first try, and some days you’ll miss practically every time. That’s how it goes, and it happens to all of us. Unfortunately, when you’re having one of “those” days, you can find yourself feeling seriously stressed out and causing your patient some unnecessary discomfort.

If you want to be an IV ninja (you know, the kind of nurse that other nurses call when they can’t get the IV inserted), you need practice, confidence, and these often overlooked tips that we are sharing today.

Important Often Overlooked IV Tips For Nurses

There are tips for inserting IVs…and there are TIPS. In order to become an excellent IV nurse, you need to know these tips that people don’t often talk about.

Positioning Is Key

This tip is listed first because it’s absolutely essential to success and yet I hardly hear nurses talk about it. Don’t overlook correct positioning for both you and your patient.

A Comfortable Patient Is A Relaxed Patient

We want the patient to be as relaxed as possible. With that in mind, get your patient in a comfortable position and take your time selecting the vein (because nothing good in nursing ever came from rushing). 

The forearm or top of hand is often best because it allows you to reach the veins easily while also allowing your patient to sit in a relaxed position. If they have to bend or contort their arm in a weird way for you to insert the IV, they won’t be as relaxed. And you will have a harder time getting the IV in.

Make Sure You’re Comfortable

This is just as important as your patient’s comfort. If you’re comfortable and positioned correctly, you’ll have a much higher success rate. Maintaining a relaxed and calm disposition for yourself (and not having your body and brain distracted by discomfort) will greatly increase the likelihood that you’ll get it the first time.

Anchor The Vein

Proper anchoring will make it much easier for you to get the needle into the vein, and ultimately make it easier to thread the catheter in. But, you’ve got to be able to do this without occluding (blocking) the vein.

Here’s how: Use the thumb of your non-dominant hand and stretch the skin next to the vein you’re about to stick.

PRO IV Tip For Nurses from Brian, The IV Guy: “If you’re using the hand, things can get a little trickier because there’s very little room distal to the metacarpal veins. The best way to anchor in this region is to have the patient lightly tuck their fingers under their palms without making a fist.  Use the skin on the tops of their fingers to stretch downward, anchoring whichever metacarpal vein you’re using in place.” 

Practice, Practice, Practice

You can always practice this technique at home on a loved one. And I highly recommend doing that because remembering these steps when your adrenaline is high can feel next to impossible.  

Do these thoughts sound familiar?

  • “Oh man I have to start and IV”
  • “I hope they think I’m good at this”
  • “I don’t want to mess this up”

I recommend really familiarizing yourself with the steps so that they become practically second nature. That will help you feel much more comfortable and ignore those anxious thoughts when you actually have to do it. 

To practice, simply use something else to pretend it’s a needle at home. You can practice selecting the vein, getting it in position, and anchoring the skin. Do it over and over again to get muscle memory built and put your reps in. 

How To Insert An IV: Proper General Sequence Of Events

Now that you’ve seen some of my best, overlooked IV tips for nurses, it’s important to quickly go over the general process for inserting an IV. Follow these steps:

  1. Get all of your supplies, plus a few backups just in case.
  2. Wash hands and put on gloves that fit well. You don’t want to wear loose gloves because it’s harder to palpate.
  3. Tie the tourniquet and palpate to select your vein.
  4. Pick a landmark so you know where to insert it. You can’t touch the site again after you clean it, so landmarking (finding a freckle, mole, tattoo, etc) is really important.
  5. Once you know where you’re going, take the tourniquet off.
  6. Clean that bad boy!
  7. While the area is drying, set up your supplies.
  8. Re-tie the tourniquet.
  9. Take the cap off the needle. Check to make sure it has no defects.
  10. Release the catheter adhesion by twisting it (not pulling it off).
  11. Anchor.
  12. Insert at 5-20 degrees with the bevel up.
  13. Once you get a flash, wait a sec! Lower your angle, advance the needle ever so slightly (about 2-6mm). Then advance the catheter.
  14. Release the tourniquet.
  15. Push your button on the catheter to remove the actual needle.
  16. Attach your flush. Make sure you’ve got blood return and can flush smoothly.
  17. Apply a dressing.
  18. High five yourself for being awesome then clean up your mess.

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