What is it about venipuncture that conjures up such deep feelings in both the nurse and the patient? I recall being a nursing student and having so much anxiety about the first time I would ever start an IV. I made it through nursing school, never even having attempted to start one and by the time I got a job, it took me probably ten attempts before I was able to successfully initiate an IV line.
Now that I work with nursing students, it seems like the general perception they have is that nursing as all about starting IV's, and having a successful IV start is the "end all and be all" of their academic career.
And let's not forget the patients...it's not like they are excited to have their physician order IV fluids or lots of serum lab tests!
Today I ran across this article
in the news about a nurse who has been credited with a new approach to starting IV's that is reported to be much less painful that the traditional methods of tying a tight tourniquet, hitting, flicking, and putting a warm compress on patients' arms. I hope that there is a lot of evidence to support this method, and if it truly helps patients that it will be accepted into practice in healthcare settings far and wide.
But I'm wondering, because it is such a big deal to many nurses and nursing students, do you have any great tips? Are you a flicker? A tapper? Do you grab a blanket out of the blanket warmer and lay it over your patient's arm? What works best for you?
I have observed many nurses over the years, and sometimes I've learned really great tricks from them. A clinical nurse specialist once showed me a great tip to avoid forgetting the point where you were going to make the venipuncture after you take the tourniquet off and start to cleanse the skin: if you take a retractable pen (that is retracted) and place it on the skin at the point you wish to enter, push down on the skin with very light pressure, and then scrub with an alcohol wipe, it creates a local histamine reaction on the skin which makes almost a "bullseye" to serve as a landmark where you want to stick. Now, of course, before you try that on your own patient, make sure that is consistent with your institution's policy.
Any other readers have any words of wisdom?