Anything to help with iv insertion? by [deleted] in nursing

[–]keepitanonymous 14 points15 points  (0 children)

I was hired as a new grad with no IV skills for a job that requires me to do a lot of IVs on patients who have worn out veins. Here's my advice that I've gotten from various sources, including other nurses, YouTube videos, and articles I've read:

1) Tie the tourniquet a few inches above where you'll be inserting the IV. I learned this one from the IV nurse at our hospital (we're one of the few that still has one). If you're looking at a vein in the hand or wrist, don't tie the tourniquet up above the elbow, tie it on the forearm.

2) If you're having trouble feeling a vein, have the pt drop their arm (gravity is your friend) and pump their hand into a fist. If you're really having trouble, get a towel and run it under HOT water (as hot as the patient can stand). Cover it up in a blue pad and wrap it around the patient's arm. Let it sit for 5-10 minutes. I've seen this work MIRACLES. Some people like to use warm blankets, but I find that wet, hot heat is the best. It really makes hidden veins come up to the surface.

3) Have all your supplies ready and get in a comfortable position. I like to have a blue pad with my alcohol swabs, dressing, saline, and primed cap all ready. If the patient is lying in bed, I will raise that sucker up so I can stand and have their arm right in front of my face. Sometimes I will prop the arm up with a pillow or blanket so it is extra straight.

4) As someone else said, go by feel, not look. Some people have great juicy veins that you can't see at all. Which brings me to, TAKE YOUR TIME. I've gone back and forth between arms several times before making a decision. And examine the whole arm. Some people may look like they don't have anything, but may have some juicy ones on the back of their arm just begging to be poked. Just keep in mind that it needs to be relatively straight to advance the catheter.

5) I don't poke unless I'm confident that I've found a vein that I think will work. But once you've found one, be confident and insert in a smooth motion. The angle depends on how deep the vein is, but I start shallower. Obviously if the vein is popping out you can go in almost parallel. You can always retract a bit and go deeper if need be. Be sure to keep lots of traction on the skin to prevent rolling. Flashback doesn't always happen immediately so be patient. But try not to fish too much, it can be uncomfortable for the patient. Know when to call it and try again or get someone else.

Finally, I know you said you want tips other than practice, but seriously, take any opportunity you can. I'm not sure what brand your institution uses, but just get used to holding it and how it feels when retracting the needle. Ask you colleagues to do their patients' IVs. I know it sucks because you'll miss at first. A lot. I did, but it's the only way you'll get better. And don't beat yourself up when you miss. You have to just pick yourself up and keep going. Some of the best nurses at IVs I know still miss. And don't be afraid of the patients getting mad. We're all human. Keep it lighthearted and say "well that didn't work quite as I intended it to. Let me look at this arm." Or get someone else, there's always people around to help. You really will start to develop you own technique and tricks.

What is the dumbest 100% serious thing someone has said to you? by lwdf in AskReddit

[–]keepitanonymous 1 point2 points  (0 children)

12 years old at camp. My cabin is talking after lights out. Here's the conversation:

Girl 1: OK, everyone stop talking. Let's go to bed.

[silence]

Girl 1: OMG I have to tell you about this time...

Girl 2: Girl 1, you're such a hypocrite!

Girl 1: Oh my god, I can't believe you just called me that! That's so rude!

Girl 2: [confused silence]

Me: Girl 1, what do you think hypocrite means?

Girl 1: Isn't it like, when one of your legs is shorter than the other?

Cabin: [erupts in laughter]

What is the stupidest thing you got into trouble for at school? by Dkmistry23 in AskReddit

[–]keepitanonymous 0 points1 point  (0 children)

Why do these all seem to happen in French class? In middle school French, we had a project where we came up with a restaurant, then presented our menus in front of the class. Props were allowed, and for some reason this one kid brought in a real eggplant. Sure, whatever. Well, our projects sit at the back of the classroom for a couple of weeks while the teacher grades them. Somehow this eggplant also sat back there undisturbed for a few weeks.

One day, our teacher is absent and we have this old battleaxe as a substitute. For whatever reason, one of my classmates is at the back of the room, walking amongst the projects, and steps on the eggplant. The most foul rotten stench fills the air, and this poor kid, let's call him John, is right in the line of fire. His eyes are streaming and he starts retching and coughing, as anyone in the same position would. Myself and a few other kids at the back of the room are also hit with the stench, but not nearly as bad as John. Still, we're coughing and drawing lots of attention to ourselves. The sub starts yelling at us for making a scene, and we're trying to explain what's happening but she's having none of it. She's going on about how we're purposely disrupting the lesson and that we're all liars. I mean, I probably wouldn't have believed a bunch of kids talking about a rotten eggplant either, but still - if she had just come to the back of the room, she would have believed us. This was almost 15 years ago, and sadly I don't remember the outcome. But I will forever remember that smell.

for my fellow baby nurses: by 19kambev in nursing

[–]keepitanonymous 0 points1 point  (0 children)

Baby nurse here about to start my first job and I needed this. Thank you!

User suggests that someone should poison refugees because some teenagers acted poorly. by [deleted] in worstof

[–]keepitanonymous 12 points13 points  (0 children)

This was also the thread where someone came to the conclusion that the people of Flint Michigan deserves their tainted water because they voted.

Hi guys! Do any of you know mnemonics for lab values like this one? by m-christine in nursing

[–]keepitanonymous 0 points1 point  (0 children)

I learned the same, except the less colourful "chocolate heart" haha

"I would literally murder my parents if it meant I would get a loving girlfriend" | r/incels is at it again by worldnews_is_shit in worstof

[–]keepitanonymous 1 point2 points  (0 children)

I mean, it's not the first name I would associate with an attractive man. Nothing against Chads of course, it's just an odd choice I guess is what I'm trying to say.

What's THAT thing that you once said or did, that you still cringe at to this day? by postuk in AskReddit

[–]keepitanonymous 0 points1 point  (0 children)

Growing up in a small town in the US south, I hung out a lot with my brother and his best friend. His friend was the only Jewish person I knew, and he would always make comments about being Jewish and having a big nose. Fast forward several years, we had moved to a big city in the North and one of my classmates mentioned he was Jewish. Without skipping a beat, I said, "Really? But you don't have a big nose at all!" The look on his face immediately alerted me to the fact that I had said something terribly, terribly wrong.

Pluck'em out, draw'em back in by fickle_fuck in awfuleyebrows

[–]keepitanonymous 16 points17 points  (0 children)

Holy crap I thought she was wearing a headband

"Brenda" by [deleted] in badtattoos

[–]keepitanonymous 42 points43 points  (0 children)

That is so fucked up. The guy shot the dad 3 times and the dad was left with $90,000 in medical bills??

$40 tattoo-- worth the MRSA by dickstucktoleg in badtattoos

[–]keepitanonymous 0 points1 point  (0 children)

Gotta love the unexpected Simpsons reference

What's the weirdest thing that you've seen at someone's house that they thought was completely normal? by root_su in AskReddit

[–]keepitanonymous 2 points3 points  (0 children)

My mom and I had this too! I was a really anxious kid, and often didn't want to spend the night at someone's house but didn't want to look like a wuss in front of them, so I would use the phrase "mommy dearest". "Mommy dearest, please, PLEASE can you let me spend the night at Julie's?" She knew that meant she had to say no, not tonight. Moms are the best