Have Your Way With Them.

WARNING: If you get woozy with needles, please do not read this.  I don't want to be held responsible for anyone passing out over my enjoyment of starting IV's.  Seriously, if this is you, do not read on, I'm going to go into detail here.
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When I first became a nurse I was terrified of starting IV's.  In school all the nurses I shadowed always said, "Oh, you don't want your first stick to be on her, her veins are terrible."  So I went three semesters of never starting an IV.  During my practicum at a cancer clinic I had some good experience with poking people but not nearly enough to become proficient at it.
Now, I'm working.  I have my own patients and I get to start IV's a lot.  If we have a direct admit from another hospital....start an IV.  If it has been three days since the IV was started.....start a new one.  If the IV catheter has infiltrated and the patients arm is pink and swollen......take out the old one and start a new one.  So, needless to say, I've gotten better at IV's.  I have times when I go to start an IV and I don't even see a good vein that I like, or they are really squiggly and I don't know where to poke, and those times I ask for help from much seasoned nurses.  But I have improved and now, starting IV's is one of my favorite things.  I know, sick nurse, but seriously it is such a high when you get that blood return in the tube and the patient can breath easy and you can use that IV access to significantly improve one's health ie: fluid maintenance, antibiotics, anti-nausea, Ativan, all sorts of goodies can go in there!
It goes like this.  I get the patient all ready, try to ease any fears for those jumpy patients, prop their arm up on a pillow.  Tourniquet above the place where I see a good vein.  Tap the vein a few times, get it good and mad.  I have all my supplies ready, tape, saline flush, more tape.  I clean the area with chloraprep, make small talk while it dries.  It's dry so I unwrap my needle catheter, make sure the catheter is loose from the needle so it threads easily.  I say, "Heres a poke," and I dive in.  Now the trick with this is to not be timid.  When I first started IV's I was timid, trying not to hurt people or be really gentle, but I've learned that this gives veins (who have minds of their own) time to roll over like a puppy or just completely escape.  I've had veins that look so good, then as soon as I poke I lose all sight of the purple I saw beneath the skin or lose the feeling of bounce back with my finger.  I've learned just to poke fast and quick and make it count.  You have to have your way with those veins.  So I poke, feel that resistance that I know is the vein, go a little further, poke into the vein, I see the flashback in my tube. I'm in.  Now, just thread the catheter past where the end of the needle is all the while slowly pulling the needle back.  It's a push-pull kind of maneuver.  I see the catheter traveling up the vein.  I see no blebs of purple, meaning the catheter is still in the vein.  That's good.  Unhook the needle from the catheter and hook it up to my saline flush.  I flush saline into the vein.  Flushes good, I pull back on the plunger and see blood in the syringe.  It's good.  That's a good IV.  Flushes good, pulls back good.  She's a keeper.  I say to my patient, "We're in."  I tape it up as much as humanly possible to secure the area and keep it from moving around.  Ah, such a good feeling.  I don't know what it is about it, but it's good.
Call me crazy, but I would want the nurse who likes starting IV's, starting my IV, wouldn't you?  Oh, you want an IV, you say?  Don't tempt me.


PS- Maybe I do have some kind of illness.....I notice people's veins anywhere I go.  I had a waitress once that had such good veins I couldn't stop thinking about what size needle I could put in those veins or that I wouldn't even need to use a tourniquet.  Yep, I know, I'm sick.