Nurse Penetration

Nurse Penetration

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IV Insertion is a skill that most nurses will need to become familiar with.
Nurses in the hospital use IVs every day to infuse fluids and medications, as well as to draw blood. While IVs are very useful, sometimes IV insertion can be difficult, – especially for the new or inexperienced nurse.
With time and experience, your IV skills will improve. In the meantime, use these 10 IV insertion tips to help you start an IV and sink those IVs like a pro .
The best location of your IV insertion really depends on which setting you are in, as well as the specific patient’s chief complaint.
It is common for inpatient nurses to be upset with AC lines, but the fact of the matter is an AC line is likely an ER nurse’s best friend.
If a patient presents with anything that can even possibly get a CTA – You’re better off choosing the AC. The LAST thing anybody wants to do is have to unnecessarily poke someone again.
So – if the patient has a neurological complaint (stroke s/s), cardiac complaint, or pulmonary complaint – a CTA may possibly be ordered and most hospital facilities/radiology staff won’t inject the high-pressured dye unless there is at least an 18g or 20g in a large vein (aka AC and above).
Additionally, patients who are hemodynamically unstable should receive a 16g – 18g in an AC for large fluid resuscitation.
If the patient is getting continuous infusions and the patient occlusion alarm keeps going off, ask the patient if you can place another IV preferably in the forearm or hand.
Forearms are the perfect location for continuous fluids because they don’t kink with arm bending.
However, not everyone has great forearm options.
Additionally, forearm veins do not always reliably give great blood return for bloodwork, although this may mainly be a consideration in the ED where they typically draw blood work during IV insertions.
Hand IVs are sometimes the easiest veins to see. However, they are usually relatively small veins, and placing an 18g here may be somewhat difficult.
They are great for short periods of time , but can easily become irritated.
Additionally, they limit the use of the hand and are more likely to start hurting the patient – especially with vasocaustic infusions such as vancomycin or potassium.
Heat is great because it causes vasodilation . When veins dilate, they become bigger.
Applying a warm compress or hot pack can help you visualize the vein, palpate the vein, and can even make threading the IV easier when starting an IV.
Just ensure the compress is not too hot to cause thermal burns.
Putting the arm in a dependent position forces blood pooling in the distal veins, which will make them bigger and easier to see and palpate.
This should make IV insertion easier with a higher chance of success.
A small amount of 2% Nitroglycerin can be topically applied to a small area in order to dilate the peripheral veins .
In a small study , those with 2% Nitro ointment applied to the dorsum of their hands required fewer needle sticks than the controlled group.
Please note that this is a medication, so you need an order!
Sometimes, elderly patients tend to have crappy veins.
Sure, you can see them alright, but once you stick them – they blow immediately (even with a 22g).
This is definitely a good time to look for larger more proximal veins , as IV insertion in these veins tends to be more stable and not blow immediately.
If you can visualize or palpate the vein without a tourniquet – try the IV insertion without the tourniquet.
Tourniquets are great for engorging the vein and causing it to dilate, but they also add pressure to the vein.
Already fragile veins will have an increased tendency to blow with the added pressure from the tourniquet. Never forget to remove the tourniquet before flushing the IV!
OK – some people HATE digging when starting an IV – and this is understandable. However, sometimes it is minimally painful and you can thread the catheter within a few seconds of “digging”.
The trick is to not “dig” blindly – but instead use your fingers to palpate the accurate direction of the vein.
After inserting the needle with the catheter, if you do not get a flash of blood, pull the needle and catheter back out to almost out of the skin, re-palpate the vein, and aim again in the direction of the vein.
I can’t even count how many times I missed on the first pass, but immediately threaded the IV on the 2nd or 3rd advancement.
The patient also experiences some desensitization of their pain receptors and it is usually less painful than being poked again.
However, some patients really do NOT tolerate this, and they will let you know not to “dig”.
Quick Note: It is not recommended to retract only the needle while leaving the catheter in place, and then re-advancing the needle. This leads to a risk of fracturing the catheter and can possibly lead to a foreign body in the patient’s body!
Learn how to start an IV, Step-by-Step, with all the best tips and tricks!
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Smaller is not always easier. Sometimes 22g and below are too flimsy.
When the veins are sclerosed, hardened, or there is scar tissue – choosing a 20G might be a better bet in order to thread the catheter without any issues.
Besides – 20g IVs are better in an emergency and are more durable.
When inserting an IV, you can accidentally hit an artery instead of a vein.
First, if the IV is pulsating – take it out immediately. It’s possible the vein is just right next to the artery, but it is likely you are actually in the artery.
This is usually accompanied by blood filling up the catheter VERY quickly – depending on the patient’s mean arterial pressure.
Arterial blood tends to be a bright red, versus the darker red of venous blood.
So what’s the harm? Access is access, right ?
Well, sure that makes sense on the surface. But peripheral IVs inserted in arterial lines tend to have much higher complications – the worst of which being thrombophlebitis .
You can literally cause a blood clot in the patient’s arm . This is even more of a risk if medications are infused through it.
Remove the catheter and try again in an actual vein.
Or rather – think outside the lower arm.
If you can, look at the upper arm as sometimes there are large veins close to the surface.
Most facilities prefer you to stick an IV in an arm, but there are exceptions. If the patient is an extremely hard stick and needs access, you can look at lower extremities, but caution against it as these are high risk for infection .
No – don’t go for these strange areas initially, but in an emergency, any access is better than none .
However, in a code situation – temporary placement of an I ntraosseous (IO) catheter is preferred .
If a better IV site still cannot be obtained, someone skilled with ultrasound-guided IV placement should try, or a PICC/Central line should be considered.
I have watched MANY nurses and nursing students miss when inserting an IV purely because of their technique.
They hold the skin taut, stabilize the vein, and insert – but they go right through the vein and can’t thread the catheter.
I have seen that this is often from approaching the vein with too much of an angle.
You should really aim to be near parallel with the skin (10-30 degrees). Gliding the needle into the vein with this angle means once you get a flash, the needle is likely still within the vein and the catheter can be advanced.
The exception is if you are aiming for a deeper vein – you may need to increase the angle accordingly.
If you find that you insert the needle and cannot float the catheter in, despite having a “good” flash of blood – try pulling the needle and catheter out just a millimeter or two , and try advancing just the plastic catheter again.
Sometimes patient’s veins just like to roll – and the patient will likely forewarn you about this. There are a few things you can do to minimize this.
First, pick a larger more proximal vein . These veins tend to be more stable.
Second, make sure you stabilize the vein by holding the skin taut with your non-dominant hand.
Lastly, make sure the patient does not tense up their muscles during the insertion. Tensing of muscles will cause movement of the veins. To minimize muscular contractions – use the tip below!
This IV insertion tip is really more for patient comfort than anything else. After you clean the IV site, place the needle flush with the skin right where you are going to poke.
Press the needle with the bevel up into the cleansed skin for 3-5 seconds before you poke. The longer you wait – the more desensitized their skin receptors will become – this theoretically should decrease pain.
With less perceived pain, the patient is less likely to tense up and should lead to a smoother successful IV placement. When I was an ER nurse, I used this technique every time and seemed to have good results.
Well, there you have it – 10 IV insertion tips to improve your IV game! If you have any additional tips that I didn’t mention – leave a comment below letting everyone know!
Hopefully this gave you a good grasp on the basics of how to start an IV.
But if you want to learn more and become an IV King or Queen, I HIGHLY recommend The IV Video Course by @TheIVGuy .
I also include some great free bonuses with the course, including:
Check out more about the course here .
The ultimate guide to get you started on becoming an IV Master!
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Learn how to start an IV, Step-by-Step, with all the best tips and tricks!

Home Working as a Nurse Do Nurses Relieve Patients? Learn the Facts

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Nurses are an important part of the healthcare industry, they spend years studying and practicing to devote their life to patient care and attend to their individual needs.
Unfortunately, their role is still underrated and many patients and healthcare colleagues don’t appreciate the role that nurses have in the wellbeing of patients.
In this article, we are going to about ethical problems like how should nurses treat their patients , what is their role in the healthcare industry, and do nurses relieve patients or give them handjobs.
Nurses have a vital role in the healthcare team. They are not only in charge of administering medication and checking the vitals but they also provide relief and increase the well-being of a patient .
Nurses regularly check patients and notice any subtle change in the symptoms that could be a warning sign, they teach the patient about his/her symptoms, how to take care of themselves.
As a nurse like I am , you need to look at patients from a physical, mental, and spiritual perspective to promote wellness. You also provide emotional support not only for the patients but also for the patient’s relatives.
You build a relationship with the patient based on commitment, trust, and support.
The nurse’s main priority is the patient , you are directly involved in the patient’s care and collaborate with other healthcare professionals in the diagnose and treatment.
The patient should trust you and know what to expect with the treatment. Proper patient care has positive effects on the patient like relieving the anxiety symptoms, more acknowledgment of his/her condition.
The answer to the question “ Do nurses relieve patients? ” is a simple “ Yes “.
But do nurses perform controversial relieving methods like giving a handjob to a patient? That’s coming up next.
Nurses are not supposed to provide any sexual relief to the patient , this includes not only handjobs but other inappropriate sexual behaviors like kisses, touching the genital area without gloves, or performing an intimate examination without the right clinical justification.
Working as a nurse , you should never feel forced to give a handjob or perform any other sexual activity to a patient.
If you need to perform a medical procedure in which the penis has to be erected like inserting a catheter the most ethical way to do it is by stimulating the prostate.
In terms of sexual misconduct, there is a guideline from the National Council of the State Boards of Nursing .
It states that sexual misconducts are not only unethical but also illegal and doesn’t include only sexual intercourse, performing a sexual examination with no clinical justification but also includes these behaviors :
Performing inappropriate sexual behavior has a wide range of consequences that go anywhere from sanctions, one-year suspension to revocations .
Certain nurses can volunteer to become sex nurses and help disabled couples that have chronic conditions like muscular dystrophy that affect their motor skills to have sex.
This is a legal activity because the nurse helps the disabled partner to have sex with his/her couple but isn’t performing any inappropriate sexual activity.
Nurses are not only in charge of taking care and promoting the physical health of the patients but also have an important role in their mental health and wellness.
Nurses have to look beyond the physical needs of the patients. Here are some basic things you need to know about treating your patient’s the right way:
It’s important to always follow these guidelines when working with your patients.
The role of nurses goes far beyond administering medication and checking the vitals of a patient.
They are part of an active team of health professionals whose main goal is your health and well-being.
Nurses don’t only pay attention to your physical needs but they also provide emotional-spiritual support and guide you through the process of making decisions.
The right way to treat a patient involves different aspects like communication to understand the situation of your patient and address his/her concerns.
Respect and treat all the patients equally no matter their race, gender and don’t make judgments.
Inappropriate sexual behaviors are not permitted and are considered unethical like giving a handjob or making sexual suggestions .
Patients that receive proper health care will have shorter hospital stays, a more positive view of the recovery process, reduced anxiety symptoms, and overall wellness.
At this point, you should whether do nurses relieve patients or not, and do nurses give handjobs to patients or not.
Here are a couple of articles of ours that you might be also interested in:
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Home For Nurses Nursing Humor 30 Funniest Nurse Cartoons That Speak Louder Than Words
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Cartoons aren’t just for entertainment. For nurses, cartoons can be a creative way to express our frustrations and anxiety at work. They can even make our shift a lot lighter and more positive, particularly when the cartoons are extra funny and totally relatable.
Here are the best and funniest nurse cartoons that are taking over the internet. Go ahead and check them out!

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