Keep Missing Veins When Starting IVs? | Nurse, Phlebotomist Venipuncture Tips

Keep missing veins when starting an IV or drawing blood? This is a common problem that nurses, phlebotomists, and other healthcare professionals face, especially when they don't have a lot of experience starting IVs on patients.

However, even nurses or phlebotomists with decades of experience can and do still miss veins from time to time, especially when the patient doesn't have visible veins due to illness (heart failure, kidney failure, dehydration, etc.), drug use, obesity, and more.

If you keep missing veins or work with a patient population that typically has few veins to use, there are several things you can try to help you increase your chances of a successful stick on the first try.

In this video, Nurse Sarah offers her insights into what to do when you miss a vein, tips on how to find veins on difficult patients, and more.

#venipuncture
#missveins
#veins
#nursing


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[RegisteredNurseRN]

Hey, everyone! Thanks so much for watching. Don't forget:

[CatFromFL]

I am a retired RN (BSN) also a CRNI, who worked in ICU/CCU and home IV therapy for almost 50 years. I also taught IV certification courses at a college. Too frequently I saw nurses using sight instead of knowing anatomy and them using their sense of touch. Trust touch, veins bounce. Picture in your mind a soft tube (slightly larger than spaghetti) filled with moving liquid. Image the depth too. Dilatation with heat is a great idea.Use gravity too. Don’t avoid practicing, you definitely will improve with repeated practice.

[biologylady]

These are awesome tips! I’m a mobile phlebotomist and 90% of my patients are geriatric, critical care, or other hard stick patents. Whenever I need to pull out and try again for missing a vein I calmly and factually say “I’m not getting anything yet, would you be willing to let me try one more time?” instead of being apologetic or anything about their veins being ‘bad’. It’s not their fault if their veins are small, and I know that I’m human and can’t be 100% perfect even if I try my best.

[mosecastro]

People ask me you are so good at starting IVs what’s your secret? I always respond… don’t be afraid to fail. You will fail a lot; but if you learn from your mistakes you will get better. Pick up in the ER if you can. Learn the venous anatomy if the upper extremities. Start an IV on every patient you encounter. You will fail. People will not like you. In due time you will be the nurse that rarely misses a vein.

[dlicious]

I’ve been a phlebotomist for only 2 months and have been missing patients. Here I am still learning

[brookeelle]

Why do patients or patients’ families think that watching over you, putting pressure on you or being mean to you when you’re trying to do a procedure will make you do a better job? Sheesh 🙄 so unnecessary

[Abbiekakez]

I’m a brand new nurse. I’m trying to be THE IV queen on my unit 💪🏼

[jaredlee]

Been a RN for 3 months and this was a skill I really wanted to learn. I asked my leadership to spend a few hours in the ER just practicing. Now I'm the go-to guy in my step down unit. It does get easier.

[chiksr]

Im crying... felt like this is a sign. I was on the verge of giving up on doing iv cannulations and blood collections because i always missed a vein. 😭 thank you.

[jwmay]

Love all of your IV videos!! I have to do about 20 IVs every day at work for sedation procedures and for a good month when I first started I kept missing veins and gave up for a bit! I started to shy away from even attempting IVs and would get others to do it for me. You're tips have helped so much and now I have improved my IV skills sooo much!! I get successful IVs all the time now and don't let myself get discouraged anymore if I miss! Just gotta keep at it! Thank you again! ♥️

[ngo]

I've been an RN for over 17 years and I still miss veins. I'm usually pretty good though. I will sometimes take a blanket from the warmer and wrap it around their whole arm, wait five minutes or so and then try and stick them. It's works! Thanks for sharing! ; ) 💕

[barbaradawson]

I am a struggling new phlebotomist and this video really helped me. Thank you!

[sittiehaynahracman]

You're a life saver to every nursing students😭😘💝

[DonnaWrightRN]

I’m a retired nurse and even though I know I won’t be doing these procedures again, I still want to keep my knowledge current. As I grow older, I will have more healthcare encounters and I want to be able to partner with my care givers.

[YvesGeorgeSanchez]

At first I thought I will never be able to start an IV on my own but after watching Youtube videos on IV cannulation including yours, I got to start one successfully. Thank you!

[dandeleona]

When I train I tell people not to LOOK for a vein because the better ones aren't visible, they're under dermis fat pad. They're "squishy, springy" as you said, but they aren't blue they look for. So I tell them to practice at home - without needles - on anyone willing to sit for them, to close their eyes and run their fingers over the arm to find veins by FEEL, not sight. When they do this off and on for a day, they eventually find vessels comfortably by feel rather than sight. Plus they get over anxiety building during tourniquet application of "what if this goes wrong?", because it can't without needles in play. They tend to find good veins at home, then again in class, approach shallow into a flash, then smoothly level off. A bigger vessel by feel gives them more room in the lumen to get it right the first time. Much moreso than the tiny blue surface venules.

Sometimes ... they'll point out a tendon by mistake, which can also be felt through skin, which of course can never be canulated. But the feel is different. A vein is spongy and pliable like pressing on the skin of a balloon, while a tendon feels like a hard strap under the skin and won't lightly compress under their fingers like veins will. Again practice on the fly with just a tourniquet at home with family, friends or with other students, gives them the feel and confidence they usually don't have with unfamiliar variations in surface anatomy. It's one less thing to worry about in class when they do it again with a needle.

The other tip is when pulling skin taut, don't put the thumb on the feeding vessel. Since blood flows from wrist to elbow, even with a tourniquet this inadvertently shuts off the flow to the access site, causing it to go oval or collapsing outright. Pressing harder won't make this situation better. They'd be surprised how many staff make this error simply because they're concentrating so hard on insertion. Instead, they need to pull the skin taut by pinning EITHER SIDE of the vessel, but not pressing ON the vessel. I had a nurse miss my veins four times before surgery before I said, "OK. Now let me talk you through it." He got it during the tutorial to both our reliefs.

[Johnhall]

I have about 15 sticks under my belt and every time I miss one I am hard on myself and I feel I miss more after I miss the first one. Trying to work on my confidence. Thank you for the video

[MgaBaByFac]

Honestly you should be a teacher, we honestly don’t have enough that students are able to grasp the concept from so quickly Btw I LOVE watching your videos :) thank you for making these!

[geecoffee]

I am a new phlebotomist at a very busy "hub" hospital and find that if I miss the first stick, my second guessing and self confidence lend to me missing my secon/final attempt. Your videos have been very helpful and I can't wait to try your approaches. Thank you so much for making these videos

[vineishanichole]

I missed today and beat myself up about it. I appreciate your video to know that we all miss sometimes but the best thing to do is try again with confidence.