I’ve been placing a lot of IVs lately. I seem to have become the go-to nurse for this task. Years of MICU nursing, many spent at night, gave me all sorts of practice with needles. When you’re the only one to draw the blood or start the IV, you figure out how to do it. Also, when your patient is knocked out with multiple drugs and likely never to remember the poke, you gain a lot of grace in your learning.
Now, I’m typically with cardiac patients who are wide awake and sometimes very particular. I’ve been working in the Cath Lab a lot, and while we treat many different kinds of people, we have a lot of elderly folks. Who don’t have veins. And who hate needles. With their family members standing beside me, the stretcher always half a foot too short, and the doctors swarming to complete assessments and paperwork, this scenario is far from my night shift sit-downs with sedated arms. This is the moment where you just have to get it in.
But even amidst the pressure, I’ve started taking a mental step back while I insert. I’ve started to crave a closer look at all of the various elements and sensations that come with starting an IV – the poetry of the process, if you will.
The preparation is slightly ritualistic – just enough of the perfect collection of supplies (I no longer need a huge towel to catch blood – sometimes I don’t spill a drop). The tourniquet, the way the patient’s skin feels, the way their veins sometimes bulge and sometimes burrow. There is an order to the search – success only comes with a certain quietness from within.
Lately, my favorite element has been the instant of insertion. The moment that I gently, slowly – no matter the din and chaos around me – communicate with the vein through the tip of my needle. It’s like sewing a very delicate fabric; the slight upward motion of the needle going into the skin always surprises. What will the skin feel like against it? Will it be easy and smooth, or tough and resistant?
Then, the tiniest of tiniest “pops” – the needle entering the vein – how does one describe this? It is a feeling and an emotion – a let down of relief and a moment of success and a confirmation of access all in one. There is no way to know it until you experience it – as a student nurse, I hated this often spoken-of phenomenon until I finally felt it myself.
Before, an IV was an experiment of learning – a needed one. Spending spare moments at bedsides – finding veins, not finding veins – this was how I taught myself, how I got over my fear of this once-scary skill. These times were silent, with just fingers and veins speaking.
Now, IVs are a chance to chat – to talk with patients about where they live, what they do, how they feel. It’s amazing how easy the moments become – even when I miss or blow a vein – if I focus on talking with people. I enjoy myself, the pressure lifts, and I assess through our conversation. Patients bare deep wounds amidst these tiny moments.
It is magical to provide access to a person’s life force – their blood. To find my process for success took time, patience and practice. There are days when I never miss a shot, others when I apologize more than gloat. But isn’t this the process of nursing? One [IV] at a time.
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