IV Start Tips for Anxious Patients
Needles/shots/IVs were some of my worst fears growing up. I remember kicking + screaming as a kid then eventually hesitating + crying with anxiety as a teenager. I did not handle it well. When I chose nursing as my major in college, I realized that I couldn’t be afraid of them anymore. Weirdly, I knew I’d love starting IVs and drawing blood, so I didn’t want to feel like a hypocrite!
After this decision, for my very next round of shots + lab draws, I decided to quit the anxiety + fear cold turkey. I made myself watch the nurses and phlebotomists insert every single needle from then on out. And crazy enough, it worked for me! And I do it to this day. It really helps me make sense of the sensation and makes me feel like I’m in control of the pain.
But that’s my story, so listen, I do not recommend you make your anxious, needle-phobic patient quit their fears cold turkey. However, I DO recommend you check out these other tips I’ve gathered over the past decade, as the nurse who holds the needle. So first things first…
Get Comfortable.
If the situation is not emergent: take your time, slow your roll + grab a chair. Set up your IV start kit and grab some extra 2x2’s for the extra blood.
I also love bringing an extra pillow or folded up blanket to prop the patient’s arm up on. This naturally + comfortably straightens the elbow and improves visibility of all the veins.
Prepare the Patient for Blood.
Always ask your patient (and visitor) if they are okay with the sight of blood or needles. If not, have them look away and please, don’t be afraid to ask visitors to step outside for a moment.
Even if the family or visitors don’t have an issue with blood + needles, sometimes it just feels more relaxing for you to have less eyes on you while you poke their loved one. Time to make use of those waiting areas!
For the Needle-phobes…
Show them the needle. Yeah I know, stick with me here—THEN show them how little of its length is actually used to thread the little plastic tube in.
Knowing that less than 1/4 actually goes into their skin can be really helpful for many patients!
Be Messy.
Making a mess is NOT a problem, so until you feel like you’re entering pro territory, just focus on a successful flash + flush!! The more you get used to the dexterity of it all, you will figure out little ways to keep it cleaner, but it takes time!
This is another reason I love having an extra pillow under the arm—it catches any mess and prevents you from having to change their gown or blankets underneath.
Keep it Light-Hearted.
Chat with your patient about pretty much anything as you prep supplies and check out their veins. Relax them by having them talk about themselves or their life. Ask things like:
“Do you live in town?”
“Do you have pets?”
“So tell me more about ___!”
“Do you have any hobbies?”
Getting their mind off the task at hand is the goal here. Don’t stop what you’re doing to make eye contact and listen to what they’re saying, just keep them talking about light-hearted topics as you focus on the task at hand and pick out that perfect vein + approach.
Prep the Patient.
Prep the patient for the poke. Show optimism in the vein you chose, EVEN IF you’re not feeling the most confident. Give your patient a brief expectation of what’s going to happen and ask them if they prefer a countdown to the poke or if they would rather you “just do it.”
If they want you to “just do it” continue that conversation they were just having about their dog/grandkids/career and as they are talking, poke em, and get the flash. Immediately remind them to stay still, do your flush, then announce your success!
Didn’t Get the IV In?
Do not beat yourself up. I get it, we are all perfectionists going into this field. Just remember that the more practice you get, the better you WILL get and on the days you are a patient’s last poke after several unsuccessful attempts by other nurses, it will all be worth it.
Even as a veteran nurse (who has started thousands of IVs, is ultrasound-guided IV specialized, and used to start IVs all day every day in pre-op), I miss. If your goal is to be the go-to last-resort nurse for IVs, just practice. Never say no to an opportunity, ask to watch your colleagues start their IVs, and LISTEN to your patient. They know their body. Ask their IV history and I promise you, they will give you a wealth of information that will lead to your success.
Check out more tips, tricks, + more on our Blog!
Happy flashing + flushing nurses 💉💉
