Diana Holowaychuk

Sarah Cusack
Reflection

During day surgery on Friday, I was given a chance to do a pre-op assessment of a

patient. This included taking height, weight, temperature, vital signs. It also involved asking the
patient questions as to his cleansing his bowels prior to a colonoscopy, asking him about nausea
or pain if present, if he was diabetic, if he had any jewellery he would like to remove, etc. I was
also becoming more familiar with the paperwork that needed filling out. I was given the
opportunity to do an IV start on this patient and the patient agreed to let me attempt the
venipuncture. The patient was cheery and encouraging. I prepared my supplies as I was waiting
for the instructor to join me. I applied the tourniquet and was feeling for a proper vein on the
back of the hand. The man had large sized veins visible just under the skin on the back of his
hand. I attempted to insert the needle into the vein and got flashback. After I advanced the
catheter, attachment for the IV tubing was connected. When the roller clamp for the normal
saline was opened it was not dripping. My instructor thought I had penetrated or blown the vein
with the needle. I closed the roller clamp and removed the needle from the vein. The patient
was given a gauze to press on the insertion site and it was taped in place.
I thought I had correctly inserted the needle into the vein, however I was wrong and that
made me feel worried I had caused the patient pain. I apologized to the patient and he expressed
that he was okay with me doing a second attempt when I spoke to him later. I was hopeful I
would be successful next time I attempted an IV start. At the time of insertion I was slightly
nervous because there were a lot of steps to remember and this was my first time with an actual
patient.
The communication was good with the patient and I allowed him to express his feelings
and was able to empathize that it was not easy to allow a student nurse to learn with him. The
thing I found difficult was the lack of knowledge to see what is the best procedure to follow for
venipuncture and how to make it easier for myself to get the needle into the vein. Pottery and
Perry notes that the patency of the intravenous needle or catheter means that the tip of the
needle or catheter has no clots and the catheter or needle tip is not against the vein wall(p. 973).
I learned that confidence of IV start comes with practice and experience. The knowledge
of the procedure needs to be familiar with the student nurse however application of this
knowledge comes with success and failure. In the future I will attempt the IV start with patience
and a feeling of optimism that I will be successful. If this situation occurs again I will learn from
any mistakes that I make with my technique. Going forward this learning attitude will ensure I
will be successful.