The day has come

I’m going to share a dirty little secret, which is that up until recently I was actually very poor at starting IVs.

“But you’re an ICU nurse!”

And??? What the hell does that have to do with anything? We were primarily a trauma and neurosurgical ICU. They all had central lines, dude. Or if they were coming from OR or ER, they were expected to come to us with at least one working peripheral.

And yeah yeah, every four days or so we’re supposed to replace the peripheral, but that doesn’t always line up with your working days or your patient assignment. So at the time that I left ICU and started CRNA school, my IV skills had about a 50% success rate. Looool.

I was secretly embarrassed and ashamed of this, and me worrying about this deficiency during clinicals made it even more embarrassing and shameful. Lol.

Anyway, if there are any other ICU nurses in the same boat, let me assure you that the IV skills come pretty quickly in anesthesia. You don’t even have to ask for a day in Pre-Op to get IV practice in (which some people do, and its obviously helpful, but I didn’t). You just do IVs so much in anesthesia — on the old, the neonatal, the obese, the morbidly obese — that one day you realize you’ve crossed the threshold where your hit rate is ≥ 75% … then 90% … and then this happens:

You’re starting a cardiac case with your attending, and you both realize the IV they placed in pre-Op isn’t working. While you place the A line, your attending quickly slips another IV in, but then that IV is faulty, too. The whole team is waiting. As he starts looking for another IV with the ultrasound, you start attempting an IV on your side — and get it within 3 seconds.