It is amazing when you meet someone and they find out you are a nurse (infusion nurse), they start asking a lot of health related questions. Honestly, I don’t mind and I am grateful that most people I meet know what “infusion therapy” is, although a few are still confused that it means…blood draw!! I’ve met the most amazing patients and hope that I have answered some of their infusion therapy questions.
Here are a few tips I have shared with them…
1. An infusion nurse (aka IV nurse) is not the same as a phlebotomist. An infusion nurse inserts an IV catheter into your vein to “infuse” solutions or medications. On occasion, an infusion nurse may draw blood from the IV catheter immediately after insertion then leaves it dwelling in your veins so you can receive your ordered solutions or medications. A phlebotomist inserts only the tip of a needle into your vein to draw out blood, then the needle is removed when all blood tubes have been collected.
2. Dry heat improve the success of IV insertion! YES, it is true. Don’t be shy to ask your infusion nurse to apply dry heat (instant warm packs) to your arm/hand to assist in finding your veins. The use of heat increases blood flow allowing for good venous dilatation, thus improved vein visualization. Simply stated, it helps us find “juicy veins”.
3. Don’t be a creature of habit – allow us to use different veins for venipuncture. Ok, you know which vein worked the last time you got an infusion , so why not use the same one? Not a good idea, repeated puncture of the same vein will result in damage to the vein lining resulting in phlebitis and sclerosis of the vein. Blood flow will not be as good if this happens and can be a problem depending on what you will be receiving.
4. Hydrate, hydrate, hydrate. It’s not easy to palpate veins when you are dehydrated. It is always good to have fluids (water) in your system, it helps us find those juicy veins much easier. Try to remember to take extra fluids (as permitted by your condition or doctor) a few days before your infusion therapy. Don’t wait till the night before to hydrate, it will keep you from having a good night’s sleep. Avoid alcoholic drinks, just stick to water.
5. Yes, sticking an IV catheter through your skin/veins will hurt!! It’s true, no matter how tough/brave you are, it will hurt to some degree. But the good news is there are topical anesthetic agents (like LMX) that can be applied to your skin prior to the venipuncture to help numb the site. Be sure to ask your nurse about it.
6. Please don’t mess with the infusion pumps just so your infusion will finish sooner! There’s a reason your pump is set to a specific rate. Some medications, if infused rapidly than recommended can result in poor patient outcomes. So hands off the pump, please!
7. Try to relax! Ok, I know this is hard to do when I’m getting ready to stick your arm/hand. Please try to take a deep breathe, hold your arm still but not tense. Tense muscles can trigger veins/valves to constrict making venipuncture and catheter advancement difficult.
8. Don’t allow nurses to keep sticking you until a vein is found!! You are not a pin cushion! The Infusion Nursing standards of practice states each nurse is limited to two unsuccessful IV attempts. But this doesn’t mean, 6 nurses should attempt twice. In my experience, after two nurses has unsuccessfully attempted (4 sticks by now) , both the nurse and the patient are not feeling so confident at this time. So stop and take a break, have the nurses apply dry heat to your arms/hands and ask them to patiently look for a vein first before attempting another stick.
9. Speak up when….a) your nurses flushes your IV line with saline at a fast rate. Tell them to slow down, many patients say that rapid flushing with saline gives them a metallic taste in their mouth. b)when you see a nurse not using gloves when they stick you or when they poke a hole in one finger of the glove during the venipuncture. Not good, they can get needle stick injuries.
10. Consider a central line! If you are going to receive infusion therapy long term, getting frequent blood draws, or if you are getting a medication that can be harmful to your vein if it leaks out, ask your infusion nurse or doctor to prescribe a central line. Don’t put up with peripheral IV’s when you can get a PICC (a peripherally inserted central catheter), a tunneled catheter (Hickman catheter) or an implanted port (Port-a-cath) and avoid unnecessary sticks.