My major milestone this past week was completing my first IV blood draw on a patient, during my ICU rotation. My nurse guided me. I stuck the patient with a butterfly needle and was able to draw blood on my FIRST try! 💉(Luckily, my patient had a really nice big, palpable vein).
My nurse and I walked into the patient room, she handed me the supplies, told me to go ahead, and began charting. I was lost and told her I needed her supervision. I had seen a nurse draw blood from a patient line the week before, so I thought I was going to take blood from an existing IV line. My nurse stopped me when she saw that I was about to sanitize a peripheral IV port. My nurse looked at me like I had three heads 🤔. I worried I wasn’t going to be allowed to do the skill anymore! She explained blood is never drawn from a PIV. The blood draw I saw was from an arterial blood line. I hadn’t realized blood draws are not taken from PIV lines; in retrospect, it makes sense not to draw from a line where a patient received meds.
Despite my nurse’s obviously concerned look, my nurse patiently guided me and let me continue. She repeatedly commented how she was astonished I hadn’t done an IV needle stick on a patient before. I was totally nervous and felt judged, but I knew I had to take my opportunity to practice such an essential skill of getting a needle into a vein. I’ve practiced many times using IV catheters in the skills lab on mannequins, but it’s not the same as inserting IV needles into humans.
LESSON 1: Speak up when uncertain about how to do something. At the very least, talk through the steps BEFORE walking into the room. While our patient’s primary language was not English, it would have been better to have the conversation that I had never drawn blood on a human and discuss the expected process OUTSIDE the patient room. It’s stressful enough being a patient in a hospital; I don’t want to raise a patient’s concerns about me or my abilities with the procedures I’m about to perform.
LESSON 2: Talk out loud while completing steps in a process. While I’m still new and learning, talking out loud helps to reinforce what I’ve learned and the expected process. This applies to any skill, even medication administration (i.e. “…clamp the NG tube…insert syringe…unclamp…push syringe…clamp, etc). Verbalizing steps helps me confirm what I should do or stop myself when something sounds incorrect or strange. Also, my nurse or instructor can hear me as I do things, and guide or interrupt me as needed.
Last week, I also spent more time in my Pediatric rotation. 🧸I’m really loving my Pediatric (Peds) clinical rotation and feel drawn to the particular hospital and patient population. However, I recognize I need more practice feeling baby pulses, particularly pedal ones 🦶. I can usually find pulses quickly on adults, but I find babies’ pulses harder to palpate. I eventually felt the pulses on my infant patients, but it took me a long time. My nurse would feel a pulse and point me to where “it’s a good pulse”. I’d put my finger on the location, and feel hardly anything. I may have been pressing too hard in trying to feel a pulse. I gotta ask my mom friends if I can feel their baby’s pulses to practice this skill – at least it’s not invasive so it should be relatively easy to practice. I often practice assessments on my family and myself, but my daughter is now a toddler – I just need access to more BABIES!