How long did it take you to feel comfortable at drawing blood/inserting an IV?

[Butterfly944]

Hi!

I'm somewhat in between of being a student and being a doctor. I'm in my final year, we have a different system so in less than 5 months I'll be starting my residency.

My problem: throughout all of the past 5 years I wasn't really practicing drawing blood or inserting an IV since its been the nurses job for a few years now and I didn't want to bother anyone with my requests to practice. But I still need to be able to draw blood or inserting this long needle IV thing :-(
Now I've been struggling, it just never worked out. I'm wondering about my competence and if I'll ever learn how to draw blood. The past few days I wasn't even able to succeed with patients who had really big veins.

Can anyone cheer me up? :-/

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[VA Hopeful Dr]

Never?

I've started exactly 2 IVs and drawn blood exactly 3 times.

 

[Butterfly944]

Never?

I've started exactly 2 IVs and drawn blood exactly 3 times.

How's that possible?

 

[VA Hopeful Dr]

How's that possible?

Because I went to doctor school, not nursing school.

 

[LucidSplash]

Yeah. I have done 1 IV ever, about 10 (!?) years ago when I was getting ready to start MS3. On my classmate who had enormous veiny man arms. I didn’t do residency in a sweat shop like NYC so it’s not a skill I ever needed to learn.

I’ve handed off a few syringes of blood while putting in a CVL though. If you need me to stick one of those nice deep veins it’s all good.

 

[mvenus929]

I spent a week with the techs in the ED during residency, and think I placed 3 IVs.

I was a phlebotomist prior to med school, so I can draw blood pretty well, but I think outside of above week working with the techs, I have used that skill like 3 times since starting med school, and all of them were in med school and only one was for actual patient care (I was in ophtho clinic late, a patient needed labs, and apparently all the nurses had left for the day).

 

[Ironheme]

It took me about 1-2 months to feel comfortable, 6 months to do it competently on the harder patients. But yeah, it's not a big thing here in the States. If you spend half your day placing lines or drawing blood, you aren't doing the assessment/plans and learning...

 

[Oo Cipher oO]

I was practicing placing IVs on a helicopter the other day and my corpsman were laughing at how bad I was. It’s not something most physician are experts in placing nor do they need to be in modern medicine.

 

[hamstergang]

I've done 0 IVs in my life. I was actually sick the day we learned it in med school and so had to watch a video later instead of seeing/practicing it live like my classmates.

 

[evilbooyaa]

Yeah maybe < 5 total for peripheral IV placement. Don't do residency in NYC and you won't have to do them on a daily basis. Ditto with drawing blood - outside of femoral sticks in trauma situations, I've never routinely drawn blood.

 

[DocVapor]

Unless you're going into Anesthesiology, then you'll have plenty of opportunity to practice and get better throughout your career. Starting with anesthestized patients.

 

[sunshinefl]

I was a nurse before I was in medical school (only M2 now though...) and I still have only placed <10 IVs and drawn blood <10 times. My nursing role made it so that it wasn’t very often part of my life. My draws were only patients in TB isolation, and IVs have been few and far between in a pinch.

 

[Raryn]

The only IVs I know how to place go in the neck, groin, or upper chest. Similarly, the only place I can draw blood is the radial artery or the groin. Have done <5 peripherals in my life, all on my anesthesia rotation as an M3, and none in all of residency/fellowship/practice.

 

[Smurfette]

I drew blood countless times in residency and basically just learned by doing. My seniors more or less told me where else to look for veins on patients who had crappy or rolly arm veins and off I went. Any stat blood draws on the floor had to be drawn by us at one of our hospitals, including blood cultures, ABGs, etc., because phlebotomy only came around at scheduled times (*and still was not reliable). It was annoying but I didn't think it was a bad skill to have. Put in some IVs as well although if it could wait a bit, a nursing shift change would generally solve that problem.

As an attending, I think I tried to draw blood once (soon after I started) due to frustration labs weren't getting done and the floor nurses freaked out when they realized what I was doing and felt it a failure on their part.

 

[Cryc_to_the_point]

I've done thousands (I was a paramedic prior to medical school) and I can say you can put in 90% of lines in a few month's time. The other 10% you're never going to be able to reliably hit if you don't place them day in/day out.

 

[cubsrule4e]

As MS2's we had a fun day where we all stuck each other...I actually did pretty well. Havent attempted it again since.

 

[Perrotfish]

I wish I had learned. Being able to reliably get an IV on an infant is one of the things that old school rural Pediatricians are really good at. A lot of the time the nurses just can't get the IV and you're the back up. Except that I'm not the back up because I've done less than half a dozen in my life and all of them on adults.

Its by no means necessary, but if you're covering a nursery its a good skill to have.

 

[sluggs]

Medical intensivist here. Rarely do IVs and not that good at them. Must say, though, had a former partner who was anesthesia/ccm. He was mad good at em. Nurses would call him for central line on an "impossible stick". He would put in 2 18s and a 20 and walk out of room with a few snide comments!

 

[SDF1]

Most physicians do not know how to put an IV in. Its not really something that you necessarily should be "competent" in doing. I am an anesthesia resident and put them in all daily, but unless you are in a particular field that necessitates this skill set, I never understood nurses calling residents to put IVs in when the nurse clearly has put 1000s more IVs in vs. a resident.

 

[deleted500612]

How's that possible?

I'm guessing you are in medical school somewhere other than North America. Generally in the US/Canada system doctors do not start IVs or draw blood as it is not part of their job description there (as you can tell by the comments in this thread). I know in the British/European/Australian medical system however, it is more much more common, expected even, for senior medical students and interns/junior doctors to start IVs and do blood draws as you are expected to be proficient at it as a core skill.

 

[chooks]

Here is how I have drawn blood and body fluids:

1) Femoral blood: Stick a large needle somewhere around where you think the femoral vein should be. Try to suck out blood with strong suction. If you get nothing, stab around a few times until you do, applying suction the entire time.
2) Heart: Before dissecting out heart, stick in large needle in aorta and get blood. Proceed to cut heart out and dissect (if at medical examiner - record is < 3 minutes which I will make sure to tell anyone who wants to date my daughter) or (if at hospital) let fix in formalin for a detailed and usually unnecessary coronary artery and conduction system dissection.
3) Vitreous fluid: Again needle, maybe slightly smaller bore. Stick in eye and draw.

Other fluids left as an exercise to the reader. It's been a few years, so my technique is probably off.

Caveat: All of this has been post-mortem on former patients. Would not recommend for living people.

 

[Siggy]

I'm almost comfortable with starting IVs... but my IVs are measured in french so...

 

[Rendar5]

30 iv’s at least to be comfy if I had to put a number on it. I work in em so I do a standard PIV or blood draw maybe once a year If we are so overloaded I don’t have the nurses or medics or phlebotomist to spare. I do place external jugulars once or twice a month but slightly different technique, i.e. no tourniquet and not necessarily a flash. And that is only because the nurses and medics in my hospital are not allowed to place them.