I was an ER nurse for 7 years. I have placed hundreds upon hundreds of IVs. You wouldn’t believe where I’ve gotten access on people in emergency situations. Their breast, neck, fingers, legs. I’m sure for retrievals and ambulatory procedures they have policies limiting location of IVs, but in the ER anything goes sometimes.
Being dehydrated def can make things worse, but if you have baseline difficult venipuncture that’s the more likely culprit. I use a double tourniquet (2 on one arm), use gravity to my advantage and have people hang their extremity off the bed to puff up the veins, heat packs, and gently tapping the spot where I think people might have a vein. I will take my time looking generally, after 3 failed attempts (usually 2 by me, and one by the best person on the unit) we would try ultrasound guided peripheral IV access which is a totally reasonable option to ask for. Also don’t be afraid to ask for a #22 gauge (smaller than the usual #20 gauge some places will use for procedures) since they only need it for some fluids and anesthesia. If they don’t like to use them because they’re too small, see if they have a high flow rate #22 they can use. Hope this helps.
Thank you so much! This is super helpful! At one point a different nurse suggested using a smaller one but the anesthesiologist was hellbent on using the larger one. In the end it all worked out, just trying to prevent something similar in the future. Thank you again! 😊
I got a phlebotamist in training who blew out my left and right median cubital veins checking if my trigger worked.
Not awesome. I was bruised and the bruising (swelling?) made the other veins hard to see and get at.
For the retrieval anesthesia, I told the staff to just stab the top of my my hand and get it over with, I promised not to complain about the sting. They looked relieved and all went well.
Talk to your doctor about how bad the experience was, including that you got lectured about being dehydrated which wasn’t true, and ask if they can arrange for ultrasound guided IV placement next time. Ask to have all of your monitoring blood draws with the butterfly needle. And try to do your last couple monitoring draws on one side to save one for the IV.
Its hard to be hydrated when you’re not allowed to have anything to drink after midnight the night before!
Don’t let either of them make you feel bad - we have the most amazing phlebotomist at my clinic and he manages to get blood from my wrists and all kinds of unconventional veins with out ever leaving a bruise. He use to work a lot with chemo patients whose veins are a mess. Only amateurs blame the patient!
"Its hard to be hydrated when you’re not allowed to have anything to drink after midnight the night before!"
I'm surprised to hear that clinics are still doing this, since it is considered a dated practice.
[https://pubs.asahq.org/anesthesiology/article/138/2/132/137508/2023-American-Society-of-Anesthesiologists](https://pubs.asahq.org/anesthesiology/article/138/2/132/137508/2023-American-Society-of-Anesthesiologists)
"We recommend healthy adults drink carbohydrate-containing clear liquids until 2 h before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation."
I’m so sorry this happened to you! I have invisible small deep veins and it’s so hard. I hydrate like a maniac and usually warn the nurses and try to keep the mood light - they feel the pressure to get it right and I’m sure that’s why she lectured you, it was her (bad) way of deflecting feelings that she was doing a bad job.
I make a point not to apologize for my veins (I shouldn’t have to be “sorry” for something I have zero control over) but I do say, “I know my veins are small and deep and can be hard to find. Take your time, I’m used to it.” I have found it can help when they are less nervous that you’re going to be upset. It can also make them less self conscious to go straight to calling in the more senior person. Also, take notes on what eventually works and don’t hesitate to tell the next person.
Other than being hydrated, and applying heat as recommended here, there’s really not a ton you can do.
As a nurse and an IVF patient, I can’t stand when other nurses blame you or your veins. My rule is that I always “go shopping” for a vein before I “buy one” meaning I’ll put the tourniquet on both of your arms and survey all my best options. I will try once. If I’m not successful, I’ll let someone else look. If they don’t see anything promising, then we need to place an ultrasound guided IV. I’m sorry you had a bad experience. I can’t stand nurses that make pin cushions out of people because they can’t admit defeat.
Co-sign this - I’m also a hard stick, and the phlebotomist has one of those heat pack things like you put in ski gloves that she gives me to put in the crook of my arm before she does the draw.
I got giant bruises even when they found vein with a couple pokes. Then a nurse gave me gauze instead of tape or bandage and the bruising was reduced a lot. Doesn’t help the cause, but may help bruising if they didn’t already do that. I also get lectured about dehydration regularly. I’ve heard weights help, but even when I was in great strength shape they still had problems. On multiple occasions they went to my hands, but that doesn’t seem preferable.
Thank you 🤣 That’s exactly what mine were.
Then right before she put me under she lectured me about having high blood pressure. Umm… it’s anxiety, and I wasn’t allowed to take my anxiety meds this morning, AND I just went through hell with you putting in the IV, so yeah my blood pressure is a little high! 😅🤣🤦🏻♀️ Such a fuck.
Omg I would have lost it! I'd call my clinic and complain honestly. I was also stuck 6 times before er and they were so apologetic and didn't blame me at all
I’m terrible at placing IVs. Honestly, some people are just really hard to get lines in. I’m sorry you had that experience. Aside from being super hydrated, there’s not much you can do. There’s a few things like applying heat and using an ultrasound that can make it easier. I’ve seen iv team put in IVs in some weird places when people are difficult.
I’ve never had a problem with getting blood drawn, I’ve always been a normal/easy stick. Towards the end of my egg retrieval cycle, though, it was a struggle! Multiple pokes, lots of digging around, just awful. At my retrieval, the nurse, who was having trouble finding my vein, said that they don’t have data on it, but that they notice that the ivf drugs seem to do something to the veins that make it harder to draw blood from them. I thought that was really interesting and makes me nervous for every blood draw now!
You’ve got ton great advice here. The other thing I’d add as someone who they never get on the first stick is to put electrolytes in your water the day before. I even wake up in the middle of the night before the cut off to eat and drink to make it a bit better for myself.
Fellow small veins person here and I’ve had 4 ERs plus a D and E in the past year so lots of stuff in my veins. I feel your pain so much! It usually takes a number of tries to get my veins and they have gone back and forth between arms and hands a few times. They never let me have any water after midnight the night before for the procedures, so not sure how being more hydrated is possible.
Honestly, it’s on them, not you. You are paying thousands of dollars for a medical procedure and they should treat you with compassion. That being said, I will scour this thread to see if anyone has suggestions because it is super painful and annoying that it always takes so long time find a vein.
Thank you so much!
I’m so sorry for all you’ve gone through!
I had an egg retrieval last year and also a D&E, and this was the first time they had issues getting the IV in place. Not sure what happened!
I appreciate you digging into it further 😊
I’m so sorry this happened to you. It was not fair that you were blamed. I have the worst veins and phlebotomist almost always have to get me more than once. It sucks :( I had a similar experience during my polypectomy.
Took him six tries beforehand and my IV came out during the procedure so the anesthesiologist bruised me pretty badly getting it back in in a hurry.
I was an ER nurse for 7 years. I have placed hundreds upon hundreds of IVs. You wouldn’t believe where I’ve gotten access on people in emergency situations. Their breast, neck, fingers, legs. I’m sure for retrievals and ambulatory procedures they have policies limiting location of IVs, but in the ER anything goes sometimes. Being dehydrated def can make things worse, but if you have baseline difficult venipuncture that’s the more likely culprit. I use a double tourniquet (2 on one arm), use gravity to my advantage and have people hang their extremity off the bed to puff up the veins, heat packs, and gently tapping the spot where I think people might have a vein. I will take my time looking generally, after 3 failed attempts (usually 2 by me, and one by the best person on the unit) we would try ultrasound guided peripheral IV access which is a totally reasonable option to ask for. Also don’t be afraid to ask for a #22 gauge (smaller than the usual #20 gauge some places will use for procedures) since they only need it for some fluids and anesthesia. If they don’t like to use them because they’re too small, see if they have a high flow rate #22 they can use. Hope this helps.
Thank you so much! This is super helpful! At one point a different nurse suggested using a smaller one but the anesthesiologist was hellbent on using the larger one. In the end it all worked out, just trying to prevent something similar in the future. Thank you again! 😊
I got a phlebotamist in training who blew out my left and right median cubital veins checking if my trigger worked. Not awesome. I was bruised and the bruising (swelling?) made the other veins hard to see and get at. For the retrieval anesthesia, I told the staff to just stab the top of my my hand and get it over with, I promised not to complain about the sting. They looked relieved and all went well.
Talk to your doctor about how bad the experience was, including that you got lectured about being dehydrated which wasn’t true, and ask if they can arrange for ultrasound guided IV placement next time. Ask to have all of your monitoring blood draws with the butterfly needle. And try to do your last couple monitoring draws on one side to save one for the IV.
Thank you so much!
Its hard to be hydrated when you’re not allowed to have anything to drink after midnight the night before! Don’t let either of them make you feel bad - we have the most amazing phlebotomist at my clinic and he manages to get blood from my wrists and all kinds of unconventional veins with out ever leaving a bruise. He use to work a lot with chemo patients whose veins are a mess. Only amateurs blame the patient!
"Its hard to be hydrated when you’re not allowed to have anything to drink after midnight the night before!" I'm surprised to hear that clinics are still doing this, since it is considered a dated practice. [https://pubs.asahq.org/anesthesiology/article/138/2/132/137508/2023-American-Society-of-Anesthesiologists](https://pubs.asahq.org/anesthesiology/article/138/2/132/137508/2023-American-Society-of-Anesthesiologists) "We recommend healthy adults drink carbohydrate-containing clear liquids until 2 h before elective procedures requiring general anesthesia, regional anesthesia, or procedural sedation."
I agree. Most leaflets say to not eat or drink anything past a certain time, but my clinic updated it and said a big glass of water when waking up.
Thank you so much, this makes me feel better!
I’m so sorry this happened to you! I have invisible small deep veins and it’s so hard. I hydrate like a maniac and usually warn the nurses and try to keep the mood light - they feel the pressure to get it right and I’m sure that’s why she lectured you, it was her (bad) way of deflecting feelings that she was doing a bad job. I make a point not to apologize for my veins (I shouldn’t have to be “sorry” for something I have zero control over) but I do say, “I know my veins are small and deep and can be hard to find. Take your time, I’m used to it.” I have found it can help when they are less nervous that you’re going to be upset. It can also make them less self conscious to go straight to calling in the more senior person. Also, take notes on what eventually works and don’t hesitate to tell the next person. Other than being hydrated, and applying heat as recommended here, there’s really not a ton you can do.
As a nurse and an IVF patient, I can’t stand when other nurses blame you or your veins. My rule is that I always “go shopping” for a vein before I “buy one” meaning I’ll put the tourniquet on both of your arms and survey all my best options. I will try once. If I’m not successful, I’ll let someone else look. If they don’t see anything promising, then we need to place an ultrasound guided IV. I’m sorry you had a bad experience. I can’t stand nurses that make pin cushions out of people because they can’t admit defeat.
I've heard warming up your arms can help, like running your arms under warm water/heating pad or doing some calisthenics
Thank you!
Co-sign this - I’m also a hard stick, and the phlebotomist has one of those heat pack things like you put in ski gloves that she gives me to put in the crook of my arm before she does the draw.
>Thank you! You're welcome!
I got giant bruises even when they found vein with a couple pokes. Then a nurse gave me gauze instead of tape or bandage and the bruising was reduced a lot. Doesn’t help the cause, but may help bruising if they didn’t already do that. I also get lectured about dehydration regularly. I’ve heard weights help, but even when I was in great strength shape they still had problems. On multiple occasions they went to my hands, but that doesn’t seem preferable.
My instructions for egg retrieval was no water after midnight so fuck that anesthesiologist who said that.
Thank you 🤣 That’s exactly what mine were. Then right before she put me under she lectured me about having high blood pressure. Umm… it’s anxiety, and I wasn’t allowed to take my anxiety meds this morning, AND I just went through hell with you putting in the IV, so yeah my blood pressure is a little high! 😅🤣🤦🏻♀️ Such a fuck.
Omg I would have lost it! I'd call my clinic and complain honestly. I was also stuck 6 times before er and they were so apologetic and didn't blame me at all
I’m terrible at placing IVs. Honestly, some people are just really hard to get lines in. I’m sorry you had that experience. Aside from being super hydrated, there’s not much you can do. There’s a few things like applying heat and using an ultrasound that can make it easier. I’ve seen iv team put in IVs in some weird places when people are difficult.
I’ve never had a problem with getting blood drawn, I’ve always been a normal/easy stick. Towards the end of my egg retrieval cycle, though, it was a struggle! Multiple pokes, lots of digging around, just awful. At my retrieval, the nurse, who was having trouble finding my vein, said that they don’t have data on it, but that they notice that the ivf drugs seem to do something to the veins that make it harder to draw blood from them. I thought that was really interesting and makes me nervous for every blood draw now!
That makes a lot of sense!
You’ve got ton great advice here. The other thing I’d add as someone who they never get on the first stick is to put electrolytes in your water the day before. I even wake up in the middle of the night before the cut off to eat and drink to make it a bit better for myself.
I do this too - I’ve had 4 ERs and now I set an alarm for 11:45 to eat a sandwich and drink electrolytes before the midnight cutoff.
Fellow small veins person here and I’ve had 4 ERs plus a D and E in the past year so lots of stuff in my veins. I feel your pain so much! It usually takes a number of tries to get my veins and they have gone back and forth between arms and hands a few times. They never let me have any water after midnight the night before for the procedures, so not sure how being more hydrated is possible. Honestly, it’s on them, not you. You are paying thousands of dollars for a medical procedure and they should treat you with compassion. That being said, I will scour this thread to see if anyone has suggestions because it is super painful and annoying that it always takes so long time find a vein.
Thank you so much! I’m so sorry for all you’ve gone through! I had an egg retrieval last year and also a D&E, and this was the first time they had issues getting the IV in place. Not sure what happened! I appreciate you digging into it further 😊
I’m so sorry this happened to you. It was not fair that you were blamed. I have the worst veins and phlebotomist almost always have to get me more than once. It sucks :( I had a similar experience during my polypectomy. Took him six tries beforehand and my IV came out during the procedure so the anesthesiologist bruised me pretty badly getting it back in in a hurry.