Was this unprofessional from the nurses?

[twatmas]

Was in A&E last night / this morning for a horrible SVT run.
My veins are shot to pieces from years of bloods / cannulas / chemo so I know I'm hard to bleed.

Paramedics tried twice in the back of my hands but failed. (No blame there, I'm aware I'm hard to get a line into)
Got to hospital, and a nurse came along. I usually need the ultrasound to get a line in. I was happy for her to try a couple of times before asking for a machine. I did mention to her they usually need the US.

Anyway, after 5 goes in various different places (going over my already swollen sore hands from the paramedics) I started to get restless as it was hurting. I asked her if she could get an US machine as it was now hurting and I don't want to be prodded for the sake of it. She said no, she will keep trying.

6,7,8 goes, I was now bleeding out and my arms and hands were really painful blue. I was crying at this point as my chest was hurting and I was being poked and prodded from every direction. Going over repeatedly battered veins hurts. I said this to her, I apologised for being difficult to bleed but 9 times is too much. The nurse then said 'you've got to be brave, it's only a cannula, what do you want me to do?' And just shrugged.

This comment is what's pissed me off. I don't have a phobia of needles. I have had probably thousands at this point of those bastard things. I've had chemotherapy. I don't need to be brave. I don't need someone poking me 9 times. I need an US machine which could've saved so much time and pain.

I refused to have her try a 10th. A senior nurse came in quite disgruntled that I didn't let the previous nurse try again. He said to me 'well you've been through a lot but we need to get a cannula in.' Well yes, I agree. But not at the expense of battered and bruised arms. He tried for the 10th time, and managed to get the cannula in between my wrist and crook of my arm. Right in the middle of my arm. It fucking hurt, but it was in. I apologised again and thanked them, but they just seemed so annoyed with me.
This is NOT a nurse bashing thread. I have the utmost respect for them, but 10 attempts was horrible and I was made to feel like a wimp.
AIBU? Or is this standard practice?

'then either a consultant anaesthetist or at the very least, a senior anaesthetist'
Your having a laugh if you think a consultant anaesthetist would trouble themselves with a difficult cannulation! Were there gaps between attempts? Perhaps the nurse had escalated and no one was available, and they had persuaded her to try again

Sometimes it is just really, really hard. I'm a senior anaesthetics reg, i.e the person who gets called when everyone else has failed. Sometimes I can then get one in first time, other times it takes ages, US (though as @Greybeardy says, ultrasound isn't always the answer to everything), and ends up needing a central line. For a variety of reasons, some people do just have really difficult veins, no matter how well trained the staff are. (Though this doesn't mean the treatment the OP describes is ok! It may well be that the nurse isn't able to use US.)

Over the last few years, the UK population has got more overweight and is living longer with multiple health problems which might need IV treatment. We also have many more treatment options available than we did 20-30 years ago, but lots of them need to go IV. And in some people this will mean veins get worn out. I'd love for there to be an easier solution (if nothing else, so that I don't get called at 4am for a cannula!) but there's nothing out there yet

Depends on why the person needs a cannula - if they are sick, or bleeding, their peripheral blood vessels may have shut down. If they have had chemotherapy in the past, their veins may be damaged. If they have lymphoedema there may be fewer sites to try. Obese patients can have very deep veins (too deep for a blue cannula to reach). Renal patients will have fistulas putting one or both arms out of action, and may have central stenoses meaning no neck veins for CVC lines.

99 people out of 100 are easy to get blood out of. Those are not usually the same people who need regular cannulas in A&E.

None of that is any excuse for having ten goes without getting the scanner and/or the specialist team. In a crash situation then defer to the anaesthetist or anyone senior after a couple of tries. Ploughing on and on isn’t acceptable.

Nope - I was replying to a poster asking how “basic” things like cannulation could possibly be so hard, by explaining why some people in some situations can be objectively hard to cannulate.

I wasn’t suggesting anybody should have ten attempts.

I'd just like to thank all the HCPs on this post for explaining that cannulation is difficult, ultrasound doesn't always help and you can't put all drugs through a tiny cannula, even if they might be easier to insert.

Sadly they didn't use 10.

Paramedics used one on each hand.

The 8 other attempts in hospital, 3 cannulas were used. :(

To all PPs - yes, there are always some difficulties with taking blood and cannulas etc with some patients, sometimes including myself.

But, whilst not diverting much from the OP's case (requiring serious attitude adjustment from the HCPs involved), i'll still stand by putting the HCPs at ease before they delve into my insides. I'd rather the Consultant went for a fag to relax their nerves than tickbox their way to resolution instead.

Call me selfish but needs must. Should have been dead at 19 but still alive and kicking at 60.

Yes, it’s called infection control!

3 goes, MAX, tho I usually stop after second attempt and ask someone else.
Take a photo of your battered arm to demonstrate what you went through, as this will help people understand in a way in which the written record of “10 attempts “ cannot

Oh yes, no need to make formal complaint- just go via PALs

I work in ED and I think you should complain. Sounds like utter torture. Did they give you any iv drugs after it was inserted?

Suggest you search for the cannulation policy for the hospital trust that you were in, so that you can complain effectively.
For example I just searched and found this one for Plymouth hospitals. See page 6. - only 2 attempts per staff member.

www.plymouthhospitals.nhs.uk/download.cfm?doc=docm93jijm4n12688.pdf&ver=18306

many years ago, while fighting cancer, I became very hard to stick. I learned to be very, very firm that they got a maximum of two tries.

you have to be more assertive. It’s your body and you are in charge. You know your history better than anyone else.

If nothing else, someone else might have better luck reading your veins, even if the ultrasound can’t be available for hours.

Sounds like you have a complaint to make.

But this I apologised again and thanked them why did you apologise??!

As a nurse, this is horrifying! You absolutely can not ever use the same cannula for multiple attempts. It needs to be a fresh one every time.

we have the guideline of trying twice too. Then we either get someone more experienced or go straight for the ultrasound.

I’m sorry you had to go through that. In future, please remember that you can withdraw consent at any time, you do not have to allow multiple attempts.

That was wrong OP.

I'm difficult to cannulate. Some years ago I.was in hospital with meningitis symptoms and my cannula fell out. 3 nurses tried twice each, all being as gentle and reassuring as possible then they got the doctor who tried 3 more times and finally got it into a vein of top of my foot. .So 9 tries but hey were as kind and gentle as they could be and became more and more apologetic as my stupid veins refused to co operate

Actually my body was uncooperative in general and they finally did lumber puncture under x Ray after 3 failed attempts. I.was glad they'd didn't keep trying bruises were still there months later.

That was a horrible situation for you and could have been dealt with very differently.

Anybody thought about the massive infection risk these repeated tries causes?

Apart from the aghast HCP’s, I don’t think anybody really did!

And especially not posters such as @nottodaytomorrow who can only think of the money the NHS didnt waste on 10 needles!

As if it was OP’s choice that her veins refused to cooperate!

I'm so sorry but I too have too many stories of uncaring and unprofessional nurses and doctors. They do an important job but certainly won't serve the revere they get.

Don't deserve the revere they get that should read!

Deffo not being unreasonable!

My sympathies.

My veins disappear too when a needle is within spitting distance.....

I almost wanted to punch one idiot junior doctor who ignored my 'please try there.... It's usually successful when I give blood'.

29 fucking attempts..... Yup that's right 29...
In the end I insisted on someone else....

He was aggressively unpleasant and seemed to regard it as his mission to ignore me.... Twat

I agree. I understand you were vulnerable and you didn’t want to be rude, but I would be firm with them, after 2 attempts they should get someone more experienced.

I’m so sorry that this was your experience! My usually low blood pressure has shot through the roof reading this and the other accounts posted on this thread.

I sincerely wish that I had been the nurse, as I would have washed that doctor’s hair for him! And I would have made complaints to not only the NHS Trusts Board but the medical association as well because he severely compromised patient safety and unless he was using a new needle each time, put your health at risk.

It’s unbelievable that these so-called professionals are allowed to practice unfettered and I can only think that it’s because of what I call God complex, (that is patients viewing doctors and nurses as being able to do no wrong, because well, doctors and nurses) and I’m always quick to tell patients that whilst I know about medical stuff, medications, diseases and such like, they are the only ones who know their bodies and as such, they need to tell me or tell the doctor when they think we are wrong. Because we aren’t omniscient and we can only go by the information that we have at the time, so speak up and don’t be shy! Or if they really don’t feel they can tell the doctor that he’s wrong, let me know because idgaf about telling a doctor when he’s wrong and I know my nurse manager has my back as well.

The number of times I’ve scanned and emailed wrongly written drug charts to the nurse manager and consultant because I refuse to allow anyone to put my patient at risk. If a doctor cannot be trusted to write a prescription correctly, should they really be making decisions about someone else’s life?

Can’t see the big red sticker saying “DRUG ALLERGY” right above where you’ve written a prescription for IV Penicillin that my patient is allergic too? Should’ve gone to spec savers because I guarantee that after I’ve had to call the on-call down to correct your Fcuk up, the whole hospital will know what a complete and utter moron you are!

Honestly? I can’t even with these “professionals”!

By 'gold dust' they meant the Doctor who's trained to use it, as nurses are not trained to use ultrasound for this purpose. With the current shortage of Doctors, nurses seem to have to take on more and more responsibility for things that, in my opinion, their training is simply not robust enough for.

I agree, someone went and got an US machine for me, I hadn't a clue how to use it and what I was looking for, when I put it on the patient's skin, I mean it look like a map of London. I just said no, I'm not doing that and got the reg in the end.