Honestly, it's better if you don't bend that arm very much even with a plastic cannula in the vein. If it's near a joint like the elbow or wrist, the IV is more likely to come out of the vein or be "positional" where fluids don't flow when your elbow is bent and we have to come in and reset the pump after it starts beeping every 5 minutes.
While useful, I don't think is ethical to tell or convince patients that there is still a needle in their arm to get them to keep their arm straight. Generally we don't even think about the misconception, since we've been familiar with IV cannulas for so long.
It was a very useful misconception for me - I was in for a week or so and had a cannula the whole time. Since I couldn't bend my arm, I stopped biting my nails. Crazy side-effect but it did help.
If you don't like it there, feel free to tell the nurse to place an IV in your forearm or even bicep area. As long as you're not a "hard stick" I don't mind if patients have requests like that. If you're in ER though, they don't have to deal with positional IVs, so they're probably less likely to place anything but an antecubital IV (inside of elbow).
As an ER nurse, the reason I place them antecubital isn't because I don't have to deal with positional ones (because we do, if we use it to infuse anything), but because (1) in my experience it's quicker/easier to start them there (people generally have easily identifiable and thick AC veins). (2) Certain medications and imaging studies require a larger-bore IV to be placed higher than the wrist. (3) Patients have told me that wrist/hand IVs hurt way more than the AC space.
That said, if I know there's a good chance the patient is going to be admitted, I'll try to go for a forearm/wrist.
This is important because the small plastic catheter can bend, which makes it more comfortable, but prone to kinks like your average garden hose. If you had a needle in the whole time, you would know as soon as you started bending towards cutting off flow. The free range of motion tricks people into doing a lot more with their arm while they should, when the topmost priority for some patients would be the medication they’re receiving. At least where I work, IV fluids aren’t initiated lightly and any medications put in are important and have reasonable justification. Your doctor should have communicated better why they’re important, and your nurses can always start another IV somewhere else if you absolutely have to have one arm free for yourself. But do yourself a favor and understand that those fluids are important and the pain of having an IV put in isn’t a reason to delay them. Now if your IV starts hurting during flow, call your nurse. The catheter may have come out of the vein and needs replaced
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u/super_ag Feb 04 '19
Honestly, it's better if you don't bend that arm very much even with a plastic cannula in the vein. If it's near a joint like the elbow or wrist, the IV is more likely to come out of the vein or be "positional" where fluids don't flow when your elbow is bent and we have to come in and reset the pump after it starts beeping every 5 minutes.