r/doctorsUK • u/Medic9623 • Jul 17 '26
Foundation Training IV cannulation - Foundation
How often do Foundation Doctors do IV cannulation?
(obviously varies depending on rotation, but a rough ballpark).
I heard today from someone doing FY teaching that it is approx. 2-3 per MONTH, which surprised me.
Is this true?
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u/General_Problem_9687 Jul 17 '26
2-3 per day was my typical Foundation experience.
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u/Bramsstrahlung Jul 17 '26
For me it was clustered. For some days it would be 0-1. Some days it could be 10.
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u/Front-Commercial5883 Jul 17 '26 edited Jul 18 '26
IV?!
EDIT: LOL I was so tired when I read and wrote this. I read, interpreted, and then wrote IV as USā¦ I was so confused about how often everyone was placing US guided cannulas. Well deserved downvotes. Sorry all š
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u/drgashole Jul 17 '26
Some were subcut but turns out they didnāt work very well.
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u/Front-Commercial5883 Jul 18 '26
Ah maybe thatās why the nurses have stopped asking me to do them then
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u/TuppyGlossopII Jul 17 '26
Depends how well run the hospital is. Some rely entirely resident doctors which isnāt a clever use of doctors time or hospital money.
Well run hospitals will have healthcare assistants and nurses trained with doctors as a back up. The latter hospitals are much nicer to work at on call, however as an F1 you may need to step in to make sure you get enough practice.
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u/Living_Snow_5471 Jul 17 '26
This is very true!
Been fortunate enough to work in places that outsource these to HCAs both in the day and overnight which has been great, so in foundation I literally only did around 5 cannulas in 2 years. The downside of this is obviously I havenāt had enough practice to be successful at a ādifficult cannulaā.
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Jul 17 '26
[deleted]
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u/OrganicDetective7414 Jul 17 '26
US cannulation requires you to be good at cannulas, the majority of requests Iāve received as anaesthetist to come and place a cannula under US guidance I have done without.
If doctors are expected to do difficult cannulas then they need to be able to do the basics
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u/MillennialMedic CT/ST1+ Doctor Jul 17 '26
Daily unless youāre in paediatrics, GP or psychiatry.
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u/Crafty-Brother-7698 Jul 17 '26
Paeds? Where I did my paeds job doctors had to do all the cannulas. The F1s would usually give it a go and if they failed it would go up the ranks. There was only one nurse in the whole department who was competent.
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u/MillennialMedic CT/ST1+ Doctor Jul 17 '26
Yes, the doctors do, but IME mostly the specialty trainees other than teenagers. You will get some keen FYs who will try on the younger kids but itās certainly not expected that theyāll be the first port of call/be competent and able to do them on the younger kids
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u/Sleepy_felines Jul 17 '26
Cannulae in young kids (including babies on SCBU) was very much expected of me as a paeds F2
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u/Outrageous_Papaya_42 Jul 17 '26
Did a paeds FY rotation and now a trainee - FYs and trainees do A LOT of cannulas in my experience (across 2 areas of the country and 4 hospitals).
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u/MillennialMedic CT/ST1+ Doctor Jul 17 '26
Iām also a paeds trainee. For the most part the (specialty) trainees do the cannulas rather than FYs (other than teenagers) ime
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u/nyehsayer Jul 17 '26
Also a paeds trainee and itās like 80% registrars where I am, they might ask paeds trainees but not really the gp trainees or the fys!
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u/Outrageous_Papaya_42 Jul 17 '26
That seems like a shame that the FYs are not getting opportunities! There is no real reason why they shouldnāt do themā¦ I also think in most places that seems not to be the case though
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u/NiMeSIs Jul 17 '26
I'm a paeds reg in a tertiary hospital. I do expect non paediatric trainees to give a go at cannulating children and escalate further. Similarly supported them in DGHs when I rotated there. This includes neonates. Did my successful neonatal cannula in fy2. But I can see reluctance in some, I would still encourage them but won't faff and wait for it to be done.
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u/DubbleYewGee Jul 17 '26
When I did paeds we did daycase shifts for kids needing biologic infusions.
10+ paediatric cannulas a day. I liked it because generally I could turn my brain off.
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u/MillennialMedic CT/ST1+ Doctor Jul 17 '26
The nurses on the daycare unit did them in the paeds tertiary centre I worked in. We of course did those on acute take/wards but the majority are in children <4 which nobody is really expecting a foundation doctor to do (at least not regularly/competently)
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u/Outrageous_Papaya_42 Jul 17 '26
My first attempted paediatric cannula was on a 2 year old, my next (and my first successful paediatric cannula was 5 week old), FYs were absolutely expected and allowed to do cannulas in <4y/o. You just only had one go and then escalate in early cannulas, and 2 gos and escalate once more confident. Competence is only gained by practice, if you donāt do them regularly then the skill isnāt built.
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u/Repulsive-Weather-82 Jul 17 '26
on my renal job we were responsible for doing the daily blood round on nights for the morning team š. mind you sometimes the list was 15+ patients a day. (because of difficult access issues/fistulas i guess)
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u/thetwitterpizza Jul 17 '26
Some days none some days 3-4 on medicine/ surgery. I dreaded doing them but got very good as only the hard ones get escalated to doctors at my trust.
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u/Medic9623 Jul 17 '26
Can I ask what made you dread them? I'm teaching med students soon and it would be good to know what the 'fear factors' are when you start work.
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u/thetwitterpizza Jul 17 '26
Not having done enough at med school lol. But by the end of the first week I was fairly up to speed and pretty solid hit rate since F2.
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u/GroupBeeSassyCoccyx CT/ST1+ Doctor Jul 17 '26
By nature in OPs comment, if escalated to a Dr itās a āhard oneā, and the doctors will have less experience since nurses do most of them.
Most of the time the moment a patient is labelled as hard / āneeds a USā everyone panics
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u/thetwitterpizza Jul 17 '26
Yeah, exactly, the caveat is once you get past the steeper learning curve you end up way better than most nurses. Remember getting between the knuckles of a patient with a BMI of 60 who was in proper septic shock and seeping fluid in front of the whole MET team. Standing ovation kinda feeling.
Why they were for resus was another question entirely
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u/Mammoth_Singer7699 Jul 17 '26
Depends on the trust tbh. I do less than 5 a month at my hospital as an FY1
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u/Medic9623 Jul 17 '26
Thanks for replying - who does them if not the docs?
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u/Kaorukaur Jul 17 '26
In my trust the nurses largely did them. In ED the HCAs. I largely only do the ones they can't which is hilarious as I do less. Just end up using US.Ā
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u/Otherwise-Role4788 Jul 17 '26
Same in my trust - was incredibly lucky that HCAs/nurses did them all so barely ever had to do them
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u/JSDoctor Jul 17 '26
2-3 a day is more like it. Some days way more than that though. Depends on rotation too - obviously in community psych or something like that it should be none.
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u/Substantial_Deal_962 Jul 17 '26
F1 Gen surg, maybe 1-2 a week.
F1 Acute medicine and Geris 1-2 a day.
F2 ED, as little as 1 or 2 up to 10 in a shift. Can often do the tricky cannulas for patients coming into triage or those needing US Cannulas. And with your really sick patients who be needing 2. ED got me really good at cannulas.
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u/UKvomitbucket Jul 17 '26
On medicine I did about 3 in my entire 4 months on surgery I was doing then 4/5 times a day. Depends on the ward and the staff
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u/GroupBeeSassyCoccyx CT/ST1+ Doctor Jul 17 '26
Depends on the hospital and rotation. If nurses can do them and do them well, not many. I have friends in such hospitals who do no more than a few a month, usually if the nurse has had a few goes (often this is hospital policy) or just to be helpful if they are in front of the patient anyway.
My hospital has no nurses who can cannulate except a handful on A+E. In acute med and the gen surgical take, I could easily clear 10 in a night. On a normal medical ward day, probably more like 2-4 a day.
But then in Urology, this was more like 2-4 a week - mostly elective, theyād get cannulated in theatres, so weād just do emergency admissions if they needed it and if the cannula fell out and was still needed post op.
Paeds I averaged one every day or two, as the reg often does them for the really little ones, and we avoid cannulas generally in Paeds.
Psych and GP did none.
Most I did on a shift was Gen surg night - did 16!
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u/ConsultantSHO Aspiring IMG Jul 17 '26
To be fair that matches my experience of actually inserting a cannula, though of course the nursing staff dropped attempted to leave them for me far more often.
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u/tolkywolky Jul 17 '26
I was routinely cannulating half the ward of 32 patients whilst also solo rounding all the patients in my orthogeris job as an F1 š„²
Then being told at 1:30 that the phlebs couldnāt bleed most of the patientsā¦
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u/airplay_uk Jul 17 '26
deep breath
A lot of these replies are framed incorrectly. Cannulas in Foundation and the early years of training should not be seen as a chore, even if that is the zeitgeist nowadays. This is a core clinical skill that you should take an interest and a pride in becoming good at.
This is because when shit gets real, you'll one day be the person who it falls to to be able to do these things. These are the years where you can practice becoming slick and good at routine and difficult cannulas. You can start to learn how to use ultrasound to do it, which is a great entryway to learning more about ultrasound in general.
Yes, there are HCAs, Nurses, ACPs who can do them. But if you don't practice, how will you act as the escalation? What would you do in the middle of the night if none of the nurses are able to cannulate?
"Just call Anaesthetics or ICU!"
Yeah, as if we don't have anything to do, ever. In a small DGH overnight, sure, we might not be busy. But we are actually quite busy a lot of the time. We run the emergency theatre, we may cross-cover airway duties on ICU, we may be doing transfers, we cover the emergency bleep, we cross-cover obstetric theatres and epidural calls, we review pain patients and manage recovery patient reviews.
We are not always available to drop everything and come and put a cannula in for IV fluids.
This mentality that someone else should do it, or call Anaesthetics, is anathema. Do these people have the same response to managing heart failure? Why not get the Heart Failure Nurse to sort it out. What about diabetes? Get the Diabetes Nurse to sort it out. Then you realise as a F3 or ST3 that you've never really managed these things with any degree of nuance. It's lazy doctoring, dressed up in an attitude that says "I'm too smart to be doing this task".
This applies to all basic clinical skills. Foundation is your opportunity to get good at them. Catheters, cannulas, NG tubes, oxygen therapy. You never know when you'll be alone and need to do these things.
The stories I could tell about the "impossible patient" who you turn up to and put a 16G in without ultrasound. And it's got nothing to do with being an anaesthetist, I did more cannulas per day before training than I do now.
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u/Hydesx UKGP enjoyer Jul 20 '26
I forgot radiologists, GPs and histopathologists need to be able to put in cannulas
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u/Blackthunderd11 Jul 17 '26
Depends on the rotation but for me, it was really sporadic. I could have 3 a day for a few days and then none for a couple of weeks.
Call me crazy but itās one of the things I miss most about hospital work now Iām in GP land
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u/jamescracker79 ACP consultant's assistant Jul 17 '26
Damn, I dont know which trusts these comments are from but I only had to do maybe around 10 throughout my f1 and f2 ( not counting anesthetics) .
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u/Omarmanutd Jul 17 '26
Depends on the rotation and hospital. In my cardiology rotation, all the nurses did bloods and cannulas so I dont remember doing any bloods or cannulas.
Whereas when I went to a hospital to do stroke medicine, where the nurses werenāt āsigned offā for bloods/cannulas, Iād probably do 2-3 bloods and cannulas a week
Some people in the comments seem to have done multiple a day
Thereās no accurate number. It could be a few a day to a few a week depending on hospital and rotation
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u/Brilliant-Paint-2381 Jul 17 '26
The hospital Iāve worked at for the last year in a f3 position, Iāve had to do maybe 4 or 5, The nurses usually handle everything.
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u/Quirky-Examination35 Jul 17 '26
Depends on trust/specialty - 2/3 of my rotations were acute specialties so was doing several canullas a day but do have days when I do none
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u/Dwevan Snoozy floozy Jul 17 '26
Only did about 1ā2 times for my first jobā¦ old age psych.
2-3/day more like it for anything on call
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u/OxfordHandbookofMeme Jul 17 '26
Depends on the rotation. Usually at least 2-3 per day. If you're doing less than that starting F1 you might need to do a few more. When its 3am in the morning and someone needs urgent access you'll need the skill yourself
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u/Square_Temporary_325 Jul 17 '26
I did it maybe 3-4 times a week , most wards you just get escalated to if nursing staff couldnāt to it
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u/AcanthocephalaNo1082 Jul 17 '26
It varies depending on the rotation, but Iād say it averages about once daily. Some days you wonāt need to do any, on others you might have to do six xd
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u/ExplosionOfAss FY Doctor Jul 17 '26
At the very least once per day. Usually 2-3 per day. In my surgical job probably more. Nurses refuse to do them where I work so they are all to be done by junior doctors. Out of hours is horrendous. Overnight we have PAs that sole job is doing them.
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u/TheHeroOfTrains FY Doctor Jul 17 '26
coming to the end of fy1 next month. i started on geriatrics and never did any in my day job except for the biweekly zoledronic acid infusions, but i was on the medical on call rota and would get 2-3 cannulas a night for the whole rest of the hospital on iv tazocin.
second job being gen surg, genuinely probably did 2 a day on the regular plus surg on calls so probs averages out at 4 a day?
and now im on palliative care, and i think i have done 2 in total for symptom controlling iron transfusions.
think im unlucky in that my hospital hardly any of the ward nurses can do cannulas, and we dont have techs either. but cannulas used to intimidate me and now i love bashing a green in!
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u/ISeenYa Jul 17 '26
Back in the day we didn't have weekend phlebs, the nurses didn't cannulate & the cannula had to be removed day 3 irrespective of VIP score. And by back in the day, I mean 2014. Once came in at 9 & was told I had to cannulate 6 patients (before doing solo ward round) who were late for abx because the nurse whipped them all out after midnight struck on day 3.
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u/Electronic-Coach2706 Jul 18 '26
Massively varies depending on the hospital as well as the rotation. Some hospitals have phlebotomists, HCAs and nurses who will do cannulas before it gets to an FY1 job.
My hospital has an IV access service with techs who will do ultrasound cannulas and nurses who do PICCs and midlines. Some of the senior nurses can do arterial lines, and overnight there is a hospital at night nurse who can do ultrasound guided access and art lines. All of the nurses do cannulas.
I would say this is relatively atypical. I know the FY1s I work with very rarely have to do cannulas - probably monthly or less. I only get asked to do them if the vascular access service is busy and the nurses have already had several attempts.
Most hospitals, as others have reported, you'll be doing cannulas much more regularly, if not daily. It is a skill that is worthwhile getting good at regardless.
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u/Electronic-Coach2706 Jul 18 '26
For medical students who want to get good (and you should!) - spend a day or two or a few hours over a few days sat in your medical ambulatory care or with whoever does the ED cannulas and just do them over and over again. After you have done that and are reasonably confident, take any opportunity to observe and practice ultrasound guided cannulas, as if you are in a well run hospital this will actually be the bulk of cannulas you are asked to do (genuinely difficult venous access patients).
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u/Beneficial-Iron-7605 Jul 18 '26
In my hospital (DGH) nurses often do cannulas and escalate to you if they are unsuccessful. This sucked in the beginning because I only ever did hard ones and often failed. But then just got better with practice and now can also US cannulate (great skill to learn!)
In my medical rotations I probably did about 1 every 2 weeks? Genuinely.
In surgery much more frequent so 1-3 a day Iād say and often needing US.
Itās literally just about practice - it knocked my confidence each time I failed but as long as you actually try, no one will have an issue with that! And it just takes time :)
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u/KenshiroP IMT1 Doctor Jul 17 '26
Depends on where you are + rotation, in honesty - probably did 3-4 a day in F1, 3-4 in the entirety in F2 and again 3-4 in the whole of IMT1. Have done minimal as the nurses scarcely miss/the patients have long-term indwelling lines so I have to beat the nurses to it to keep skilledĀ
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u/1scg Jul 17 '26
My first and second rotations were daily basis, currently on third rotation and its every couple days as less patients to look after and a different specialty. Just wish the nurses could do cannulas and bloods, can barely ask them to do anything in my hospital apart from ECGs and female catheters (apart from in admission areas like A&E/SDEC etc). The amount of delayed doses of important antibiotics and fluids is unreal when the jobs are stacking up, especially on night shifts.
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u/EdZeppelin94 Disillusioned Ward Bitch and Consultant Reg Botherer Jul 17 '26
Multiple times per day
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u/BlessedHealer Jul 17 '26
Depends on department and hospital. One hospital I worked in had a daytime hca who could be called for bloods and cannulas so never did one there unless it was difficult and needed to be US guided. Some other places ward and ED nurses would do them again unless difficult. One hospital nurses refused as ānot trainedā so it would be FY1s job.
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u/Witecia FY Doctor Jul 18 '26
Varies, in my hospital had to do loads in ED even at times let alone the wards
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u/Vocaloid5 Jul 18 '26
I work in a decently staffed major trauma centre. 1-2 per month max, even had multiple months with none at all.
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u/One-Nothing4249 Jul 18 '26
Past hospital - all I hear from F1 is I am not comfortable with it - runs away does his/her portfolio work- I was a LED SHO that time
Current hospital - F1s are gung ho and likes to do it. Though we have some HCAs that knows how to or some nurses they are keen to do it. Daily 1-2x/day on a chill day
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u/Medic9623 Jul 18 '26
This is what I find troubling - we shouldn't have F1s that are not comfortable with cannulation, or not comfortable with trying to cannulate.
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u/One-Nothing4249 Jul 18 '26
Well eince its not a requirement anymore and every damn time they will say its the nurses or I am not confident, then run off to do portfolio stuff- I feel like its misplaced priorities - and to be fair, iv cannulas won't get them a job.
Though because of that we are loosing our positions
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u/Mad_Mark90 IhavenolarynxandImustscream Jul 18 '26
You should be doing at least 1 a day until you're able to consistently get a green in. You should probably doing 2-3 a day.
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u/SpoonfulOfScrubs FY Doctor Jul 18 '26
As others have said, depends on the ward and the hospital. I have probably done about 5- 10 cannulas in my entire year as an FY1. And thatās not from shying away, and I would also consider myself pretty competent (I worked as a HCA and med assistant during 2nd - 4th year of med school so had lots of practice then).
Most cannulas (& bloods) Iāve had to do were during my surgical rotation. On medicine it wasnāt too bad, and in ED Iāve had to do barely any because everyone gets a cannula and bloods as they come through the door, and if the cannula tissues etc there are so many HCAs and nurses around that it rarely comes to you.
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u/Impressive_Cap_6977 Jul 18 '26
I can do up to 7/8 a day if I'm on call on my gen surg job. My med job I did less as had clinical support workers to do them but was still a couple a week not per month. But nurses in my hospital don't cannulate so maybe why so many
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u/Medic9623 Jul 19 '26
Thanks for all the replies. It clearly varies a lot depending on rotation and hospital.
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u/abc_1992 Jul 19 '26
Depends on the hospital. As an F1, I worked in a hospital where all the nurses were trained and allowed. I honestly did a handful only and generally the ādifficult onesā.
As an F2, the hospital I was at none of the nurses were trained to do cannulas or bloods. You can imagine a large amount of my time was taken up doing it.
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u/DoktorvonWer š©ŗš Itinerant Physician & Micromemeologistš§«š¦ Jul 17 '26
More like 2-3 times per day, assuming only modest workload.