• What is your experience of venipuncture or needle change on central catheter?
• What did you feel when you make a venipuncture or a needle change on central catheter?
• How did you feel when you encountered difficulties in a venipuncture or a needle change on central catheter?
• How do you feel when the patient expresses pain in a venipuncture or a needle change on central catheter?
• How do you perceive your role as a nurse for the prevention of induced pain during venipuncture or needle change on central catheter?
• Could you specify the nursing actions (venipuncture or needle change on central catheter) in which it is necessary to conduct pain prophylaxis?
• Are there any situations where pain prophylaxis is complicated (feasibility, time, technology)?
• Are there situations where the patient refuses pain prophylaxis?
• How many venipunctures do you do during one week? How often do you perform pain prophylaxis?
• How many needle changes on central catheter do you make during one week? How often do you perform pain prophylaxis?
• Is there something you would like to add?
Nurses’ characteristics (Table 2)
Female, n (%)
Age, mean (SD)
Years of experience, mean (SD)
Pain resource nurse (%)
Number of venipunctures per week; mean (SD)
Number of pain prophylaxis for venipuncture per week; mean (SD)
Number of needle changes per week; mean (SD)
Number of pain prophylaxis for needle change per week; mean (SD)
Findings (Table 3)
Good knowledge of procedural pain
Unlimited access to the patch
Good knowledge of behavioural techniques
Multiple injection sites
Denial or neglect of the pain
Good relationship with the patient
Failure means nurse has failed
Focus on the technical task
Poor relationship with the patient
Help and support
Clear protocol established
No protocol established
Technical and relational aspects
"But they are given so many punctures. After a while, (…) it can only be painful"(N13)
"When it must be done in emergency (…) a patient whose status is very bad, we have to set up a catheter, and then there is no time to wait for anesthesia."(N7)
A few nurses reported a vasoconstrictor effect, limiting the visibility and access to the veins: "For venipuncture and peripheral catheters, I don't use any patch ('…) I think it really fades away the veins" (N11)
"I don't propose patches to patients, that's true, because I don't think about it"; (N6)"except for patients who are regularly given an injection, we know they don't hurt."(N7)
“We know if they need a patch or not.” (N6)"The patient has to insist strongly with me to have a patch."(N8)
"We are afraid there might be a penetration. That's why we generally don't put patches during needle change."N6; «It must not be overused (…) it's not good to use it on the long run"(N7)
“I blame myself a little less because it's a very temporary pain “. (N6)
“They live so many things every day (…) all the invasive procedures (…) which hurt so much (…) that a catheter, it's… almost nothing. "(N6)
“I think it's related to the patient"; (N16)
"They will react so that I feel uncomfortable”.( N4)
Nurse professional recognition
"If we clearly see it's going to be difficult (…) to give an injection to the patient, we are like "”ah a little technical difficulty", a little challenge (…) If we succeed, we are very proud"(N16)
“We feel good about ourselves, well (…) you gave an injection once to the patient and you succeeded (…) well I am pleased with myself”.(N4)
“It has to do with the efficacy of our profession"(N8)
“It kind of hurts when you think about it… you suck at your job, you cannot give an injection”. (N4)
“Cannot manage to give an injection (…) it means we're not a good nurse. I think (…) it influences our relationship with the patient. “(N16)
“We’re going to put a needle, a tube into a vein. “(N8)
”Sometimes we have to set the patient aside (…) so we have to ignore the pain to be able to continue the nursing care. »(N6)
"It must be a team commitment" ;( N8)
"I am happy to supervise young nurses (…) who have just finished school and to show them how we do it" (N 15)
“She put the patch here, so I don't see where to insert the needle, but I would do it on this one where there is no patch”. (N8)
Some participants reported the existence of a rivalry between the nurses, regarding the skill (those who did it better that day) and regarding the patients (this patient prefers this nurse). "She told me [ the patient ] could you ask your colleague who took my blood this morning, she's very talented"(N4)
"Doing a protocol to prevent pain in new patients, when we set up a catheter (…) if we do it, we won't be poorly looked upon by our colleagues saying "she's considered as the nice nurse, and I am the bad one" (N6)
"It's really too bad, because it's true we could anticipate a lot more concerning this care"; "the patients leave with a patch they have to put at home before arriving at the hospital, for instance for chemotherapies".(N5)
"It's a false problem. (…) When we know there are… in the morning (…) needles or catheters to change, we have to organize ourselves (…) to put the patch and let another colleague in the afternoon insert the needle".(N17)
“The physicians, with them, it's every day, (…) they don't check who we gave an injection to the day before, they prescribe again and that's it".(N16)
“Well, in the morning, when we have to give an injection to 8 patients, find the vein, put the patch to everyone, come back later, it's impossible! “.(N10)