Practice, practice, practice.

Remember the fundamentals:

Stabilize the vein, check for blood return, etc, etc, etc.

Think small. Use the smallest angiocath that will do the job. 22g and 24g are great.

Try warm moist heat to the area to prepare the veins. It's amazing what a little dilation to the blood vessels will do.

Another quick tip or two
sometimes a manual blood pressure cuff will give you more even pressure for the harder veins. And may help prevent them from blowing on you.
Another trick i've used - if you're advancing and find resistance, stop and start flushing and advance the catheter along with the fluid if that makes sense. it does help from blowing.
I know nurses who don't use any kind of tourniquet.
but the best tip is just keep trying and don't give up or get frustrated. take your time finding the vein. and small guage are wonderful til you have to have an 18 AC for a spiral ct for pe protocol!

If the vein is blowing every time, did you remember to remove the turnicate before you flushed it, after you made the hit? I've taught a lot of students and they get nurvous and forget. To help you with the steps and improve your aim try getting a chair and do it from the sitting position. This will also slow you down and relieve some of the stress. Small IV's are ok, if your not using them for anything. I always try to do at least a number 20, and supprise most times they work as easy or better. Aside from that practice is right, lots of it. Good luck.

i agree with most points, but these days you can use a 22 guage for almost anything including giving blood. The only time they aren't so good is for surgery or large quick fluid boluses and sometimes they will stand up to the bolus.

I just want to thank you all for your great advice. I had an easier time this week during precepting, because I used advice from each one of you. Thank you for taking the time to reply!

What they said........
I have been a paramedic for 18 years and am currently in nursing school and believe me your dilemma is not unique, as I see many of my fellow students having difficulty as well.

Pay attention to what everyone else said, as there are some valuable tips there, the best one is to get as much practice as possible.

I may make a suggestion or two:

1. Once you visualize a blood return in the flash chamber, be sure to introduce the angiocath another 1/16th -1/8th of an inch further (depending on catheter size as well as straightness and diameter of the vessel) before you advance the catheter and remove the stylette. If you attempt to advance the catheter immediately following the blood return, the catheter itself is not yet inside the lumen of the vessel. As a result, you will be simply pushing the tip of the catheter against the outer wall of the vein and it will not proceed into the lumen but rather kink. This allows for infiltration to follow.

2. Older folks are notorious for having hypertension and decreased vessel durability. One thing I have found that works well is to introduce the angio into the vessel and advance it slightly as previously mentioned, and then pop the turniquet off immediately before advancing the catheter the rest of the way into the lumen. This in effect drastically reduces the pressure inside the vessel and allows you to advance the catheter along with the returning blood flow, much like ljane05's suggestion of advancing the catheter with a flush. You might hear some folks call it floating the catheter in.

Anyway, I am glad to hear things have improved for you and hope that these tips might help you in the future. One thing about IV's-everyone misses from time to time.

Thanks, Deathchaser, for that advice. I used that on my last day and it also helped.

You all have been wonderful!