I have been holding this in for a while and I feel like only other nurses will truly understand what I am about to admit. I am a nurse, and I absolutely judge patients based on their veins. I know it sounds strange and maybe a little unprofessional, but it is honestly part of the daily mental battle that happens in healthcare.

Whenever a patient walks in and I see big, straight, steady veins that look like a dream to work with, something inside me lights up. I feel this rush of relief because I know the IV will go in smoothly and the blood draw will be quick. Those patients instantly become the MVPs of my shift. My stress level drops and I feel like the world is finally cooperating with me for once.

But when someone has tiny veins or veins that keep hiding under the skin or rolling around like they are sprinting away from me, my brain immediately goes into quiet panic mode. On the outside I stay calm, gentle and reassuring because I know patients already deal with anxiety, illness, pain and fear. On the inside it feels like I am preparing for a mini battle. I start mentally mapping strategies, thinking about angles, imagining where the vein might shift, and hoping I do not miss.

I always act confident because the last thing I want is to make someone feel ashamed. A lot of patients apologize for their veins and I always tell them it is not their fault. And that part is true. I never blame them. But inside I am definitely evaluating everything. Nurses talk about this all the time and it is such a hidden part of the job that most people never think about.

So yes, if you have ever wondered whether your nurse is secretly analyzing your veins, the answer is a very honest yes. I do it every single day. I do it while smiling and encouraging people, but the internal commentary never stops. Sometimes I feel guilty about it because I know patients can’t control their anatomy. Other times it feels like survival mode in a busy healthcare environment.

This is one of those strange medical confessions that sounds funny on the surface but is rooted in real stress, real pressure and real human reactions. And I guess I finally just needed to say it out loud.