The use of IVs for medication administration is an essential component in healthcare and benefits the patients (Castro-Sanchez, Charani, Drumright, Sevdalis, Shah, & Holmes, 2014). Obtaining intravenous access is a specialized nursing skill that requires a combination of clinical knowledge and psychomotor coordination (Ramer, Hunt, Ortega, Knowlton, Briggs, & Hirokawa, 2016). Difficulties created by vein size, obesity, and tortuosity can make even a skilled staff member struggle which then can lead to delays in treatment (Idemoto, Rowbottom, Reynolds, & Hickman, 2014). A single phase survey was conducted in a rural southwest Missouri hospital in order to assess confidence levels in IV skills, the approximate percentage of IVs successfully started, and to examine the willingness to learn how to use an assistive device, such as an ultrasound, in order to administer difficult to start IVs. Sixty-six nurses were surveyed with a 41% response rate. Confidence levels of IV skills were high among all participants along with percentage of successful IV starts. However, the willingness to learn how to utilize an assistive device in order to start IVs was also high. The information gathered could lead to implementing ultrasound training and use for more nurses when starting difficult IVs in order to expedite medical care, improve nurses’ confidence levels with IV skills, and improve overall patient satisfaction