Needle insertion, for example for venepuncture or intravenous (IV) cannulation, is a common intervention experienced by patients. However, up to half of venepuncture and IV cannulation procedures fail on the first attempt, resulting in further attempts. Multiple needle insertion attempts can lead to pain and other complications for patients and can take up staff time and increase equipment costs for hospitals, so it is important to ensure that needle insertion practices and outcomes are optimised. This article reports the results of a US survey that aimed to provide an insight into patients’ and nurses’ perspectives on and experiences of needle insertion. The results show that multiple needle insertion attempts are common and that associated complications have a detrimental effect on patients’ satisfaction with the procedure. The results also suggest that patients and nurses are interested in alternatives to needle insertion, such as ultrasound guided IV cannulation or needle-free blood collection. Nurse leaders should be aware of these technologies and consider the implementation of sustainable initiatives to evolve practice.