I've had them several different ways.
My first was placed in an oncology office by a nurse (in the crook of my arm). It took two attempts, but the second one went in quite easily. They used numbing cream.
My second was placed in interventional radiology. This was my very worst experience. For three hours, they stuck me and finally were reduced to cutting down to deeper veins. They tried up and down both arms. Each time, they would get it partially threaded, and the vein would close up. Two different people tried. Eventually, they said it would be the last try since there were no more options for sites, and that one sailed right in. Afterwards, the nurse told me--"I've seen some bad PICC placements, but never anything like that!"
After that, all of them were done bedside by a member of the PICC line team at the hospital. One lady put it right in on the first try two different times. The other ones all took multiple attempts but did eventually get them in. The last one was finally done with no lidocaine because my veins seemed to stay open better that way. It really wasn't too bad.
Needless to say, I love my mediport!