Any tips for giving injections?

Nurses General Nursing

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It seems that when I'm giving injections, whether IM or SC, I have a hard time piercing the skin. I hate having to "poke" a few times, as I can imagine it's unpleasant. I feel bad about this. It can't be possible that everyone has "tough" skin.

Maybe it's because I hesitate?

Specializes in ICU.
Have you heard the bleat of a sickly 4 day old lamb as you shove a tube down its nose or mouth................makes me feel sooo bad! Pt are a lot easier usually to explain why you are doing it to them!

But remember you cannot put your pt in a modified headlock like you might with a lamb to put an NG in :D :D

its also frowned upon to get a sheep dog to round them up and move them along :D Some days it is tempting though!

Don't you just feel so heartless when you hear them cry? I breed Burmese cats. Sometimes they get dehydrated and have to have SQ fluids, and they act like you are just killing them. They cry the entire time I'm giving them the fluids. I feel terrible. And tube feeding them almost isn't worth the effort, because they get so-o upset they wear themselves to exhaustion.

Wonder if I could teach a sheepdog to herd CATS? Hmmm... :D

:paw:

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Specializes in ICU.

I think speed is the key to less painful injections. SQ or IM, find a way to make the skin tight (pinch for SQ, pull down or stretch for IM). As mentioned above, let the alcohol dry. Then, dart it in quickly, and administer as quickly as you can.

I also don't understand the "bevel up" concept for injections going in at a 90 degree angle. Honestly, I pay very little attention to bevel position unless I'm not going in at 90 degrees. I do if I am giving at 45 degrees, though.

I always tell my pts their heparin and lovenox shots will burn, but 90% of them tell me it didn't hurt or they didn't even feel it afterward. Most don't even realize I've given their insulin shot already.

:paw:

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Specializes in LPN, Peds, Public Health.

I don't get the whole bevel thing either... its going to be the same whether it is up or down...

I also don't agree with the whole "darting" thing. I have never been able to dart. Everytime I tried in school (we were made to do it that way) my needle would bounce off their skin. Now, I position myself, either squeeze up the fat or draw the skin taut for IM, get my needle close, and stick it in. I never have complaints on my injections. I actually have people who will refuse to let anyone but me give them or their children their injections. Darting may work for some, but certainly not for me. I do agree that you need to be quick, but that doesn't mean their arm has to be target practice.

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The only thing I can think of is some are confusing IM injections with starting IVs where one WOULD turn the bevel up to start one.

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Specializes in Cardiology and ER Nursing.

The way I figure it is if I can give my somewhat less than compliant cats a pill and give my one diabetic cat his insulin shot twice a day there isn't anything in nursing I'm likely to encounter that I can't handle.:p Anyone who has ever tried to give a pill to a cat knows what I'm talking about.

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Show them this one first, then they wont complain about the real one.

istockphoto_6062292-doctor-with-large-syringe.jpg

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Specializes in ICU.
The way I figure it is if I can give my somewhat less than compliant cats a pill and give my one diabetic cat his insulin shot twice a day there isn't anything in nursing I'm likely to encounter that I can't handle.:p Anyone who has ever tried to give a pill to a cat knows what I'm talking about.

At least you can put a cat in a headlock also. And, I don't know why, my cats generally don't seem to mind their injections (I give my own vaccines). For some reason, it's the SQ fluids that they just hate with a passion. I've even tried warming the fluids, but it only helps a little.

PS: get a pill gun. It will save your fingers.

:paw:

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Specializes in ICU.
I don't get the whole bevel thing either... its going to be the same whether it is up or down...

I also don't agree with the whole "darting" thing. I have never been able to dart. Everytime I tried in school (we were made to do it that way) my needle would bounce off their skin. Now, I position myself, either squeeze up the fat or draw the skin taut for IM, get my needle close, and stick it in. I never have complaints on my injections. I actually have people who will refuse to let anyone but me give them or their children their injections. Darting may work for some, but certainly not for me. I do agree that you need to be quick, but that doesn't mean their arm has to be target practice.

For me, "darting" is more about the technique/wrist motion than the force I use to give the shot. It's just what works for me to be able to give quickly. I don't think the specific motion technique matters as much as being able to give quickly.

:paw:

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Specializes in Oncology; medical specialty website.
It seems that when I'm giving injections, whether IM or SC, I have a hard time piercing the skin. I hate having to "poke" a few times, as I can imagine it's unpleasant. I feel bad about this. It can't be possible that everyone has "tough" skin.

Maybe it's because I hesitate?

You're probably hesitating. Use a "darting" technique when you pierce the skin; I've seen people try to put the needle in slowly, as if being gentle will hurt less. It doesn't.

Are you palpating the area first? If someone is getting frequent injections, they can develop hardened areas that can make it difficult to inject. Make sure you check you site first before you inject.

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Specializes in Surgical, quality,management.

Also remember to tell the pt if you have given an anti coagulant ( eg heparin or enoxoparin) not to rub the site as they will get a HUGE bruise!

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