Maternity Rotations and Overbearing parents

  1. Hmm our first real day on maternity and I was ask to give a Hep B Vaccination to a 1 day old, a patient that wasn't my assigned one, but I was glad get the experience so I quickly accepted the task. Fortunately all goes well and the baby is back in his parents arms shortly. Now comes the awkward situation, my patient is also due for a vaccine but not to "hog" the experience my instructor suggests that I let another student give the injection. I quickly agree but this time it goes differently. The father of the child insists in following us to where we were giving the injection ,preceding to stand over my classmates shoulder while she was giving the shot. Agh I could see the stress in her eyes I felt so bad for her especially since this patient was my responsibility.
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  2. 12 Comments

  3. by   RNIAM
    That is too bad. It is sad when stuff like that happens. Did she make it through alright?
  4. by   OBNURSEHEATHER
    Hi there, and welcome to the board!

    I want to start off by saying that OB and Peds are particularly difficult areas to work in because not only are you dealing with a patient, you are dealing with their parents. You are poking and prodding at their most prescious and prized posession. I know it's hard when you're learning and tend to be nervous, but try not to take it so personally.

    I'm sure your classmate was stressed. These new experiences and skills are scary enough, let alone on a newborn.

    It sounds to me like both of your patients babies got the vaccine, so why the student/baby switch? I would nicely remind the instructor that continuity of care is very important, for both the nervous student, and the nervous parent!

    Good luck!

    Heather
    Last edit by OBNURSEHEATHER on Sep 6, '02
  5. by   mark_LD_RN
    I have to agree with heather for a change,. the child is the parents most prized posession. we were always present when procedures were done on our children no matter what. peds and OB are some of the most diffucult areas to work because of that reason. also the continuity of care issue is a big concern. I personally would have done the shot my self. remember the patient is a person not just a procedure. we never rotated procedure on patients as students and i don't have my students do it either.
  6. by   kimmicoobug
    Yeah, I totally understand. I chose to do one of my clinical rotations this summer in a peds clinic so I got to give infants vaccinations all day for a week. Before that first day, I had never given an IM at all. Needless to say, I was nervous and overreacted when one of my patients started to bleed from the site. Not a lot, but enough to freak me out. I just said, "but I aspirated! How could have hit a vein!" Totally stupid of me, because the parent became overly concerned and looked at me like I was totally incompetent. Actually, I probably was with IM's at that time. However, the nurse calmed me and the parent down and said she witnessed the aspiration and that some kids just bleed sometimes when stuck.

    My instructors usually don't like to switch students on patients because it can make the patient uneasy. However, if it is a procedure like NG tube placement, or a catheter, or a complex dressing change, then an exception is made since those are fairly hard to come by here. We get a lot of OB rotations in our program so a Hep B injection doesn't seem to be pushed alot.
  7. by   zacarias
    Originally posted by kimmicoobug
    Not a lot, but enough to freak me out. I just said, "but I aspirated! How could have hit a vein!"

    Hey!

    Kind of on topic, but I recently heard from someone who read this in a reputable source (I know...lol) that aspirating is not necessary anymore. Something about it not being scientifically proven to actually benefit. Anyone know anything about this?


    Z
  8. by   OBNURSEHEATHER
    Originally posted by mark_LD_RN
    I have to agree with heather for a change
    I didn't know we disagreed on so many things Mark

    Heather
  9. by   NurseAngie
    Originally posted by zacarias



    Hey!

    Kind of on topic, but I recently heard from someone who read this in a reputable source (I know...lol) that aspirating is not necessary anymore. Something about it not being scientifically proven to actually benefit. Anyone know anything about this?


    Z
    My text book says that apirating is no longer necessary on SQ injections ONLY! ALWAYS aspirate when giving an IM injection.
    {I got this info. from Basic Nursing Essentials For Nursing Practice 5th Edition By Potter & Perry on page 329 &330 and this book is copyrighted for 2003 so it should be extremely current}

    ~Angie

    I in NO WAY mean to offend your "reputable source" and I hope this helps!
  10. by   Swiftee
    "overbearing", huh? You must not have kids. Ditto for me with Mark and Heather.

    Good luck!
  11. by   delirium
    I think I would be concerned if a new nursing student was handling my newborn, too. Don't think I'd categorize that as 'overbearing'.

    And I've heard it is no longer necessary to aspirate insulin, but besides that, I aspirate all injections ('cept heparin, of course).
  12. by   kimmicoobug
    Yeah, I was taught to aspirate all IM injections to make sure you don't hit a vein and inject the contents of the syringe into the vein which could be a bad thing. I wouldn't feel comfortable giving an IM without aspirating since I am still not great at identifying the landmarks.
  13. by   mark_LD_RN
    really just a few times heather
  14. by   jloihle
    maybe the term Overbearing is a little harsh and yes I do have children. What I was really referring to is that i felt guilty because of the added stress my classmate had to go through in giving her 1st IM.

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