Nursing students and new nurses.....about injection sites - page 2

I heard something today that just flabbergasted me......when I was in school back in the days of the horse and buggy, we had to name all IM injection sites and be able to demonstrate how to... Read More

  1. by   loriangel14
    I am in a rpn couse (5 semesters long) and we were briefly taught where the VG was but told that it is not to be used anymore.One of my classmates had a disagreement with a nurse in clinical placement about doing it( she refused) and our preceptor backed her up.Times are changng everywhere.
  2. by   HappyNurse2005
    We learned how our first semester of nursing school. then, we had to be checked off on it every semester since htey knew it was a seldom practiced skill.

    where i used to work (cardiology) i gave LOTS of flu and pneumonia vax-though all in the deltoid,a s they were 1mL.
    now, i work in labor and delivery, and betamethasone is the most common IM injection. The first time i had to give that gigantic needle in a lady's rear end i might have been more nervous than her! it looked barbaric!
  3. by   firstyearstudent
    We were given instruction but seldom get an opportunity to practice IMs (outside of flu clinics). I think one of the issues might be that few IM shots are given in med-surg units any more. Everyone is hooked up to IVs...
  4. by   TazziRN
    Thanks, guys!
  5. by   tookewlandy
    I am just finishing up my first semester of Nursing school, and we had to learn all of the IM, subQ, intradermal, sites and angles and everything that went along with them. Yes the instructor has told us we might not use them anytime soon or even ever, but as nurses we should know when, where, why and how to give those injections.
  6. by   ns lpn
    I learned them and then never had to use them untill the last few years and luckly its only B12 (IM) and insulins (s/c) which I am comfortable with. If I had to use all the different IM sites I would need to go over them first with one of the RN's or the DON. If you don't use them for years then I think you just don't feel comfortable with it.
    Also I was taught VG site which is not suppose to be used anymore according to all the new grads.
  7. by   AnnieOaklyRN
    I am a current nursing student and can honestly say that there are students in my program who still have yet to give an IM injection and we are in semester #3 of 4. I am sure there are not a whole lot of them now, but still...
  8. by   TazziRN
    I ran into the MA who works at my PMD's office and described what the other MA did, and her eyes got wiiiiiiide. She's been out of school less than two years, assured me that MA schools still teach all inj sites. The office now has pedi flu vax, I think I'll take Baby DD back there for the second dose.
  9. by   smk1
    Current ADN student, we need to know the landmarks for deltoid and ventral gluteal sites, also vastus lateralis, however in clinical the only IM opps that have come up were deltoid. I did a flu clinic for more practice (but obviously those are deltoids as well.) We go to OB/peds in January so we will have to know the preferred sites on the babies and the landmarks. It is possible that the nurse just never had an opportunity to practice IM and forgot the landmarks. These are things that I review every now and then so that hopefully won't happen. I will say that many people are still giving dorsal gluteal injections and we are not taught that because of the risk of nerve damage, so I wouldn't know the names of the landmarks for that off hand if someone asked...
  10. by   smk1
    Also shocked about giving over 1 ml in the deltoid...
  11. by   TazziRN
    I am really surprised at the answers I'm getting. We do so many glute and VL injections in the ER, I guess that's because of the type of unit? Just today we gave so many butt shots that we were walking around with syringes like they were swords! (needles capped, of course)
  12. by   smk1
    It is interesting, we are taught never to give shots in the butt, but to use the ventral gluteal site to decrease risks of nerve damage to the sciatic nerve. However, we also are on the main med surg floors right now, so most everything is given PO or IV with some SQ heparin and insulin. In January I expect to see more IM injections because of immunizations and such for the newborns and the peds rotation.
  13. by   jwilson2
    I am going to a reputable BSN program on the West coast and am about to graduate. We were taught all of the IM sites, which I still know today, but as many have mentioned before, the opportunities for practicing IM injections are few and far between. At our school there is a strong emphasis on evidence-based practice, and what we are taught is based on the latest research. We were taught that the dorsogluteal site is no longer being used because of the risk of hitting the sciatic nerve (although we do know how to landmark it), the ventrogluteal site is the preferred site in adults, and the vastus lateralis is the preferred site in babies. The max volume is 1ml in the deltoid and 3ml for the other three sites in adults. I'm sorry, I forget the volumes for newborns. I have the published articles to back this up. We're taught to always know what "best practice" is and not to do things a certain way just because "that's the way it's always been done."

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