New Psych Nurse

pamssister · Jul 9, 2012

Hey everyone! I am a new psych nurse and have been off of orientation for about 3 weeks. I have worked in a school setting for the past two years after graduating nursing school so I am also feeling relatively new to the nursing profession. My orientation felt a little rushed because I was catchng on very quickly but I am still lacking confidence specifically when it comes to giving an IM. At my previous job I would often give influenza vaccinations but I am nervous about giving a medication restraint. I have not had the opportunity to participate or even see this occur and am fearful that I will not be prepared when the time comes. I'm looking for some tips and techniques from more seasoned nurses. What medications can be mixed (Haldol 5mg, Ativan 2mg, and Cogentin 1mg seems to be the restraint of choice at my facility) and how to shake the nerves of giving the injection to a combative patient with 10 people watching?! Any and all other tips for becoming a confident psych nurse would be most welcomed as well!!
Thanks in advance!

10 people won't be "watching"you, they will be counting on you to go in quick and confidently. Safety is priority for you and the other staff involved. You will need practice, but hopefully you will be able to watch a more experienced RN give a few IMs before you're on your own. at our hospital, Ativan and Haldol are the only drugs we mix. Everything else goes in separate injections. Hope that helps.

Jayesse7 · Jul 9, 2012

Don't worry about your nerves. I remember when I started, my hands were trembling sometimes. Take a deep breath and focus on what you are doing. I predict after the first few you'll be fine. My facility has a compatability chart in each med room. If yours doesn't, try asking a pharmacist for one.

Some tips:

*Open a bandaid and remove only one tab, then stick it on your non-dominant shoulder so you can reach it quickly if needed.

* Put a bunch of alcohol pads in your pockets

* (Our Ativan comes in 1 ml=2mg vials) If your order is for haldol 10mg ativan 2mg, draw up the Haldol first and inject it into the ativan vial. Ativan is thick and the haldol makes it easier to draw it back into the syringe.

* Make sure you don't try to inject anyone who is thrashing around until your support staff gets them still.

* Sometimes it happens that you can go through a blood vessel so that when you aspirate your site looks clear but when you remove the needle blood begins to flow....IT'S OK! Thats why you need extra alcohol pads in your pocket. Just put pressure on the site til the bleeding stops.

* You can ask another nurse to hold stuff for you too.

In the case of a combative person you do need to be fairly quick about what your doing so dont be shy...get in there! Climb under or around til you get a good space and don't feel some kind of need to lay everything out and measure out your injection site like you did in school but pay attention to what you are doing and DO IT, then leave.

Give good shots. You don't have to stab like a dart but don't go slowly when inserting the needle. I've seen newbies kind of set the needle on the skin and then push... don't. A smooth steady insertion is most comfortable. BUT above all remember, nobody is as critical as you are on yourself. Tell yourself; "You've got this".