I'm a nursing student and this is second time I've pricked a patient for glucose monitoring. I did everything right I thought, alcohol wipe, pricked the side of the finger, and the patient complained in front of my preceptor that that was the most painful prick he had. He said in general the pricks here are painful and leave marks- the needle is longer at the hospital. The one time I felt I did everything perfectly is the one time I get yelled at and so now I feel unconfident. Did I push the needle in too hard? Is there such a thing as pushing too hard? I wanted to make sure to get the blood. That' the only thing I can think of....
In some ways while my internship is making me more confident in other ways it's making me less confident. I just feel like I'm a slow learner, like I need to do things 3-4 times before it imprints in my brain and even then I'm slow for some things, like filling up a syringe from a vial. Did anyone else feel this way?
Also, this is a stupid question, but whenever peal the backing of a medication, it doesn't peal fully so I have to push it out and twice now it popped out and once it fell on the floor. So I go really slow just to make sure it stays in the med cup. What am i doing wrong??? Grr, nursing makes me feel dumb
I always ask the patient if they have a preference for which finger they'd like me to use. Most don't, but I tell them I like to spread the joy around and that I am just making sure I'm not using a finger that's been used the last 3 times. They seem to appreciate that, even if they don't care which one I use.
I never use the pointer finger....not sure why not. In my own experience, that one seems to hurt more (although I know everyone is different......I remember donating blood one time, and they used my earlobe to get a drop to do the iron test. The lady told me they started using earlobes instead of fingertips because they hurt less; I did NOT agree with that assessment!). I check my own blood sugar once in a while, I have episodes of hypoglycemia here and there (they don't know why) and I test it when I'm symptomatic (just out of curiosity, I of course treat it either way....I've had it drop as low as into the 30's). I tend to use the outside of the tip of the pinky finger, that's always the least painful for me.
The lancets where I worked didn't have a depth setting, but it would feel dramatically different if you rested it just against the skin vs. pressing it down. I tend to put a fair amount of pressure on them, especially with people who have been checking their sugars for years and have thick/numb skin. Too many times I've had to run for a second lancet when what *should* have been a perfectly reasonable poke gave me NO blood in return, no matter how much I would work the finger. Some people DO need a good (surprising) amount of force behind it. If someone is on sugar checks just because they're on TPN, though, I definitely start off with a lighter touch, because their fingers aren't used to it.
When I was a nursing student, I was doing clinicals in a local hospital and I had 3 patients to do FBSB's on. The first two were males with thick skin that I had to really try hard to prick. The last was an elderly lady with delicate feminine fingers. Right as I stuck her, I realized I used a bit more force than necessary. She graciously waited until I was finished before stating in her southern belle drawl... "Deah, that was just fine, but next time you might want to just prick it a little - you don't need to get a runnin' start and jab it like a spear!" What a trooper!
TRACEY RN - that story was priceless and way too funny!
as a senior in my last semester of a BSN program...there are times that I feel like a failure everyday....I try to keep my chin up...I've also been lucky enough to have clinical instructors who were very supportive if I erred....
The facility where I do my clinical rotation use scanners (dolphins) and to see me try to work those things to enter information. most of the pens that came with the units are missing so you have to use your finger to type in the information...I swear that Christmas comes and goes every time I encounter one...the patient's must think that their in the middle of a sitcom at times.
I always have an issue with pushing the meds out so sometimes I use my scissors. That way I cut right to where I need it to open. Only downside is that the pill could crack or the capsule could tear. I think that will go away as you do it more often.
As a diabetic RN, I can say from experience that the hospital lancets hurt way more than the ones we use at home. And to say that a pt is a baby because they say it hurts sounds rather judgemental. Before I was diagnosed, I often felt that way about some pts as well. But, if a diabetic is in hospital, and having blood glucose checked with those awful lancets four times a day or more, the fingers become very painful. If a pt tells me it hurts, I just say "I know, trust me I know". I am one of those pts who always does it myself if I am capable of doing so simply because I know what fingers give blood easier, and then I only have myself to blame if it hurts. I use the shallow setting on the hospital lancets, both for myself and my pts. One trick my diabetes nurse taught me is to put your hands together as if you are praying. Avoid poking where your fingers touch each other - in other words, avoid the pads of the fingers because it hurts more. I have taught that trick to many pts, and they are usually pleased to find out there are places to poke that don't hurt as much. As a student, you'll learn what works best for you. We all have.....
and that I am just making sure I'm not using a finger that's been used the last 3 times. They seem to appreciate that, even if they don't care which one I use.
Anna Flaxis, BSN, RN
1 Article; 2,816 Posts
Agreed, I do typically ask the person if they have a preference for where I poke. Usually, they don't.