Clinic staff ask pt how to find injection site?

[MinneNurse, BSN, RN]

My apologies ahead of time if this is posted in the wrong section.

I need some advice as to if I should report a situation I experienced and who to report it to.

I'm going to try to make this quick and simple, but if more details are wanted I can elaborate.

Today I went to my clinic to get my depo-provera injection and the CMA asked me,

"So how do they give this in your hip? How do they find the right spot?"

I explained how to find the site, and she then asked me after finding the spot, "Does this look right? Is this where they usually do it?"

After having to tell her not to pinch the skin during an IM injection, she told me "you don't look like you have enough meat though."

This is the third time at this clinic I have encountered a situation where the person giving the injection was unaware how to locate the appropriate site and/or the correct technique to administer the injection.

I feel this is not necessarily the staffs fault for not being aware of the location and techniques of giving these injections if this information came into practice after they have graduated and their facility has not trained them on it.

But I am very uncomfortable with the fact that this last time I was asked by the person responsible for administering my injection how to do it and where to give it. I'm a nursing student and I have learned about the appropriate injection sites and techniques, but she was not aware of that..

[cayenne06, MSN, CNM]

Yikes. Id call the clinic manager and speak to them directly about that.

[TheCommuter, BSN, RN]

At least the MA was asking you about the appropriate site to administer the injection. Many other people would have winged it, rolled with the punches, and pretended to know what they were doing when they really don't know the difference between didley squat and a can of paint.

So be thankful for the clinic employee's bold honesty.

[Dogen]

I feel this is not necessarily the staffs fault for not being aware of the location and techniques of giving these injections if this information came into practice after they have graduated and their facility has not trained them on it.

Yeah... sorta. I mean, it's absolutely the facility's obligation to train their MA to do a procedure before letting them do it. That seems obvious... but IMs are also pretty easy, and flipping through the package insert probably would have saved her looking bad in front of you.

[Farawyn]

My apologies ahead of time if this is posted in the wrong section.

I need some advice as to if I should report a situation I experienced and who to report it to.

I'm going to try to make this quick and simple, but if more details are wanted I can elaborate.

Today I went to my clinic to get my depo-provera injection and the CMA asked me,

"So how do they give this in your hip? How do they find the right spot?"

I explained how to find the site, and she then asked me after finding the spot, "Does this look right? Is this where they usually do it?"

After having to tell her not to pinch the skin during an IM injection, she told me "you don't look like you have enough meat though."

This is the third time at this clinic I have encountered a situation where the person giving the injection was unaware how to locate the appropriate site and/or the correct technique to administer the injection.

I feel this is not necessarily the staffs fault for not being aware of the location and techniques of giving these injections if this information came into practice after they have graduated and their facility has not trained them on it.

But I am very uncomfortable with the fact that this last time I was asked by the person responsible for administering my injection how to do it and where to give it. I'm a nursing student and I have learned about the appropriate injection sites and techniques, but she was not aware of that..

When I worked in the clinic only nurses gave the injections. That meant an LPN or RN, not an MA.

[KatieMI, BSN, MSN, RN]

Then next time, when you go there, just nicely and politely tell the receptionist that 1) you want to be seen by an RN, not by MA, if possible, and 2) not to be seen by that particular MA. Done. If they ask why, tell them the truth, it may provoke some changes.

Off topic, I found out that many categories of patients actually like and benefit if asked where they want their shots, IVs and such. From chronic diabetics to FBM to ol' drug abusers, quite a few of them know their own bodies way better than I do.

[tsm007]

When I worked in the clinic only nurses gave the injections. That meant an LPN or RN, not an MA.

I worked as a CMA before being an RN and did IM injections. Not every facility has an RN or LPN some just use CMAs exclusively. CMAs do receive training on this and she should have known how to do this properly.

[MinneNurse, BSN, RN]

At least the MA was asking you about the appropriate site to administer the injection. Many other people would have winged it, rolled with the punches, and pretended to know what they were doing when they really don't know the difference between didley squat and a can of paint.

So be thankful for the clinic employee's bold honesty.

I am very thankful for her honesty, but I'm also concerned with her relying on the patient to provide information on where and how to find the appropriate injection site. It is not the patient's responsibility to have the correct answer, and I could have given her incorrect information that could have had consequences for my health (and others if she continues to perform this action incorrectly.)

In a previous experience the LPN told me she didn't know how to do it and wasn't comfortable doing it. I think that response is much more appropriate than asking the patient to give directions and guidance on how to perform a skill they may have no knowledge of. I have family members who hate needles and have to look away every time they get an injection.

Even though she did the better thing in comparison to those who don't ask at all and just go for it, I don't find that very bold. The bold thing to do would have been to tell me she didn't know how to perform the injection and she would find someone who was capable. And if she doesn't know the difference, she needs to take the initiative to find out, otherwise she shouldn't be providing patient care.

[MinneNurse, BSN, RN]

Then next time, when you go there, just nicely and politely tell the receptionist that 1) you want to be seen by an RN, not by MA, if possible, and 2) not to be seen by that particular MA. Done. If they ask why, tell them the truth, it may provoke some changes.

Off topic, I found out that many categories of patients actually like and benefit if asked where they want their shots, IVs and such. From chronic diabetics to FBM to ol' drug abusers, quite a few of them know their own bodies way better than I do.

Unfortunately, they do not have any RNs on staff. Only CMAs and LPNs. Because of previous similar experiences with other staff not being comfortable giving ventrogluteal injections, I always request to see a certain MA who performs the injection correctly. Unfortunately she is out on maternity leave right now.

I do appreciate being asked where I want my injection, I have chronic back pain from a car accident and I found that ventrogluteal injections are painless where as dorsogluteal injections leave my back hurting the rest of the day. I just don't think it is appropriate to ask the patient to show you the appropriate site.

[Pangea Reunited, ASN, RN]

The nurse who works at my doctor's office did the same thing, but I think it was actually a courtesy of sorts. She knows I'm a nurse and knows that I've taken quite a few IM injections at home for a short, but intense, treatment.

When she gave me an IM injection at the office, she asked me where to give it and also asked, "How does your husband give it at home?" I told her, "No particular place and no particular way...". She gave the injection flawlessly.

I've also heard, from other staff there, that some nurses (as patients) can be very particular about injections, lab draws, etc. I wonder if this "fact" could be influencing the MAs and the way they interact with you at your doctor's office.

The nurse who gave my injection was an RN, by the way.

[MinneNurse, BSN, RN]

The nurse who works at my doctor's office did the same thing, but I think it was actually a courtesy of sorts. She knows I'm a nurse and knows that I've taken quite a few IM injections at home for a short, but intense, treatment.

When she gave me an IM injection at the office, she asked me where to give it and also asked, "How does your husband give it at home?" I told her, "No particular place and no particular way...". She gave the injection flawlessly.

I've also heard, from other staff there, that some nurses (as patients) can be very particular about injections, lab draws, etc. I wonder if this "fact" could be influencing the MAs and the way they interact with you at your doctor's office.

The nurse who gave my injection was an RN, by the way.

That would all make sense except nobody there would have any reason to know that I am a nursing student. I've never shared that information with anyone at the clinic.

[TheCommuter, BSN, RN]

Then next time, when you go there, just nicely and politely tell the receptionist that 1) you want to be seen by an RN, not by MA, if possible, and 2) not to be seen by that particular MA. Done. If they ask why, tell them the truth, it may provoke some changes.

This request might be impossible to fulfill since many doctors' offices and clinics no longer hire RNs due to labor costs.