Difficult diabetic resident

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Hello fellow nurses =)

I recently got a job at an assisted living facility and I love it! I've been working there for about 4 months now and got used to the residents, my co-workers, and my daily tasks... however I have one task that I seem to dread everytime and that is giving insulin to one of my diabetic residents....

In school you are taught to rotate injection sites, inject where there is most fatty tissue, and if in large insulin dose (inject slowly or it will cause pain and burning) With this resident however wants it in the same arm (same spot too where there is less fatty tissue) and inject FAST!!! i mean it would just take you 1 second...(according to the resident)

It seems all the time i do it the resident screams (saying it hurts, you do a bad job, etc...) however when i ask my co-workers to do it the resident doesn't say anything...

I tried to tell the resident we should at least change the spot but always refuses and i learned from my co-workers that the resident wants it fast and in the same area...

I really don't know what else to do... ive asked my coworkers their techniques but ive always seem hurt my resident (which i dont want =( ) I've never had a problem with my other diabetic residents so im not sure if its the way I inject or just that the resident doesn't like me...

This is probably more like a rant than question haha but/ what are your guys' thoughts? Do you guys any similar incidents'? perhaps suggestions?

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If the resident supposedly "screams" with just you, do you think maybe she doesn't like you OR maybe you are doing it wrong? Does she let the other nurses rotate sites?

I never learned to inject insulin slowly btw. I do it fast.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I also inject insulin quickly. The slower you inject, the more uncomfortable the patient will be. Why draw out an uncomfortable process?

In this day and age of self-entitlement and increased attention to 'customer service,' I give patients whatever they want so they won't report me or complain. So if a diabetic wants the injection in the same arm, I'm going to administer the insulin wherever they tell me to give it.

Some patients want things done their way and will shut out any education you attempt to give them. It is best to identify these patients early in the process and not waste your valuable time and effort teaching them the right way.

It is also possible to rotate sites within the same body part, as long as each injection site is spaced 1.5 inches away from the previous shot.

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Specializes in nursing education.

Many people left to their own devices will inject in the same one or two spots which leads to lipohypertrophy and poor absorption. As the professional you do need to encourage rotation. It only has to be one inch though. Also I did a lit review on this and what is found in RCT's is that the finer the needle, the less the discomfort- pain is correlated much more with needle gauge than length.

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Thanks for the reply =) she does not let the other nurses rotate sites but i guess my coworkers mastered the technique to deliver insulin for this resident.

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Thanks for the reply =) well i guess with my other diabetic residents they prefer i inject slowly rather than fast.

The problem is that my residents shows me where to inject to a specific spot in the arm ( I tried a different spot in the arm for which I got yelled for) and that particular spot already has a depression from all previous injections (which i believe cause the injection to hurt)

My co-worker would tell me that the resident always been like that and hates anything that would cause the slightest bit of pain.

It just troubles me that I do what my residents asks of me and I'm always belittled by her. I guess somehow ive got to master this technique to deliver larger amounts of insulin fast without hurting my resident.

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Has anyone ever educated the resident regarding insulin administration? I would walk in and say "I have your insulin. I'm going to inject it into your stomach today. It's important to rotate injection sites."

Also maybe you could speak with a family member and have them talk to her...or your DON? ADON?

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Specializes in Utilization Management.

Excuse my bluntness, but I'm a Rehab nurse and am all about promoting independence :) You said this is an assisted living facility, which means the residents are able to live somewhat independently. Is there something stopping the resident from giving herself her insulin injection? If she doesn't like the way you do it, educate her on the process, then hand over the syringe.

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Thanks for your input! It is difficult to do teaching due to the fact there is a communication barrier( as the resident knows little English )and family is not involved in the care unfortunately. Also the reason we administer the insulin is due to the fact t resident is scared to do it herself (I have come to the conclusion she has a fear of needles and anything that will hurt her) -> since she does say ouch when I prick her finger with the lancet .

my co-worked say that's how she is (I think it's because the resident knows I'm new?)but I don't like having to hear I'm causing pain/doing a terrible job. I guess I'm just sensitive. I appreciate all of your guys' thoughts and advice! Maybe I can just try harder with the teching =)

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