Flu Shots

Nurses General Nursing

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Still sort of anti-vaxxer here, but perhaps there is hope for all of us, what?

Guess who's going to give flu shots this year at my hospital. Aw, go on. Guess.

Anyway, any advice from experienced givers of these shots?

I still wonder how they know several months in advance what viruses are going to appear in the Fall and Winter.

But my main question here is seeking advice from experienced flu shot nurses. Technique, do you watch patients for 20-30 minutes afterwards, have you dealt with anaphylaxis, bad shots, hysteria/excessive fear of needles, pregnant patients, etc.?

Thanks in advance.

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Specializes in OB.
19 minutes ago, Kooky Korky said:

Still sort of anti-vaxxer here, but perhaps there is hope for all of us, what?

Guess who's going to give flu shots this year at my hospital. Aw, go on. Guess.

Anyway, any advice from experienced givers of these shots?

I still wonder how they know several months in advance what viruses are going to appear in the Fall and Winter.

But my main question here is seeking advice from experienced flu shot nurses. Technique, do you watch patients for 20-30 minutes afterwards, have you dealt with anaphylaxis, bad shots, hysteria/excessive fear of needles, pregnant patients, etc.?

Thanks in advance.

https://www.cdc.gov/flu/prevent/vaccine-selection.htm

The folks at the CDC are not clairvoyent, nor do they claim to be. They don't know for sure what strains will be most virulent each flu season, it's their best guess based on a lot of different research.

You do not watch patients for 20-30 minutes after a flu shot, you give it and send them on their way, directing them to Employee Health or the ED if they have a reaction. I've never personally known or witnessed anyone have an anaphylactic reaction to the flu shot but I know it does happen. I don't know what a "bad shot" is. Needle phobic people---just do the best you can. Pregnant patients don't get treated any differently, they need the flu shot like everyone else.

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Holy smokes, is it already that time of year again?!?! It feels like my hospital just lifted flu restrictions two months ago.

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Specializes in Public Health, TB.

Strains to include in the annual shot are based on predominant ones seen in Australia, as these are usually a good predictor. Of course, it is still an educated guess.

As for administration, try to be level with the person you are vaccinating, know your landmarks, and don’t jab too high. Yes, you should observe for 15 minutes or so, but this is a good time for documentation.

Squeamish people need to sit just in case they vagal.

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On 8/24/2019 at 3:38 PM, LibraSunCNM said:

https://www.cdc.gov/flu/prevent/vaccine-selection.htm

The folks at the CDC are not clairvoyent, nor do they claim to be. They don't know for sure what strains will be most virulent each flu season, it's their best guess based on a lot of different research.

You do not watch patients for 20-30 minutes after a flu shot, you give it and send them on their way, directing them to Employee Health or the ED if they have a reaction. I've never personally known or witnessed anyone have an anaphylactic reaction to the flu shot but I know it does happen. I don't know what a "bad shot" is. Needle phobic people---just do the best you can. Pregnant patients don't get treated any differently, they need the flu shot like everyone else.

bad means, to me, given poorly, infection after it, stuff like that

I don't know how many people ever have serious adverse events after any vax, but the policy where I work does mention observing for 20 - 30 minutes after the shot. We'll see if that is what the supervisor does. Of course, depending on where people go to get the shot, there might or might not be time to get help if they have a very serious bad reaction. Same with other vax, antibiotics, 'caines.

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Specializes in Surgical, quality,management.

If you are injecting people working in a clinical area then send them back there as there are clinicians available. Otherwise we had to stay for 5mins. Also the immunization team came to service meetings, wards etc.

The Australian flu season hit earlier this year and was bad early on. We were flexing beds 2 months earlier than anticipated.

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Specializes in OB.
15 hours ago, Kooky Korky said:

bad means, to me, given poorly, infection after it, stuff like that

I don't know how many people ever have serious adverse events after any vax, but the policy where I work does mention observing for 20 - 30 minutes after the shot. We'll see if that is what the supervisor does. Of course, depending on where people go to get the shot, there might or might not be time to get help if they have a very serious bad reaction. Same with other vax, antibiotics, 'caines.

Weird, I've never seen any mass-flu vaccination program at a hospital require any type of observation after the shot at all. Everywhere I've been it's just stick and go, here's your receipt.

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Specializes in Psychiatry, Community, Nurse Manager, hospice.

My tips: Ask folks which arm they want you to inject. If they don't know, suggest the non dominant one. Infection is pretty rare, but folks do get induration when you didn't hit the muscle and instead got them in the subQ, so select a longer needle for a morbidly obese person. Feel for the acromion process and then go 2 finger widths down. Just past the 2 finger widths is your spot. Wipe with alcohol and then let it dry, you get less pain that way. I say "We do it on 3. 1,2" and then administer on 3. For children and if someone has a lot of anxiety or worry about pain I say "On 3 you say ouch. 1, 2" and then administer on 3. It's amazing the calming effect saying "ouch" has on people. Just don't make a big deal of it or talk too much about it. Quickly you give the one sentence "On 3 you say ouch, 1,2,3." I've given deltoid IMs to crack addicts, kids with oppositional defiant disorder, and the most severely anxious people you could ever meet and this works.

Thanks for giving your coworkers the flu shot. Yeah, it doesn't work as well as the other ones, but its not a total waste of time.

When folks come back to you and complain that they feel mildly sick with a runny nose, cold, etc right after their shot (and you work with them, so this may happen) you say "Yay, it probably worked. That happens to some people when their immune system is mounting a response to the vaccine, which is exactly what you want to happen. Of course, if you get a temp over 100.5 or you feel very, very badly then see your doc."

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Specializes in PICU.

We usually just fill out paper work, stand in a line, hand the RN our paper work, get the flu shot, go on our merry way. I always have to look away as I don't like watching myslef get a shot, but oh well.

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5 hours ago, LibraSunCNM said:

Weird, I've never seen any mass-flu vaccination program at a hospital require any type of observation after the shot at all. Everywhere I've been it's just stick and go, here's your receipt.

These events won't be at hospitals, rather at companies not related to health care, who want their workers to be immunized. Like factories, offices.

I will be given Epi to have on hand + a standing order to give it for apparent anaphylaxis. I know very few serious reactions occur, but better to have and not need Epi than vice versa.

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On 8/25/2019 at 3:45 PM, FolksBtrippin said:

My tips: Ask folks which arm they want you to inject. If they don't know, suggest the non dominant one. Infection is pretty rare, but folks do get induration when you didn't hit the muscle and instead got them in the subQ, so select a longer needle for a morbidly obese person. Feel for the acromion process and then go 2 finger widths down. Just past the 2 finger widths is your spot. Wipe with alcohol and then let it dry, you get less pain that way. I say "We do it on 3. 1,2" and then administer on 3. For children and if someone has a lot of anxiety or worry about pain I say "On 3 you say ouch. 1, 2" and then administer on 3. It's amazing the calming effect saying "ouch" has on people. Just don't make a big deal of it or talk too much about it. Quickly you give the one sentence "On 3 you say ouch, 1,2,3." I've given deltoid IMs to crack addicts, kids with oppositional defiant disorder, and the most severely anxious people you could ever meet and this works.

Thanks for giving your coworkers the flu shot. Yeah, it doesn't work as well as the other ones, but its not a total waste of time.

When folks come back to you and complain that they feel mildly sick with a runny nose, cold, etc right after their shot (and you work with them, so this may happen) you say "Yay, it probably worked. That happens to some people when their immune system is mounting a response to the vaccine, which is exactly what you want to happen. Of course, if you get a temp over 100.5 or you feel very, very badly then see your doc."

thank you mucho. I appreciate the review of deltoid usage for IM. I always prefer the hip, but am OK with the arm.

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Specializes in NICU, Infection Control.

I always seemed to be in line behind the needle phobic customer. So I would hold their hand and try and keep them calm.

Don't go w/the hip--no one has time for that! Positive attitude: this is going to keep folks healthy and at work, not home wishing they were dead. Flu hurts. Not to mention that @ some HCFs, it's more or less mandatory, esp. if working w/immunocompromised clientele. For those folks, they really could die if they get the flu.

If some people claim "they always get the flu after they get the shot"--they were likely incubating it @ the time of the injection.

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