help with allergy testing

[runner502]

I have worked at an allergy/asthma practice for a few months. They have just started training me to do the allergy testing. Things seem to go well when I am testing an older child or an adult, but I have been having trouble getting the bubbles to appear when I'm doing the intradermal shots on a young child or an adult that has very loose skin. We do the IDs on the upper arms. I have watched the other nurses do it perfectly on very young kids, and I feel so frustrated that I'm not getting it right. I have practiced on the other nurses and do it fine on them. Any tips or advice would be greatly appreciated! I think I'd really like doing it if I felt more confident in my ID skills on children.

[Heidi the nurse, BSN, RN]

I would ask your colleagues to watch you do an ID on a child and see if they have any ideas. Are you going to deep, not deep enough etc. That would be hard to assess unless in person.

[runner502]

Well, they have watched me, and the problem is that I'm going too deep. They watched me yesterday, and I think the problem is that on looser skin, I'm pushing the needle down onto the skin before I insert it. On someone with firm skin, I guess I don't push down because the skin is already firm. I practiced on them yesterday, trying not to press down at all and just slide it across. I was able to do it that way, but I'm so nervous that I still won't be able to do it right on a child. The other problem is that I can only train when we have an extra person, so I'm not getting a lot of steady practice. I wish I could practice at home to get my confidence up. So, any tips or advice you could offer would be great!