Giving injections to babies

Nurses General Nursing

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Hello! I am a new nurse. I just got a job as home care nurse. I have a case and my patient is an 1 year old. I have to give subc injections, I know how to inject but I am having a hard time injecting her. Parents are present so far but I wonder how I will handle giving the injection when the parents are not around to help hold the baby still. Baby moves and cries when she feels I am cleaning with alcohol pad her tight. She starts moving and crying. Can someone please tell me how to place the baby and hold her when I am alone with not help and I have to give the injection.

Thank you in advance for the comments or suggestions !

Specializes in Pedi.
Diabetes?

Congenital heart disease (many require lovenox...I give it daily)

Another blood disorder?

There are endless possibilities. Welcome to the world of peds.

Plenty of possibilities. I've seen babies with sinus venous thromboses who require BID lovenox. Oncology patients (the youngest baby I've ever seen with cancer was 2 weeks old) may require GCSF post chemo. I have many infants right now who get shots daily, most of them because of cancer.

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Specializes in MedSurg, PACU, Maternal/Child Health.

WIth small children, it is best to model the injection (of course with a syringe with no needle attached) on the child's favorite stuffed animal and allowing the child to play doctor/nurse. Depending on the child's cognitive level, she will likely respond to this as play demonstrations are often effective and also distract the child from focusing on the injection entering their skin. Restraining her will only scare her more and cause her to dread the injection. The suggestion with the blanket with the limb sticking out may also work but using play distraction along with it will lessen the dread and when the child does not focus on the injection she will feel minimal to no pain. The injection takes a few seconds so as long as you can shift her attention for a short period it should work out.

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Specializes in Peds, Float, Ambulatory, Telemetry (new).

Also HGH injections. (just to add to the list). I know one of my friends son has to get that every night.

But I totally understand your need for a job but just think about your license and your comfort level.

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Sure I know there are a variety of serious medical conditions.

Just the whole secnario sounded so odd. Hard to believe a critically ill one year old, diabetic, cardiac condition, cancer, would be under the care of a new RN with no peds experience. And the parents didn't seem too concerned...."how will you do this when we are not home." just sounded a little cavalier. I would think parents would INSIST a nurse would be highly trained and highly skilled.

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Specializes in Pedi.
WIth small children, it is best to model the injection (of course with a syringe with no needle attached) on the child's favorite stuffed animal and allowing the child to play doctor/nurse. Depending on the child's cognitive level, she will likely respond to this as play demonstrations are often effective and also distract the child from focusing on the injection entering their skin. Restraining her will only scare her more and cause her to dread the injection. The suggestion with the blanket with the limb sticking out may also work but using play distraction along with it will lessen the dread and when the child does not focus on the injection she will feel minimal to no pain. The injection takes a few seconds so as long as you can shift her attention for a short period it should work out.

That might work with an older child but the OP says her patient is one. You can't rationalize with a 1 year old. Hold the leg, give the shot as quickly as possible and then she'll forget about it two seconds later if you distract her with a toy.

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Specializes in Oncology.

Are you getting everything ready as much as possible before involving the child at all? A subq injection should really only take seconds and if timed well be done before the child even has a chance to respond. Swab, stab, push. Perhaps distract the child with a favorite toy?

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Specializes in Pediatric Critical Care.

In what scenario would a responsible adult not be with the baby when you arrived? It makes no sense that the child would be alone....giving injections to an unsedated baby takes two people, in my opinion. They need to understand that. How would they do it if you weren't there? With two people.

I agree about this sounding like a dangerous situation, though. Home health is a scary place for a new grad.

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Specializes in ICU.

I agree with Blondy~ get it ready, swab, stab and you're done. I worked with pediactrics for years and I can't see why it would be so difficult to give a sub-q injection to a one-year old. Also, did you not learn to give them in nursing school? Why on earth would anyone need more than an hour of training to do this? The child probably senses your anxiety, which makes her more anxious. Don't make a fuss about it, just give it.

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Hold the baby sideways in your lap with his/her legs held firmly inbetween your legs. Use one arm to hold the upper half of the baby and your other arm to give the injection

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

First, I'd agree don't appear to be too nervous or afraid to handle the baby. Develop a calm outer appearance no matter what is going on.

You mentioned that you went out for an hour of training. What did they demonstrate for you during that time? Did you ask questions? Who did the training? That orientation hour was your golden opportunity to make sure that when you arrived the next day you knew what you needed to know based on the child's care plan and what to do in the event that you didn't.

I don't think it's possible to tell you how to do this since "1 year old child" isn't near enough information to give you helpful advice for your specific situation.

Agencies will do things that make your jaw drop they are so reckless but we as nurses need to take back that control on behalf of our patients. I'm sure there are people who disagree but if I needed another hour of training and I was only paid for one I'd go for the hour anyway, because it's my peace of mind that's important to me.

I would suggest you'll find a lot of pertinent info on the Private Duty Nursing forum because your dilemma is not that unusual. Wish you the best!

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Specializes in Public Health, Women's Health.

Someone said it already, papoose! Ask your company if they will purchase one for you. It's a Velcro type blanket with a board in the back you can set the baby down on, wrap snugly and you can leave out just legs, or arms, an arm, combo, etc. I work as a public health nurse and give a lot of immunizations, I know how strong these little ones can be. I cannot imagine doing it alone, we always have someone hold. Tell them you would like one for the child's safety, keeps them from squirming and possibly injuring themselves.

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Specializes in Public Health, Women's Health.
Hold the baby sideways in your lap with his/her legs held firmly inbetween your legs. Use one arm to hold the upper half of the baby and your other arm to give the injection

This could work if done quickly enough but a toddler who knows the routine isn't going to be held without a fight I would imagine?

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