Gluteal injections...

[kd2010]

Hello

I'm currently employed at a local doctors office. I am a nurse among medical assistants so I find myself doing all injections. Recently, co workers have been giving me a very hard time. I will agree to all injections, but gluteal injections aren't something I am comfortable with. We were shown in school once how they would be administered, but were told to avoid at all costs because of the potential damage to the sciatic nerve. With this in my mind, I usually ask for the help of one of three other nurses to perform this injection. It is rare one comes in, but the medical assistants are giving me a difficult time about not doing them. They say that as a nurse I should do this, it's just an injection, and I'm wrong not to give. There are about 10 nurses in the office, most of which will also not give an injection to this site. I'm just curious some opinions about this issue and how to deal with the critisicm from coworkers. I believe myself to be a good nurse, but this is just not an injection I feel safe about giving. Thank you for reading everyone!

[mrmedical, ASN, BSN]

Gluteal injections (dorso - have not seen many ventral injections) are pretty safe as long as you know the landmarks. The sciatic nerve, even in larger patients is pretty deep and medial in the leg/buttock and if injected must be pretty deliberate. Vastus lateralus is usually the 2nd choice. Obviously the deltoid for flu vax and the like.

I would say don't force yourself to do a technique that you feel uncomfortable with and that may harm the patient, yet also as the nurse it is your duty (in my opinion) to become knowledgeable and proficient in the technique. even if that means giving the injections to healthy weight patients so you can see and feel the landmarks and then moving on to different or more challenging patients after you gain confidence.

[gramkram]

You are correct in your practice. This site is not recommended anymore. I am wondering what you are giving in that site? You don't need to justify your practice with those who have much less education than you! Show them the literature or invite them to sit for NCLEX! It makes me angry when non-nurses tell us how to practice. I am a nursing instructor and have 35 years experience. Hang tough and don't go with the flow!