Well, today was my special day! I got fired from my job for giving one (yes, one) injection wrong, and for telling some lady I wasn't trained on how to use an EpiPen. Apparently all of that deems me "unable to safely practice as a nurse" according to them.
And then they had the nerve to ask me if I wanted to work as a scribe with a $15 pay cut. I was SO offended.
How do you guys deal with this? ? I've already applied to new jobs but....IDK. It's just hard to all take in....
Also, I'm pretty sure the lady I told was from the state. Why am I not allowed to be honest with people on things I don't know? Why didn't they just train me, instead of just firing me? I just don't get it. It seems like their goal was to just get rid of me.
Specializes in LTC/Rehab, General Hospital Medical.
11 hours ago, CrunchRN said:
It sort of surprises me that with 2 years of experience you did not know how to give an IM properly.
Maybe you do need to look within a little bit.
I know how to give an IM medication. The thing was that the CDC also gave us those very long needles, which could easily hit bone if pushed too far. I didn't gauge it correctly, and didn't go far enough into the skin because I was too scared of hitting the bone.
I do know how to give an IM medication otherwise. I would like to point that out. I've done it at my other job as well, and I'm kind of offended you all think I don't know how to do it. This was one incident where I did it wrong.
I know how to give an IM medication. The thing was that the CDC also gave us those very long needles, which could easily hit bone if pushed too far. I didn't gauge it correctly, and didn't go far enough into the skin because I was too scared of hitting the bone.
I do know how to give an IM medication otherwise. I would like to point that out. I've done it at my other job as well, and I'm kind of offended you all think I don't know how to do it. This was one incident where I did it wrong.
Most nurses don't given IM injections regularly anyway ..........so I wouldn't think a thing about it if you hadn't.
Specializes in Psych, Addictions, SOL (Student of Life).
1 hour ago, JabuJabule said:
I know how to give an IM medication. The thing was that the CDC also gave us those very long needles, which could easily hit bone if pushed too far.
I have given hundreds (Probably at least a 1000 as I regularly work flu clinics) of IM's in the deltoid with that "Very Long" (1.5") needle. Except in a very small arm with poor muscle mass there is little danger of hitting bone if the injection is given in the right area of the deltoid muscle. The fear of hitting bone in a normal adult's delt while normal in one with less experience should not be a significant concern for the seasoned nurse who would use their nursing judgement and ask for a shorter needle if the muscle is small or wasted. The covid vaccine is to be given deeply into the deltoid muscle by z-track method. In persons with smaller arms a 1"needle is appropriate and if the CDC did not provide them your facility should have 1" needles on hand. Our facility did not get injection supplies or vaccine from the CDC as they did not manufacture them. We got vaccine from Moderna and our facility provided all the other supplies. Our pharmacist was on hand during our vaccination clinics to offer help and guidance.
If a longer needle is not inserted deeply there is a greater risk of patient injury as well as needle contamination and needle stick injury to nurses.
In persons with smaller arms a 1"needle is appropriate and if the CDC did not provide them your facility should have 1" needles on hand.
When giving IMs in vastus lateralis, ventral gluteal, sometimes you need to judge how much depth to insert the needle. Couldn't this be done by changing the insertion depth? Why would one need to get a shorter needle?
Anyone with a first aid/ CPR cert is taught how to use an epi pen. Plus they all have instructions. When in doubt, remove yourself, and phone a friend. I ask other nurses all the time when I’m not 100% sure on something. Just some kind advice, “Some lady” doesn’t sound very professional. All in all, tough way to learn a lesson. Hopefully you will take this as a learning opportunity and move on, continuing on your nursing career. Best of luck to you!
Specializes in Psych, Addictions, SOL (Student of Life).
16 hours ago, londonflo said:
When giving IMs in vastus lateralis, ventral gluteal, sometimes you need to judge how much depth to insert the needle. Couldn't this be done by changing the insertion depth? Why would one need to get a shorter needle?
In the case of our facility and vaccinating 200+ people a day we would change needle length rather thad insertion depth, especially since "Bunching the muscle" is not recommended for the Covid Vaccine.
Specializes in Community Health, Med/Surg, ICU Stepdown.
What is the concern if you don't give the injection deep enough? I know with something that can be caustic like phenergan it's more risk to irritate the muscle/tissue/skin. Other than that is it an issue with absorption? Just curious ? I usually go in pretty deep and have never hit a bone except with an extremely emaciated, malnourished alcoholic pt who weighed probably 80 pounds. I used a one inch needle and didn't go in far at all, but still happened! What a horrible sound, I can still hear it! He didn't have any pain, but was also drunk =/ Maybe I should have used a 5/8" SQ needle!
"Why am I not allowed to be honest with people on things I don't know?"
You're allowed to be honest, but should you tell the patients? You supposed to get another nurse to do it. You should practice again if you aren't comfortable doing it.
I found out the hard way that being honest all the time doesn't pay off. I'm not saying that you should be lying. I'm saying that you should look at who is in front of you.
Rule #2 in nsg school was to NEVER TELL A PT YOU DIDN'T DO SOME TYPE OF TASK!
Repeating my rule #2. What you inadvertently did was to present a pix of your inexperience and lack of knowledge to a pt causing them to doubt your efficiency and posing a risk to their safety.
Not an image that a facility wants to project to potential or actual clients.
Specializes in LTC/Rehab, General Hospital Medical.
3 hours ago, ThursdayNight said:
You're allowed to be honest, but should you tell the patients? You supposed to get another nurse to do it. You should practice again if you aren't comfortable doing it.
Saying this once again, I didn't tell a PATIENT I didn't know how to do it. It was a lady from the state.
amoLucia
7,736 Posts
Rule #2 in nsg school was to NEVER TELL A PT YOU DIDN'T DO SOME TYPE OF TASK!