How does your program teach/evaluate injections?

[amok]

I was perusing another nursing forum and stumbled on a discussion about how programs handle injections during skills labs and evaluations. My skills group has a practice lab where we practice drawing the "medication" (i.e., 0.9% NaCl) and injecting into mannequins/mimic pads (or hotdogs with "skins" during the intradermal, for bonus humor). On evaluation day our instructor watches the entire process from vial to injection individually. We perform the injections on a partner who then has their turn, all with supplies right out of the packages of course. We also swap the syringes we prepared with our partner, so we're always being injected with something we drew (with supervision) ourselves. Subcut was back of the arm, transdermal was the forearm, IM was ventrogluteal.

The discussion I saw was mostly about the IMs, but also about the whole general idea. People were outraged about the ventrogluteal IM! Like, suggestions for the student to get a lawyer and general freaking out. Is how my program does things atypical?

[Julius Seizure]

We gave each other injections of a small amount of normal saline in skills lab but it was definitely deltoid only for IM. I would not have allowed another student to administer a ventrogluteal IM injection on me. And, to be perfectly honest, in 10 years of being an RN, I've never given an IM injection in the ventrogluteal muscle. It's not a muscle used in pediatric IM injections. I've given vastus lateralis IMs a bunch in babies and deltoid IMs in older kids.

In school, during our pediatric clinical, there also was an outbreak of pertussis so we gave each other the TDaP boosters we were required to get.

Was this in addition to the TDaP you had to provide documentation for prior to starting the program? (I am assuming, since my school required up-to-date vaccine records before starting.) So people who had just had a TDaP maybe 2 years prior still had to get another one?

[BookishBelle]

We aren't allowed to practice shots on each other. I kind of wish we could do at least one to see what it feels like before doing it for real!

[lola kitty]

We practice on dense sponges (the kind found in the auto department at Walmart). We demonstrate our skills for subcu, IM, and ID for return demo. Then, we will give our first real injections to patients on clinical days. I'd appreciate the flu-shot clinic approach very much, though. The idea of putting a needle in the skin is a bit off-putting to me and doing it a few times in advance, in a safe site like the deltoid, would eliminate this initial fear. This would allow me to focus on the proper injection technique, itself, when caring for my patient.

[Guest123456788, MSN, RN]

We practiced on each other in my program but only for intradermal (PPD) placements. No one was forced to participate but if you didn't give your arm to someone else you also didn't get to use another person's arm (which I think is fair). We practiced IMs and SubQs on fake skin, but I have had the opportunity to do real IMs in the deltoid at a local volunteer clinic

[gypsierose]

In my program, after checking off on SIM man the nursing students give flu vaccinations to employees at the hospital. That gave me hundreds of arms to "practice" on. Its not a hard skill and everyone did great. Only a few people refuse to get a shot from a student and the majority understand. There were no complications with anyone. After checkoff we are also expected to jump in and give subcut shots in clinicals.