I was fired for refusing to give injections incorrectly!

kleelpn · Jan 20, 2005

As I said in my orriginal thread, this practice had children ranging in age from birth to 18 years old. I agree with you that in some instances a 5/8 inch needle is appropriate, that's what nursing judgement is for. My point was that they did not have any 1" needles at all in the office therefore making it immpossible to give an IM injection to an older pt with more adepose tissue. The nurses there had no problems at all with the way they were doing things, that was the scary part.

Kat, I've read through this thread, and as one very experienced LPN to another, I say, God Bless and Love You. You know your stuff, in theory and in practice and you opened your mouth as a Patient Advocate, which I consider to be the highest part of our calling as nurses. It is never easy to "do the right thing" in an atmosphere of "that's how we do it here"...

So, to paraphrase a great man... "kick the dust off your sandals and move on to the next village", because there IS a place for you where you will be cherished for your integrity... your job is simply to "seek until you find" it.

Sincerely, klee

nursemike, ASN, RN · Jan 20, 2005

First of all, I would like to think that you do not consider pediatric nurses utter morons.:) Taping syringes together has never been an accepted practice in any practice area that I have been in in my 25 years of pediatrics. Certainly one wants to traumatize a child as little as possible, but if you give the injections one right after the other (in separate sites), the child's reaction is no different than with one injection. Certainly using two sites and giving the injections a few minutes apart would be more traumatizing. I have given thousands of injections and have been told I am quite good at it, even when having to give multiple injections.
The original writer should report the practice to the state regulating bodies as soon as possible. It sounds to me like the nurses in the practice are the ones who are not willing to change.
Also, try and give peds another shot (pardon the pun:rotfl: ) if the opportunity arises. Not all pediatric nurses are like the ones you encountered in that office.

Sorry if it sounded that way. I only meant that it seemed like a pretty dumb way to save time, until I realized that wasn't the point.

jeepgirl, LPN, NP · Jan 20, 2005

how the heck did this nurse aspirate for her IM injection with this technique?

Like others said before, use two sites and use EMLA... for IM I usually place it longer than one hour.

Oh, and why didn't she just get another nurse to do a second injection at the same time as the other one... so the kid gets two sticks at the same time at two different sites. less traumatizing.

camay1221_RN · Jan 21, 2005

Katherine,

I almost fell over when I read your post about the two syringes being taped together!!! And someone asked the question that came to mind...How do you aspirate?

I worked in a pediatric clinic for five years, and I think anyone who would even think of giving immunizations the way you described should be the one without a job, and back into a continuing education program for skills development!

Good luck to you! There is another pediatric clinic out there just waiting to get their hands on you!

norinradd · Jan 21, 2005

Sorry it didn't work out but you don't want to work were you don't feel safe. On paper at least they can let you go in the early stages for any reason. If they stated why on paper maybe, but face it, it's not a place you want to work. As for,"From what I understand the department of health got word of this and has since gone in to correct the situation." Wink, wink.

gajalama · Jan 23, 2005

You should count your blessings that you are out of there! I have been a RN for almost 31 yrs and have a MS in nursing. I have never heard of such nonsense: taping syringes together! Go back to school and get your RN, you sound like a bright and dedicated nurse. You will find another job, be sure to interview your interviewers when looking for another job. All the best to you!

Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!

chickamauga4 · Jan 23, 2005

Hello, my name is Katherine. I have been an LPN for 10 years. I am an experienced clinition and have won awards for my excellence in clinical practice. I worked in an office for 10 years which gave me a vast amount of experience, from family practice,internal medicine,pre-op teaching,pediatric nursing to urgent care. I take pride in my skills and am dedicated to doing it right for the benefit of my patient. I loved my job but felt it was time for a change so I took a new job in a pediatric office, this office served patients from birth to 18 years old. When I discovered the nurses in this office were giving IM injections with a 5/8" needle I requested that they order some 1" needles, which they did. When the nurse who was orienting me told me that she "tapes syringes together" to give immunizations I almost fell over! I told her that was not clinically appropriate and I would not be doing that. I worked there for two weeks and was brought into the office managers office after work one evening and told that it wasn't working out and they would have to let me go. When I asked why she told me it was because I was too set in my ways and obviously was not willing to do things their way. As difficult as this has been for me, I feel proud that I stood my ground and refused to do it wrong to just keep my job. From what I understand the department of health got word of this and has since gone in to correct the situation. Unfortunately it was at the expence of my job but at least I know the children are being properly immunized because of my sacrifice. Now I'm off to the trenches again to find a job that appreciates a skilled and dedicated nurse!

Way to go!!!!! I applaud you for having pride in your work and yourself. Those children are safer for your sacrifice. Thank you for being such a good and attentive nurse.

Fun2, BSN, RN · Jan 31, 2005

How old was this nurse? I am 31, and was lucky enough to miss out on the booster shot that had a million needles. :chuckle

I am just wondering if this is how that nurse came up with the idea to tape the syringes together. I have never done that, nor thought about it....and I surely was never told to do that. I have always asked another nurse or medical assistant to help, or gave multiple injections/opposite legs myself.

As for the needle size, it all depends on the person (child), but did they use only one size needle on EVERYONE????? I've never heard of a "one size fits all" needle! :uhoh3: I can't imagine them not using different sized needles without you having to ask them to order a different size!!!

WHEW!!! Good luck with your job search, that was definately not a good job for a good nurse!!!

NoCrumping · Jan 31, 2005

Katherine-
Your professional ethics are sound.
Perhaps it would have helped to show the orienting nurse a professional reference on correct techniques of pediatric IM injections. For instance, a book on clinical skills and procedures. Sometimes if you can articulate why a certain technique should not be performed, the other nurse can modify their administration technique appropriately.
FYI: the word 'clinician' has no 't' in it.

*another FYI*

the word expense has no c in it.

In order to not "rock the boat" so to speak, could you just have been oriented to the office, and then when on your own , done things your own way? While I agree the taping of needles together thing is not common practice (to my knowledge) , but if you think about it, is it really harmful to a pt? Its not like she told you something crazy like... "we give our im injections by mouth here" Sometimes people dont want you around if your only willing to do things your own way, complain about the way they do theirs, etc....

NoCrumping · Jan 31, 2005

Katherine,
I almost fell over when I read your post about the two syringes being taped together!!! And someone asked the question that came to mind...How do you aspirate?
I worked in a pediatric clinic for five years, and I think anyone who would even think of giving immunizations the way you described should be the one without a job, and back into a continuing education program for skills development!
Good luck to you! There is another pediatric clinic out there just waiting to get their hands on you!

How do you aspirate??? the same way you would aspirate for one, i imagine?

blondebritbrat · Jan 31, 2005

I am shocked by what I am reading! You are the type of nurse that I aspire to be and good for you for standing up for your patients! I am sorry that you lost your job but since the health department has come in since then its probably safe to say that you probably don't want to be there in the aftermath. I haven't even started nursing school yet but I am just shocked. I have never heard of "taping" like that nurse tried to teach you! Plus that just sounds lazy and could lead up to a lot of infections on the injection site. Way to go!

BRANDY LPN · Jan 31, 2005

I applaude you for sticking up for your pts, but what happens after the dept. of health completes their investigation? Most likely (God willing) this nurse will be fired, but that doesn't stop the problem she will just go on to get another job where she will most likely NOT change her practice. You really need to report this nurse to the BON, they are the only ones who can discipline her license and prevent her from cont. to endanger pts.