IM inj hitting humerus

Nurses New Nurse

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Hi. I'm a new nurse on my first nursing job. I was giving vaccinations today on 2 teens. One of them was really really skinny and I managed to hit bone. I've been feeling horrible all day, naive me never even thought of that happening, no one ever mentioned it during my education, not the books either. I wanted to take a smaller needle but it came prefilled with needle that wasn't removeable She was a bit nervous and flinched when I pierced the skin but didn't say anything, I know bone doesn't have pain receptors but could I have hurt her beyond pain? I pulled the needle back a tiny bit before injecting, there was basically almost no room to use. I got so horrified I forgot to aspirate too. I might just be the worst nurse ever :( Just looking for some support!

I hit the bone on my very first IM injection when in nursing school but had been warned it can happen with super thin (especially older) people. My patient didn't flinch and didn't notice at all.

I wish someone/or some swedish nursing manual book had mentioned it, then I wouldn't have gotten so horrified plus known what was ok to do when it happened.

You can also estimate the needle depth you actually need and control the depth. It does take a little practice but I did this all the time the thin elderly. It also keeps my other hand out of the way with less chance of hitting myself with the needle. I have seen a lot of nurses poke themselves this way even going through theri skin..then the patients. :no:

Do you know any youtube vid or pdf where that is explained/shown? I haven't had that explained either, basically "this for im, this one for sc". I asked if I could use a sc needle before and got told no. I did tell the boss (also nurse) yesterday I was kind of nervous about the teens and asked gauge and she just said blue without seeing the pt. We have this website where we can also look at swedish directives but it didn't really explain.

If it makes you feel better, a friend of mine had the worst IM story hands down! She was in nursing school and went to get the supplies, but all she could find were the needles that you use to draw up meds (you know, the reeealllly thick ones). She didn't know the difference, so she asked the instructor if it was the correct needle size, and the instructor (who I guess had no idea herself) said that's fine lets get your meds ready. Well, time to give the injection, the patient is afraid of needles :eek:. She injects the patient, who immediately starts SCREAMING :crying2: because it hurt so bad. She finishes the injection and leaves, the instructor says nothing... She still felt bad about it telling me, and this was many years ago.

Also, when I was in nursing school, instructors told us to aspirate, massage after using Z-track method, massage after a freaking tetorifice shot. Really, every single instructor had "the right method". The one nurse that was still practicing and teaching at the same time had all of the correct info. One person followed what another instructor said and buried the needle in the deltoid. Freaked the correct instructor out and said it isn't necessary and you might hit someones bone. I think she was the only one to point out that you can hit the bone if you aren't careful; all of the other instructors assured us the needles look bigger than you think, don't be afraid etc.

The important thing is, you now know what not to do and your patient is fine. Learn from your mistakes and improve for next time. :)

If it makes you feel better, a friend of mine had the worst IM story hands down! She was in nursing school and went to get the supplies, but all she could find were the needles that you use to draw up meds (you know, the reeealllly thick ones). She didn't know the difference, so she asked the instructor if it was the correct needle size, and the instructor (who I guess had no idea herself) said that's fine lets get your meds ready. Well, time to give the injection, the patient is afraid of needles :eek:. She injects the patient, who immediately starts SCREAMING :crying2: because it hurt so bad. She finishes the injection and leaves, the instructor says nothing... She still felt bad about it telling me, and this was many years ago.

The important thing is, you now know what not to do and your patient is fine. Learn from your mistakes and improve for next time. :)

Yikes! Now, that story gave me the heebie Jeebies!

If it makes you feel better, a friend of mine had the worst IM story hands down! She was in nursing school and went to get the supplies, but all she could find were the needles that you use to draw up meds (you know, the reeealllly thick ones). She didn't know the difference, so she asked the instructor if it was the correct needle size, and the instructor (who I guess had no idea herself) said that's fine lets get your meds ready. Well, time to give the injection, the patient is afraid of needles :eek:. She injects the patient, who immediately starts SCREAMING :crying2: because it hurt so bad. She finishes the injection and leaves, the instructor says nothing... She still felt bad about it telling me, and this was many years ago.

Also, when I was in nursing school, instructors told us to aspirate, massage after using Z-track method, massage after a freaking tetorifice shot. Really, every single instructor had "the right method". The one nurse that was still practicing and teaching at the same time had all of the correct info. One person followed what another instructor said and buried the needle in the deltoid. Freaked the correct instructor out and said it isn't necessary and you might hit someones bone. I think she was the only one to point out that you can hit the bone if you aren't careful; all of the other instructors assured us the needles look bigger than you think, don't be afraid etc.

The important thing is, you now know what not to do and your patient is fine. Learn from your mistakes and improve for next time. :)

Wow, owwwww, omg I can understand why your friend still feels bad about it! :o How does it work in US, do you get to practice on eachother or volunteers before you get to go practice for real? We never had, patients were our guinea pigs unfortunately. Something about insurances. We only practiced on plastic arms or dolls.

I remember being taught about the possibility of hitting bone and our instructor asking "Do you guys think that would be painful?" all of us nodded our heads and then the instructor said "Believe it or not, it's not painful at all and your patients probably wouldn't notice!" We were all shocked. It's not a big deal... and don't aspirate. You're doing fine :)

We HAVE to perform the skills on each other and be signed off before we are allowed to perform skills on patients. At least that is how my nursing school was, some people say they weren't allowed to do it with their classmates.

That being said, we were NOT allowed to 'practice'. We were supervised and did the injection with the instructor, one time only (or if you didn't pass, a second time). We were not allowed at all to practice injections in the skills lab outside of the fake arms etc.

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