Injections, needles, etc

Aunt Bytes · Mar 18, 2006

Hi!

I've given alot of shots in my time, and I and tell you this. If you give an IM injection quickly, it doesn't hurt as much. Also, if you use a different needle to "draw up" the med then change to a fresh needle to "give" the injection, it doesn't hurt as much. This is because when you puncture that rubber cap with a needle to draw up, it dulls the needle a bit. That's what makes it hurt.

Finger sticks are always going to cause discomfort. Patients know this, that's why they "cringe" when it comes to accucheck time! But, you know what?.... this is your job. When you go to the.... oh, lets say "dentist".... you know that the shots in your mouth are going to hurt. But you don't hold it against the dentist, do you? Your patients are not going to hold it against you if you are putting a needle in them, and it happens to hurt!

If it really concerns you, ask your instructor if she will do an accucheck on you. Then you can see what it feels like. Then maybe you won't worry so much.

You are going to have to do things to people in your career that are going to invariably cause some degree of pain. It's just part of the package. But, far outweighing the "pain" you inflict, is the healing you provide. Please focus on this, and not the "maybe I hurt him, maybe I didn't" stuff. Girl, you are going to drive yourself crazy if you don't get a handle on this soon.

Please don't worry,

Your patients seem to love you and that's a great thing!

Hope this helps,

Aunt Brenda

MIA-RN1, RN · Mar 18, 2006

What I have found for fingersticks is to use the side of the finger and not the first finger. It seems to hurt less.

And yes, shots hurt. And everyone expects them to hurt so the best you can do is make them hurt less. Make sure the alcohol is dry, rub it a little hard to numb up the skin a little. (The NP I work with flicks it first for the same effect). Go in quickly and with purpose.

And above all, remember it takes practice. I have only done one IM in school and a handful of SQ insulin. BUt at work I do fingersticks every day and my friend is allowing me to give her her B12 shots (she knows how to do them herself but thought I would like the practice, and since she knows how to do them and has given shots herself, she helps me along with it)

Daytonite, BSN, RN · Mar 18, 2006

You have to trust the patient. Maybe they are being kind, maybe they are just trying to suck it up and take it like an adult. My experience has been that when a patient gets an IM that hurts they often let you know. That aside, most people expect shots to hurt, that's why they dread getting them. Fingersticks are always going to hurt because the fingers are so well supplied with nerves. Unless the patient has extensive nerve damage from diabetes, it's going to hurt. In general, the faster you plunge any needle through the skin, the less likely the patient is going to feel the stick. Inject medications into tissues slowly as well to minimize pain.

Lisa CCU RN, RN · Mar 18, 2006

Thanks so much for all the advice. My skills partner did the accucheck prick on me as well as a SQ, so I know how it feels. Not only that, I've had IM's and SQ's of course--isn't a flu shot IM? Yes, the IM 's hurt,so I guess you all are right--it's just to be expected.

We were taught to do all you said in our skills lab as far as doing the pricks on the side of the finger and we were also told that squeezing the finger some while pricking makes it hurt a little less.

I think what I am really asking is there ever a time where you go in too hard or too fast? I know you go in quickly, but is there ever a situation where you'd say you were "stabbing" too hard?

I am really trying to be like some nurses I have been cared for by--the ones who are about the give you a shot with your head turned and the next thing you know they've given it to you and you didn't even realize it happened.

Daytonite, BSN, RN · Mar 19, 2006

I think what I am really asking is there ever a time where you go in too hard or too fast? I know you go in quickly, but is there ever a situation where you'd say you were "stabbing" too hard.

I don't think you can stab too hard or too fast. If you stab too hard the worst that is going to happen is that you are going to plunge the needle in all the way to the hub to which it is attached or hit bone. Either way, it shouldn't hurt the patient if it's done quickly and only requires pulling back a few cm's.

CardioTrans, BSN, RN · Mar 19, 2006

A trick that I was shown many yrs ago, I still use to this day, and no matter what kind of injection that I give, the patients always say they didnt feel the needle, just the med.

Hold the syringe like a dart. When you go to inject the needle, do it fast, as if you were throwing darts at a dartboard. Inject your med, and pull the needle out just as fast. This works well with IM and SQ injections.

DarlinNurseRed · Mar 20, 2006

I am an LPN,,,have given injections forever(the most I have ever given in one day is 280..we were giving flu shots also that day in a clinic setting.)

The fact is, if you poke a hole in someone, it hurts. It is a necessary evil, of course. The majority of my patients have always told me that I "give a good shot" but of course, in RN school, instructors will critique you to death in front of your patients. Last time I gave a SQ injectionin my RN clinicals, the instructor made my patient so nervous about it that he asked to have "the real nurse give it" (Not knowing that his "real" primary nurse had only been out of school for a year.)

Lisa CCU RN, RN · Mar 20, 2006

Ok, I feel better now and I appreciate all the great advice.

I just know that I've had many nurses give me injections that didn't hurt one bit and I wanted to know if there was a certain technique or trick to this.

Thanks again.

StudentC · Mar 23, 2006

I laughed when I was reading through this and came across the dart comment. I gave my first IM last week and a couple of sub-q's and one accuchek before that. My instructor recommended I take up darts to improve my injection skills! :)

BTW kudos to you for doing an intradermal - we didn't do those at all and the very thought scares me. If you could do that without making your skills partner cry you're prolly doing just fine with the other sticks!