Mistake?

[ABC]

Hi,

I have a question for anyone. I am newly working and am doing work in the ER. I was giving an antibiotic shot to a 9 month old boy. I drew up the right amout of medication and was doing fine. However, when I gave the shot in the vastus lateralis of the child, I hit the bone. This was the first time that I had given an IM to a pediatric patient and was very nervous and believe that I probably gave the shot a little too hard and this caused me hitting the bone. I felt soo bad about it! I was still able to give the shot without any problems and the needle was completely intact when I took it out. I guess my question is just if anyone thinks that I could have done any harm to the patient. A knot formed under the skin and the child cried, but did stop when his mother held him. I told the doctor and he went in and looked at the leg and felt that everything was fine. I am just so torn up about this for some reason and would love any input on the matter. I am fairly new and am just so worried about everything I do! Any help is appreciated!

[redwinggirlie]

maybe a shorter needle next time? Don't be hard on yourself. It's ok. These things happen. It appears no harm done.

[cannoli]

About 30 or so years ago I hit the bone too while giving an injection, in the "butt" to a cancer patient, very emaciated. I think I understand how you feel.

If the doctor feels everything was fine, don't worry about it. Just go over in your mind how you'll do it next time.

[HyperRNRachel]

Remember to only push in the plunger and not push the needle further into the skin while pushing in the plunger.

[ABC]

Thank you guys so much! I have been so torn up about this for 2 weeks now. Cried for a week after it happened everytime I thought about it. I guess things like this really hit you hard sometimes. I know its not a huge mistake, but just really tore me up! Thanks again though for all of your encouragements!

[CHATSDALE]

next time use your fingers to palpitate and make a judgement about how large a needle that you should use...don't beat up on yourself...you have a good future ahead of you

[Gompers, BSN, RN]

I'm sure the baby is okay, and next time will be better. Most kids, you don't have to push as hard to get the needle in, and you can go a little slower than you do with adults. I work in Neonatal ICU, and we give all our IM shots into the vastus lateralis as well - even on babies that only weigh 400-something grams. We always use the same kind of needle, whether the baby is tiny or one of our 15 pound long-term chronic kiddos - a 25 gauge 1/2 inch needle. In the little ones, we don't push it all the way in, but on the bigger ones it's the perfect length. Just feel the muscle of the baby and go a little slower with the next injection.

Practice makes perfect, and don't be too hard on yourself, okay?

[barefootlady, ADN, RN]

Hi ABC

I know you are upset and feel terrible over this incident, but I admire your honesty in reporting it to the physician for exam. and further treatment if necessary. I have worked with nurses who would never be that honest. You have been given some really good tips here, especially by Gompers. I know you will put them to good use. You sound like you are on the road to being a really good nurse. Good luck.

[ABC]

Thanks again to everyone for the support. It's almost like right after you graduate you just wait to make a mistake. Everyday is sooo nerve racking! There are days that I feel so inadequate. I feel that I have the knowledge, but not always the experience. Being able to talk to others though on this website is really uplifting. It is great to hear various opinions from those new to the profession and those who are more experienced. Thank you again for taking your time to support me! Hope everyone is having and will have a great weekend! Some of you will never know the power of your simple words to those of us who just need a little encouragement!

[leslie :-D]

actually, remember the same advice goes for the frail elderly- or anyone that is emaciated....you wouldn't want to use the standard 23 gauge,but 25 would be better suited; and often times i go in at an angle if they're that bony.

your actions were commendable and highly ethical. for that alone, you're going to be a great nurse.

leslie

[truern]

We were taught in OB to palpate the muscle to determine how large it was, and then use a needle half that size so that it does to the center of the muscle. I had to give a teeny 5 pounder his vit K and I was like "you want me to put a needle where?!?"

It's more tramatizing for you than it was for him