Moral of the story: Never give IM injections?

[hnwbeachbum]

So, I'm a little terrified, and would like to vent a little, and maybe get some advice. I was told Friday by a coworker that myself and two other nurses had been accused of assaulting a resident. This poor little woman had breast cancer with mets to the brain plus dementia and she had gone absolutely crazy one night. She was fully ambulatory, so she was going in people's rooms, yelling at the top of her lungs, and wobbling on her feet, so I called the oncall for an IM injection, because she wouldn't take her p.o. Ativan. From what I remember, (this being 2 weeks ago) the nurse supervisor and another nurse held her hands so that she wouldn't jerk and cause me to accidentally stab someone else. Apparently one of the cnas told the higher ups that we held her down, which is not true. I'm scared to death. This is the only job I've ever had as a nurse. If I get fired for abuse, who is going to hire me after that? I'm also a little irritated because I really don't understand why this cna turned us in. If she thought we were hurting her, I would completely get it, but we weren't. I haven't had my meeting with the big wigs yet, but I've been nauseous all weekend. Honestly how can I deal with out of control patients when reassurance doesn't work, and they won't take their p.o. prn meds?

[FLArn]

@nightowl

If I am reading the original post correctly the OP took 2 other staff with her to restrain the agitated patient so that she (the patient) would not move unexpectedly causing the OP to accidentally stab someone else. No one got an accidental stick.

[Nightowl_lpn]

Oh, I misread it. Thank you b

[hnwbeachbum]

Update, I explained what happened, wrote my statement, making sure to be very clear that the resident was able to move her hands if she wished the entire time, and everything is fine. I was told I need to document better in the future about how I give injections, not just the behavior leading up to the injection.

I'm interested in this topical lorazepam, and definitely will pick the nurse practitioner's brain about it the next time I see her. Also, I will look into insurance. I promise. Thanks for the responses.

[amoLucia]

To OP - many nurses here use NSO for our malpractice insurance. I'm sure they're on-line. Do not delay - it's your professional practice at stake without it.

[CapeCodMermaid, RN]

My medical director tells us topical Ativan is not well absorbed and therefore not a very useful drug...especially if someone is freaking out.

[ktwlpn, LPN]

Not many studies have been done on it. We use it because it does takes the edge off and it's better then the alternatives. Our DON, medical director and psychiatrist think it's safer for the staff and causes less trauma to the resident. It's been a great help in cases in which we were struggling to get the behaviors of some really challenging residents under control for the safety of the other residents and staff. It's been effective and enabled these residents accept basic care,food, fluids and psychoactive drugs on a regular basis. Best thing-the admin and docs want the staff to be safe...that's awesome.

Our goal has been to admin the drug BEFORE the resident gets totally out of control. Just like any other unit we try all appropriate intervention first, track the behaviors to try to determine the triggers,etc.