Nursing students and new nurses.....about injection sites - page 3

I heard something today that just flabbergasted me......when I was in school back in the days of the horse and buggy, we had to name all IM injection sites and be able to demonstrate how to... Read More

  1. by   donastaci
    I graduated last December and was hired to work in an awesome ER. I must say that I have the advantage over most of my fellow classmates who have not had many opportunities to give IM shots or start IV's. It is my belief that every new RN should spend at least a few weeks in the ER where there are multiple opportunities to practice these skills. I have met many nurses in our facility in different classes that I have taken over the past 6 months (ACLS, PALS, Critical Care Nursing...) that have worked there over a year and have only started a few IV's and very rarely give IM shots. If TazziRn works in the ER I bet she starts IV's at least every few hours and gives IM shots by the dozens per shift. I'm lucky that our ER has its own ER booklet it gives out in orientation that fits right in my pocket that is a great reference and when in doubt shout. Ask someone who knows, most good RN's are willing to teach a newbee, at least that has been my experience.
  2. by   miko014
    I give tons of flu and pneumonia vax, but not much else IM. There's the occasional's common practice where I work to avoid the DG site at all costs, but VG, Delt, and VL are acceptable. I've done VG and Delt, but I've never done DG, and the VL I only used once and that was on a newborn back in school. I don't like giving IM shots, and I think it's mostly because I just don't do it all that often...and I know it hurts. I give SQ injections (insulin, heparin, neupogen, etc) like it's my job ...oh wait, it IS my job...
  3. by   smk1
    My school also is big on evidence based practice. We are one of the top nursing schools in the country. Great program and if any one of the instructors asked us a question that we were not sure of the answer they would expect us to say "I'm not sure, but I know where i can find the answer, i will get back to you about____." This i think is the key, it only takes a minute to look up the landmarks if you can't remember...
  4. by   mel1977
    I was taught to do most in the butt, and that is where we do most of ours at work, of course, most depends on the med being given. I give a lot of Testosterones and I only give those in the butt. The only time I have given in the deltoid was a Rhogam in school and the pt requested that site.
    I am a new LPN. I was given my flu vax in the arm though-I like the buttock region because it isn't as sore and my patients prefer not to get really sore in the arms it interferes with their PT.
    I landmark by finding the iliac crest and sacrum-I make a triangle shape with my hands and in the middle is where I do the inj. I was taught this by an RN where I work and have had many since him support that method. I never go into the middle of the buttock, always to the side. I am lucky that I am good too, my pts rarely say mine hurt I do not give inj to babies though- we don't get many peds.
  5. by   TazziRN
    I landmark by finding the iliac crest and sacrum-I make a triangle shape with my hands and in the middle is where I do the inj. I was taught this by an RN where I work and have had many since him support that method. I never go into the middle of the buttock, always to the side.

    Um.......that's how you should have been taught in school. That is the proper way to find your site, and the middle of the butt should never be used.

    Great that you're painless inj nurse, not everyone has that quality! I had one pt tell me that he'd received a butt shot from my then-coworker and it had felt like "she was digging a hole in my a** with the end of a pipe!"
  6. by   TazziRN
    double post, sorry
    Last edit by TazziRN on Nov 27, '06 : Reason: repeated
  7. by   arv
    Hi Tazzi!
    I really enjoy your posts. Just a quick note from nursing school on the East Coast - when we covered IM injections the first semester; we were told to disregard the DG site. It was on some of the handouts and lecture stuff, but we were told that (for the most part) IM's shouldn't be given DG because of the danger of hitting the sciatic nerve, I believe. That's been quite awhile ago & my brain moved on to other things since then, but I think that is the reason we were given. I remember them telling us to cross out the info; and I know we were only checked off on the other 3 sites.
    Have a great day!
    Last edit by arv on Dec 7, '06 : Reason: Goofed! DG not VG!!!
  8. by   TazziRN
    Quote from arv
    Hi Tazzi!
    I really enjoy your posts.
  9. by   friendly one
    I work in a physc unit where im's are a daily. You give them where you can as fast as you can. These are severe behaviors with ativan and haldol mix. I gave an im in the delt on a small man using the smallest needle possible. This man gets im's every 4 hrs and can only get them in the delt. When I gave his im it caused a big bubble of fluid under the skin. I've never had this happen before. Is this going to cause an abscess? The man gets antibiotic Iv bid for infection already.
  10. by   Epona
    Hi. I will be a new RN student starting in Jan. How many shots, IV's, IM's do we give each other in RN school?? Do we take each other's blood?? I am guessing we do all this, but just wanted some insight.


    Thanks! Epona
  11. by   NurseWi_JennJenn
    We learned all the IM injection sites second semester... I didn't give an IM injection until I started working as a RN during orientation and by then needed a refresher of the landmarks...
  12. by   CityKat
    I learned them in my first semester of holistic fundamentals. I know how to find the area on the glute and adminster one. I have administered all ways. I have even had the opportunity to do a ppd and today I drew blood. But my point is, I have NEVER used the IM except for the flu vaccine clinic, but I do know where all areas are and how to find the two ways of finding the correct area on the glute so I don't hit the nerve
  13. by   lauralassie
    Know what you mean. Many days I think nursing schools need to get back to the basics. I really think that is why so many new grads become stressed to the point they leave nursing after only a couple of years. They have no practical training. I don't see the point in all the book work with no hands on. It's like training a pilot with books and then woundering why they can't take the stress of a real flight. New grads, don't be mistaken,we had just as much book work but three full days of gut wrenching clinicals on top of it.The BS they learn in school these days!