Nursing students and new nurses.....about injection sites

[TazziRN, RN]

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 administer at each site. I can give VG and glute and VL meds blindfold and asleep. Today we had a medsurg nurse float to the ER. She's relatively new, graduated about a year and a half ago, I believe. She was asking us how to find the glute sites to give an IM to a pt, because in school she had only been taught deltoids. Huh???? Let me add that she went to a very reputable nursing school and she has proven to be an excellent nurse on the floor. All pts admitted to the floors who need anything more than PO meds get IVs and injectables are given IV. My tech said that she received Toradol and Compazine in the doctor's office the other day (same doc's MA who gave my baby the flu vax I talked about here) and the MA gave both to her in the deltoids. My eyes went wide....both meds can be caustic, as well as 2 mls each. Is this what's being taught now???

[puggymae]

I teach Pharm and all students have to do a site check off (pass/fail). I teach in an LPN program, and we get alot of students who came from RN programs (flunked out) who cannot pass the Pharm step-out test because of 1) injection sites, 2) mixing insulins. So.. I don't know about everywhere, but I still teach it (just like the "old days").

[TazziRN, RN]

So I'm not losing my mind?? Thank you!!!!

[AuntieRN]

TazziRN...I am a recent grad and all I can tell you is...we were taught in school where to give them in our first semester...then we never used it. We were taught you give very few IM injections anymore. We were also taught to give it in the deltoid or the vastuslateralis rather then the vastus gluteus. I went all through school and did not give my first IM injection until I hit my last semester and had to rotate out to the pediatricians office for a day. We gave lots of vaccines. Then I never did it again until this past week which is now my fourth week of orientation. I know it is sad we are not taught things like they used to teach and sometimes I really regret waiting to go back to school for so long. I really feel we missed out on a lot in school

[Angelsamongus]

I am in my first semester of the RN program and we did go over IM locations. Our instructor has told us that if we find a patient that needs an IM to let her know so that we can have the opportunity to do one. The whole semester I have been able to only give one and that was because I was able to talk to the person in charge of giving the flu vaccination for that day and I was able to get her to speak with my instructor and they had each of us students do atleast one flu shot each. Otherwise, I have not had the opportunity to give one on the med surg floor. And I fear that I am already forgetting the locations, and so I will need to go back and study the different sites. I think that is what is happening, not enough opportunity and so many people forget what they learned especially after a long time.

[Laught3r]

I am a new grad LPN and we were taught all the sites over and over and over. We had plenty of chances to give shots due to we were in pediatric clinic, ER and they used the local nursing homes for flu vaccines.

[kcstudentnurse06]

I am a nursing student in an ADN program, and we are required to know all injection sites and the landmarks used to find them. We also were taught not to give more than 1cc in the deltoid.

[Lacie, BSN, RN]

Wow, I'm with you on this one Tazzi. I'm old school also and we had to learn all the sites for IM injections not only on paper but by giving practice injections to each other with NS. We did the same with IV starts for our check offs. We did use dummies and oranges for initial practice but the check offs we used each others rear ends and deltoids lol.

[Halinja, BSN, RN]

I'm in a BSN program right now, and we had to learn all the sites, plus give each other IM's in the ventrogluteal. In clinicals all I've ever given is subQ. (oh, and vitamin K in the vastus lateralis of a newborn) But it still is being taught.

Oh, and 1 ml in the deltoid, tops

[jschut, BSN, RN]

Wow, I'm with you on this one Tazzi. I'm old school also and we had to learn all the sites for IM injections not only on paper but by giving practice injections to each other with NS. We did the same with IV starts for our check offs. We did use dummies and oranges for initial practice but the check offs we used each others rear ends and deltoids lol.

We too had to learn the sites and give each other injections with NS. IV starts had to be done on each other and ID's were practiced on hot dogs, then on each other.

AS far as the sites go, we had to show how to find them on each other, by talking thru a demonstration, and were tested on it.

My guess is that the newbie also had to learn this info, but maybe has forgotten it or is just nervous and didn't think it through.

But I would be likely to inform her that the meds are NOT to be given together, and the reason why.

[wooh, BSN, RN]

If you don't do it much, you're going to forget. After a year and a half out of nursing school, probably a year of nursing school since really even going over it, add little practice because outside of ER or doing vax, IMs aren't all that common... Not surprised she had to ask. I'd be happy she did rather than just going in and sticking willynilly!

[MIA-RN1, RN]

we went over it in school but not much past first or second semester (of four); shots were given when we were able but rarely did anyone get to do an IM. Now where I work I have to give depo, rhogam, and once even steroids. (and infant hepatits occasionally) I hate injections because I don't feel I learned enough about them in school and finding landmarks is very hard for me.