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

pvjerrys · Dec 7, 2006

my first semester clinical group has performed the following in the clinical setting: insert & discontinue ng; insert & disc foleys; administer po, im, sqs, opiates; perform wound care (w-d, remove staples, apply steri-strips); administer enemas, e.g. harris flush; iv therapy (disc iv caths, change iv large volume); nasotracheal suctioning; learn how to assertively report changes about their pts to rn and mds. (list not inclusive.)

i have given a list of procedures within their scope of practice to the units. i "troll" the units for procedures. the rns comment that my clinic students are very motivated & willing to do the procedures. and btw, for their experience, i have students give all ims in z-track technique.

there have been bsn preceptees that have worked along side my students. they are amazed at how much these first semester students can do. for me, i take great pride in their competent manner and accomplishments.

EarthChild1130 · Dec 9, 2006

I graduated last July from a BSN program and we learned in our 2nd semester how to administer IM injections, and I used that information quite a bit as my first job was acute care inpatient psychiatric nursing, which I love and miss terribly, as I am now working medical/oncology since moving from home. I will say that I am a 'crack shot' with a syringe! I do shots very well! LOL

rnin02 · Dec 9, 2006

my first semester clinical group has performed the following in the clinical setting: insert & discontinue ng; insert & disc foleys; administer po, im, sqs, opiates; perform wound care (w-d, remove staples, apply steri-strips); administer enemas, e.g. harris flush; iv therapy (disc iv caths, change iv large volume); nasotracheal suctioning; learn how to assertively report changes about their pts to rn and mds. (list not inclusive.)
i have given a list of procedures within their scope of practice to the units. i "troll" the units for procedures. the rns comment that my clinic students are very motivated & willing to do the procedures. and btw, for their experience, i have students give all ims in z-track technique.
there have been bsn preceptees that have worked along side my students. they are amazed at how much these first semester students can do. for me, i take great pride in their competent manner and accomplishments.

what a great teacher you are! most of my clinicals were quite lacking in chances to actually "do" things besides baths, bed changes and basic assessments, and basic medication administration. 4.5 years into nursing and i still haven't gotten the chance to actually put in an ng by myself, or a foley either for that matter. any patients i've had that needed them, have been the kind of patients that take the most experienced nurse on the floor to be successful at insertion, just my luck i suppose.

back to the actual topic of the post, i've rarely needed to give an im outside of the deltoid, most have been small enough volumes that it was far easier to give in the deltoid. i have recently started working with newborns, so of course now i give ims in the vl.

CarrieH · Dec 10, 2006

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???

All I can say is there are some injections (ie - Bicillin) that I'm glad I can give it where the patient can't see it. I was also taught that the max in the deltoid is 1ml. As long as you know where the sciatic nerve is located, a gm injection isn't any more dangerous than any other location. I'm surprised that they're not teaching it anymore.

MT Student Nurse · Dec 16, 2006

I am currently in the last semester of nursing school and we were checked off on injection sites during our 1st semester and never used this info. I was recently doing a ER rotation and was able to finally use the information which I reviewed the night before. Ventral Gluteal was the site used most during the rotation. I did administer rocephin Vastus Lateralis to a 2yr. I participated in a Flu-Shot clinic yesterday which the deltoid site was used. During this event my instructor and one of the nurses participating were in disagreement about deltoid sites so that only added to my education. I guess I will continue to learn as I go along.

moongirl · Dec 16, 2006

ADn program. taught all of the sites, had to practice finding them on each other, then had to choose appropriate needle and do a check off on a mannequin in front of the instructor. we also had a lab for 4 hours on insulin prep and admisntration and also intradermals

jimthorp · Dec 17, 2006

I had to learn all of the sites, appropriate needle size, landmarks, etc. I had two clinical instructors where I got do give a number of IM's. For greater than 1cc the ventrogluteal is my site of choice for adults but whenever possible I give IM's greater than 0.5cc in the VG site. I work in LTC/Rehab and have given quite a few IM's.

RN mom of 2 · Dec 17, 2006

ID's were practiced on hot dogs, then on each other.

When I first read this I couldn't stop laughing! :lol2:

skittlebear · Dec 17, 2006

In my LPN program, we practiced on Oranges for 30 minutes and was instructed on how and where to give injection sites. It was pretty much up to us in clinicals to get any experience. I only gave about 8 SQ injections. No IM's, or Intradermal. I have still yet to experience giving a Intradermal injection. At the time, I wished we could have at least practiced on each other to get a feel for it before we got to experience it first hand with a patient.

Late Bloomer · Dec 18, 2006

I have just completed my first semester of ADN classes. We covered all of the IM injection sites and had to pass a checkoff. We did not practice on each other (I am glad to say, we practiced on maniquins and injection pads) and were told we did not really need to know the Z-track. It was covered in our book though. No one told me that the VG site was not recommened for use now. I gave my first two SQ injections to a patient at the end of the semester. No one in the class has reported being able to actually give an IM.

Next semester starts, the first day, with IV technique. I do have a problem with the clinical setting though, it seems that most of our experiences are to be found on our own. My instructor tries to be sure we get experience with some things, but a lot of things we are expected to just ask nurses on the floor if we can do stuff. Assertiveness is highly prized. I find I am worried about doing something and then having the instructor say "where do you get off?!" doing xyz. The nurses are just too happy to have us do anything they are time pressed to do.

jmeador · Dec 18, 2006

:balloons: The second semester of nursing school we had to give our trusty lab partners deltoid, glute, and SQ injections. We also started IVs, and drew blood.

BUT because of sporifice flu shots over the last 2 years our Drive-Thru Flu Shot Clinic had to be canceled.

JosieLPN · Dec 22, 2006

I graduated this past aug and we were responsible knowing and demonstrating all of the injections sites, what syringe and how many ml's each hold