Older kids and shots

CoolKidsRN · Jun 28, 2018

Talk to them and distract them while performing the procedure. However, I like to explain the procedure, ask for their preference to count to 3 or just get it done. I also position the child so they are not facing the needle, have them look away, and at times I will have parents hold the arm where I'm going to give the shot to avoid them moving the arm. I let them know firmly as well that if they move and the needle comes out, I will have to change the needle and stick them again. For older kiddos, it's better to be factual and honest.

SiwanRN · Jun 28, 2018

CoolKidsRN has great advice. In addition to above, sometimes it may help to have the 11 year old sitting up on the exam table, and then the parent standing in front of them to corral their legs (I dislike being kicked) and either bear hug or otherwise hold their arms or hands to keep the arms from jerking around or a sudden hand swiping up where I am about to inject a vaccine. Meanwhile, I stand to the side of the exam table on the side I am giving the shot in and do my thing as quickly as it is safe to do. Having the exam table with the back of the table raised so it is more like a chair is very useful if you do it this way.

As another distraction technique, you can also ask them to exhale like they are blowing out birthday candles as you give the shot. Or engage them in conversation about other topics. Each kid is different, you have to suss out what will work best in each individual scenario.

However, ultimately, some 11 year olds still hulk out and go absolutely bonkers and if their parents will not/cannot safely restrain them for you to give the injection (note - where I work has a policy against nurses doing any restraining, parents must do it) then you may just have to have them reschedule for another day. Safety first, and also I don't really want to end up in court being asked how it is I stuck a kid in the hand instead of their deltoid.

AnnieOaklyRN, BSN, RN, EMT-P · Jun 30, 2018

That's because it's Tetorifice shot time and they know how much they hurt!!! :) Feels like you are being stabbed by a dull knife!!

DisneyNurseGal, BSN, RN · Jul 2, 2018

Congrats on getting into the Pediatric field! It is so amazing, I hope you will love it. I like what everyone else has said here, especially distraction. Given the appropriate distraction and holding in a position of comfort, many times I can give shots or start IVs without the patient knowing.

What I do like to try to avoid are statements that tell kids how they will feel. For example, telling a child "It will only hurt for a second", you do not know that, you can not promise that, nor can you assume that every kid feels pain in the same way. My son from the time he was born never even flinched with injections. What you can do is talk to the patient, and try to find out what is bothering them. Maybe it is the pain, maybe it is just the unknown, whatever the reason, you can talk about it and try to ease anxiety. Offer stickers, a lollipop (or whatever your facility provides) as a treat when you are finished. Assure them that you are going to do the best you can, will try to make any pain go away quickly, and it will be over as soon as possible.

When I started in the Pediatric field, I read a couple of books on child development, specifically from the practitioner's perspective. This will help you learn about each stage of development, what strategies work and how to work with kids on their level.

In my opinion, Peds has a little steeper learning curve because of learning to deal with not only the kids but the parents as well. Give yourself time, before you know it you will know tricks and be sharing them with the rest of us.