Practice intramuscular injection students on each other, Australia

cayenne06, MSN, CNM · Feb 29, 2012

I have no idea about Australia, but when I was in Midwifery school we practiced blood draws, IV starts and even pelvic exams (!!!) on each other. I can't see why it would be a problem as long as it was strictly voluntary, and obviously only NS was used!

Did a student complain? Maybe someone felt coerced to participate, and wasn't comfortable with the situation.

mumlauf · Feb 29, 2012

Thank you. Anyway crucial is Australia experience. And yes, on the other day one student get hysteric, that she can have air embolism (intramuscular, new, totally compressed, double checked syringe etc...). That she was used as a needle cushion (every student got one needle), that she had such a sour on arm she almost die, and some other things. Don't ask me what such a student do in the last semester just before graduation to be the nurse.

associatedbears · Feb 29, 2012

I am an Australian Neuro/Trauma Nurse of 25 years experience and have never practiced injections on a colleague or had it done on me. If full consent is given and just normal saline is used under full supervision, then the hysterical reaction seems excessive! We practise on our patients, poor things!So how is that any different?There is a great Registering body APHRA in Australia and proactive Unions. I would be contacting these bodies and having a chat with them. The Unions also have Legal Services; if you need them! Good luck!

mumlauf · Mar 1, 2012

Thank you. Yes, we already contacted "proactive Unions". They asked us if we can get something saying that this method is/was used in Australia, that is the point of this thread. Thank you again, good luck to you too :-)

ceridwyn · Mar 1, 2012

I have been a nurse since 80's. I have never heard of practising IM injections on fellow students, in those days blood taking was done behind educators back, when free reign in prac room.

I would suggest it is unsafe practise even injecting saline. The university or place of education is at great risk of just this type of thing. Even though a student may/ may not suffer physically, obviously emotionally she has and this is reason for legal action.

Bullying can go on and a student can be put in a poor position to succumb to this, especially if the educator is the one that has suggested this practise.

Even in the old days, oranges or dummies have been used for practise. My first IM on a human was on a patient and I have never had problems or complaints with IMs, nor catheterisation nor iv starts, nor blood taking and they were all practised first on dummies.

I have worked with student nurses, in Victoria, NSW and Queensland and would not have asked them to practise on each other. I ordered a box of oranges. I believe doing anything that is evasive, is not done to fellow students.

I would be surprised if the USA or the UK universities allow this practise.

I could not give IM to a fellow student/colleague for the fun of it, even at my age and experience. Unless they were unwell and I was in a professional capacity.

I would have to say, that this was most unusual practise in Australia.

It is most likely nothing written anywhere, just the legal reasons why it is not practised, and in Australia there is high immunisation rates so most students remember very well what a IM injection feels like.

It is also different 'feel' depending where you give it and to who you give it, fat, thin, old young, indigenous type skins, weathered skin, old skin and 'how' you would give it, size of needs etc etc, it is an assessment before you give the IM injection.

That is why it is 'practised' trying to think of a better word, on humans in clinical practise under mentor supervision after assessment, how best to give the IM injection depending on all the above factors, also with okay from patient, so there is also no point of doing it on other students, it is these reasons why it would be seen as unprofessional.

mumlauf · Mar 1, 2012

ceridwyn thank you. Well, I can assure you it is done this way in UK/Germany and other Europe countries. Of course in organized manner, under supervision and what is very important - with agreement of students, nobody is forced. And that is how it was in this case.

I can understand, that some people can have phobia from injection, but in that case they must not be nurse. It is dangerous to give IM to student but not to patient? I don't get your point in this. Nobody is giving anybody IM for fun. It is very important and serious practice.

If only thing you practice is injection into orange, it doesn't help you much. Actually it is known problem, that poor practice leads to increased incidence of needle-stick injuries. I heard many of these finishing students had very poor practice, was not confident at all to give IM to patient, did it in the wrong way. Want you them to be nurses and start their practice on me (you, anyone) without supervision?

Again thank you for sharing your experience.

ceridwyn · Mar 1, 2012

Again,

giving it just to one another to show it hurts and the suggestion itself would cause not an in effective learning environment anyway, does not give assessment skills on the right equipment or how or where to give the injection, which I find is the most important part of giving an IM injection, not just how to push a standard 23 gauge into a person in the deltoid and push some fluid down the needle.

I as yet have not had any students nor myself with a needlestick injury.

You asked did anyone know if it was common practise in Australia and what reasons for it being called unprofessional, I have provided you with that.

mumlauf · Mar 1, 2012

I have to completely agree with this one. Only thing which helps and makes you more confident with giving IM to people is practice, best at the beginning with supervision and feedback. And that is what is it all about. With this method, and again only if you agree to participate, you practice IM to real people, also observe variations when every student, one by one under professional supervision with breaks for feedback, discussion, answers etc. give one IM.

Thank you again ceridwyn, I appreciate your answers.

ceridwyn · Mar 1, 2012

Another thing to consider,

As many student nurses, depending on the clinical placements do not get the chance to have experience in some skills, IM injections being one of them, as most substances are put through IV and pumps in hospital environments. They only have the chance if on community placement they get to go to a Medical Practice. Or in aged care they may get a few to do.

It is not considered unworthy, unskilled, if you get a nursing degree in Australia and may have done 1. IM injection, because they (students) are taught if you are not familiar with a procedure, you must get assistance from a more experienced nurse and they will mentor you through that procedure, (nearly all wards have a clinical educator) you are never to just go ahead blindly thinking because you are a newly Registered RN you have to know and have experience in everything. Thats why they did away with 'tasks' to be marked off on clinical placements.

Thats why graduate programs are invaluable and it makes the new nurse quite at home to say....have not done this before or I am still not confident to do this on my own, so please supervise me.

This tends (on my experience) to be something quite novel for nurses educated from many overseas countries.

But it is instilled in students here, if you do not have the confidence or experience get supervised even when RN with lots of experience in future years, and if you do not understand something, research it.

Of course and I agree. there will be those who do not, but task orientation does not really teach getting help when not confident, when you may have only done one to get it marked off and still not confident.

mumlauf · Mar 1, 2012

There are many things around, which we can discuss, which for sure can help but also don't have to be around always when needed to help new nurses. It doesn't change anything on the fact, that as student it is best to practice and learn as much as you can because you know you will need it. And of course, if you don't know, are afraid, not confident (like with the embolism thing), all you have to do is ask. But maybe this is the seed of this whole problem because the complaining student didn't ask, agreed and second day change her mind. Also other time before said by her words "I don't want be nurse, I just want the paper".

Thank you, but I would like to focus back on the topic of this discussion - experience with this method in Australia.

suga_junkie, BSN, RN · Mar 1, 2012

I am a 3rd year nursing student in Western Australia. When we learnt IM injections last year, we practiced them on mannequins padded with fake skin. The only needle-type practice we did on ourselves was testing our blood sugars, and we had to do our own, not someone else's. I guess its a liability thing for the university. I did my first subcut and IM injections on patients during prac rotations.