blonde0140

I always give IMs in the VG with the patient standing and leaning on the table. I have the patient pull down a small area of their bottoms so that the site is exposed but the patient is still covered and I place my palm over the greater trochanter and making a C with my index finger and thumb and inject in the center of the C. For a child, I have them lay on the table instead of standing. I have been doing VG IMs this way for 7 years and I have never had an issue.

I just looked at the manufacturer info on each. The outer leg is preferred for Varicella and IPV. DTaP is anything but glute and MMR states deltoid for all children but that cannot be true because most 1 year olds do not get deltoid vaccines.

I have never, ever had a kid sit on a parent's lap. I never trust a parent to hold their kid for me. At my previous ped job we had a kid on a mom's lap who what getting a vaccine in the deltoid. The mom let go, the kid flailed his arm and the nurse got stuck in the face with the needle. That really stuck with me. That is why I prefer the legs. With the kid laying down, knees bent over the end of the table and tucked between my knees they cannot reach me without sitting up and I will know if they try because I will feel their legs flex. This position gives me the most control and I do not have to rely on anyone to help me. I feel that it is the safest and fastest. As for the office manger... she was a ICU nurse 10+ years ago but is no longer licensed. I also would love some EBP input. I looked but have not found anything.

I have worked in Med/Peds for over 3 years now. I love how complex internal med can be. My only advice would be to learn and see all that you can! Out patient is a great place to lean about medications, test and labs. I have seen some great stuff in the office and at times I think that I am more well rounded than a hospital nurse specializing on one floor. Good luck!

I have been a peds nurse for about 4 years now. I have always worked out patient. I started in a VERY busy office with 4 doctors and 1 NP. In that office we had no help to give vaccines and had to come up with a method that we could do alone. I was trained by a nurse that had been in peds for 30 years and I respected her method. I now work for a single Med/Peds doctor and I am the only nurse. To give vaccines to anyone 5 and under I have the patient lay down and I do their legs. I can give 4 shots in under 30 seconds (have very specific safety syringes). All of my patients love my method because I am so fast. I have always given my kindergarten vaccines in the legs. I use a 1" for my IM DTaP and a 5/8" for my other 3 subqs. My IM goes in the muscle and my subqs go in the outside leg fat. I have had no complaints from any of my parents with this method. Today I had one mom call to state that the site of her son's MMR was red and swollen. The patient has no pain, fever, can walk on the leg, but has a red spot the size of a quarter. My office manager came down on me for using legs even though I have been doing this the last 3 years that I have worked here. She told me that her old nurse did arms and maybe I should start to do that. Honestly, I am not comfortable with arms on a 5 year old. There is less control than legs and the child has to remain still for a longer period of time. I researched this topic and legs are not contraindicated at this age as long as the proper needles are used. What do you do in your office? What do you think about using the legs for kindergarten vaccines?

I work full time as the only nurse for a single practice Med/Peds doctor. I love him and the practice and I have really gotten to know our patients over the past 3 years. We see 70% adults and 30% kids. The doc also teaches for a med school on the side. He is hoping to retire soon and is always saying that he wishes that one of his students would come back and be in position to take the practice in about 5 years. The other day he looked at me and suggested that I go back to school to get my NP so I can take the practice and be a stable figure for our patients once a new doc comes in. I realize that I have to work under a doctor but how can I be a NP for med/peds? Do I need to pick one or the other or can I do FNP? My passion is with the kids- more specifically the newborns so if forced to choose it would be peds but then I am loosing out on the majority of our patients. I have been accepted to a fast track RN to MSN program. Any input would be helpful. Thanks!

So I was offered a part time nights position in Mother Baby. I really wanted L&D but is impossible to get into without experience around here. I have a Lactation Consultant and Childbirth Educator certification and I have been a Peds office nurse for over a year. I LOVE our new mom's and babies in the office and I LOVE teaching my classes. My question is will I love this job if I loved my office patients and classes? Is night on Mother Baby boring? Is there a lot of one on one patient time? I have never worked in a hospital let alone nights so how hard is it really? I'm concerned about it only part time. How messed up will I be only working a few nights (11-7) a week?

So I have been an RN for 2 years. I have been working only in doctor's offices while I look for my dream job. I currently work for a Ped and I love the doctor, hours and pay. While working for him he payed for me to get my Lactation Consultant and my Childbirth Educator certifications as a way to get more patients. I have been teaching classes for about 6 months and I realized that I LOVED it. We had some internal drama in the office so I put out a few applications at local hospitals for L&D, knowing that I would never be hired without experience. Today I got a job offer to work Mother Baby at my first choice hospital. I was told if I do 2 years on M-B I can move to L&D. L&D is IMPOSSIBLE to get into around here without experience! Here are my concerns: it's only part time and it's nights 11-7. The pay is about what I make now so that is good. I have 3 kids (7,4, and 15 months) and I'm concerned about the nights part. I was told that after 2 years doors would open for different areas and shifts. So how do I leave my 9-5 Monday to Friday well paying stable job to chase a dream? I was thinking that I could keep office job on our short days (9-1) to make up the pay that I'd be missing working only part time. That means there may be days I work 11p-1p.... If any of you have ever worked nights how hard is it with kids? Should I chase this dream? I have heard so may nurses wish to be out of the hospital and in an office so am I crazy for walking away from all of this??? I would love some experienced input!