I work on a high-acuity psych unit. I deal with psychiatric emergencies on a near daily basis (fights, physical assaults, threats, destruction of property, etc). Emergency STAT IMs are given out all the time like candy lol. I almost pricked a security staff member when I was administering emergency STAT IMs the other day. I feel so torn up about it . The problem is fumbling syringes in my hands when administering the injections. Usually haldol, ativan, and benadryl are given. On occasion, I'll mix the ativan with the haldol and give the benadryl separately so I'll only deal with 2 syringes. But some doctors stress that the medications be given in 3 separate syringes. If another nurse is working with me, one nurse will hold the syringes while the other administers each one by one. If I'm working alone, I'll ask an extra security staff to hold the syringes while I administer. However, this is not always the case because in most cases I work alone and the entire security staff is struggling to keep a fighting patient still. I wish there was some policy or technique on how to address this. It's just not simple to administer 3 injections. I'm hoping other nurses here can enlighten me on their techniques?
It is definitely performance anxiety for me more then the out of controlness of the situation. My fear is to mess up in front of a crowd of people. I also have a fear of hitting the person's sciatic nerve. I sometimes have a problem spotting the landmarks. I'm new at this and don't have to do it that often.
We do two syringes. One time a charge nurse told me to use three. The patient was a true psychopath (we later learned with a serious criminal record). And the charge said, make it hurt to show him who is in control. Luckily never had to give it and the patient was transferred the next day.
One psych hospital I visited had what they called the "tripleta" for this type of emergency incident. They were prepared syringes that had a standard dose of haldol, benadryl, and ativan ready to go. One injection, wait 2 minutes, second injection PRN. (The attending always has to sign off, it's not up to the nurses' discretion.) The word "tripleta" refers to a delicious sandwich here that is made from ham, ground beef, and ground chicken or pork. Maybe your hospital needs to consider making emergency "tripleta" syringes.
Specializes in psych, addictions, hospice, education.
I'm glad I didn't work with that charge nurse! We're not here to show anyone who's boss by hurting him!
One time a charge nurse told me to use three. The patient was a true psychopath (we later learned with a serious criminal record). And the charge said, make it hurt to show him who is in control. Luckily never had to give it and the patient was transferred the next day.
. The problem is fumbling syringes in my hands when administering the injections. Usually haldol, ativan, and benadryl are given. On occasion, I'll mix the ativan with the haldol and give the benadryl separately so I'll only deal with 2 syringes. But some doctors stress that the medications be given in 3 separate syringes. If another nurse is working with me, one nurse will hold the syringes while the other administers each one by one. If I'm working alone, I'll ask an extra security staff to hold the syringes while I administer. However, this is not always the case because in most cases I work alone and the entire security staff is struggling to keep a fighting patient still. I wish there was some policy or technique on how to address this. It's just not simple to administer 3 injections. I'm hoping other nurses here can enlighten me on their techniques?
WarrenpeaceRN
22 Posts
It is definitely performance anxiety for me more then the out of controlness of the situation. My fear is to mess up in front of a crowd of people. I also have a fear of hitting the person's sciatic nerve. I sometimes have a problem spotting the landmarks. I'm new at this and don't have to do it that often.
We do two syringes. One time a charge nurse told me to use three. The patient was a true psychopath (we later learned with a serious criminal record). And the charge said, make it hurt to show him who is in control. Luckily never had to give it and the patient was transferred the next day.