Vaccinating Adolescents

[missnurse89]

I have been an RN for the past 2 years and work in public health. Love my job! I am wondering if anyone has any helpful tips when it comes to vaccinating adolescents. I find that this group presents the most challenges when administering vaccines as their behavior can just get out of control. I honestly think starting an IV on a chunky 3 year old is an easier task! In my experience, I find that there is no reasoning with adolescents and their over-dramatic irrational thinking at that age. I am very calm yet firm with my patients and vaccines are usually no problem. I do try to be quick and not drag it out. If they get out of hand I usually tell parent that I will step out of the room for a few minutes and give child and parent some time to talk and calm down. Usually when I just tell them what I am doing (so as not to startle them: " just cleaning your skin now" or letting them know that I am just going to put my hand on their arm), they do well. When time to vaccinate I will tell them to take deep breath in and then to let it out. When they let it out they will usually relax there muscles and makes it easier on them. These are the techniques I have found to work really well. However, there are just some kids that these techniques don't work on and I really prefer NOT to allow the parent to "sit on them." I have been told by other nurses to have parent hold them down or sit on them. I really don't think that is appropriate. I refuse to administer vaccine into a tensed up muscle or with hand clenched. I don't want my patient to feel threatened or like they are in danger, and make it even harder to vaccinate in the future. And also I do not want to have an accidental needle stick because of a combative patient or end up with them jerking in some other direction when I administer vaccine and end up causing damage. And also I don't want the patient to pass out afterword from working themselves up over the whole deal. So I usually just tell the parents they are going to have to come in another time for the vaccination. I really don't have any other ideas for the matter. I don't want to force it into the kid and them feel like I am violating them. Has anyone else dealt with this type of situation before? Any tips that you have? I would certainly appreciate it! :)