Are you scared of giving flu shots ?

[UES Girl]

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

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[TXPharmDStudent]

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

Just do it. If you hurt them then you hurt them.


Even the best baseball players get hit by a pitch every once in a while. Just do it.

 

[DAW2]

ive given thousands of flu shots. at first i was scared, but now it is ok. the worst ones are the old ppl with no meat. some flinch and you have to jam it in harder cuz they back away. but id say 99% of the comments i get was something along the lines of i give good shots and that didnt hurt.

its the customers that are really b***hy that i wanna stab hard and make it hurt but eh what u gonna do just poke em and move on

 

[KARM12]

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

Of course it will hurt...all shots do. Think of it this way, they people are there because they want it. No one is forcing them. You are doing a greater good by giving them the shot...a tiny bit of pain is okay for protecting their health.

 

[Sparda29]

Not at all. I prefer to use the alcohol swabs w/ benzocaine for a little numbing effect. Then when I'm going to give the shot, I tell the person to count to three.

Patient: One...Two...
Me: Adminsters Shot
Patient: Oh, that's it?

 

[diastole]

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

That sounds awful. Were you crying loud and noticeably or were there just a few tears running down your cheeks? I think I'm more traumatized by your story than the thought of giving flu shots. I don't even like to cry in front of my friends. Crying in front of everyone has to be one of my worst nightmares. I wish you luck in getting over your fears.

 

[WVUPharm2007]

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

Don't look at it as causing pain. You have to look at it as a whole process. You are potentially preventing the pain of a severe pulmonary infection...just with the slight caveat at that you have to break an egg to make an omelet. Do you honestly think that the additive minor pain associated with a group of patients at an immunization clinic can possibly trump the pain that you are preventing if only one of them doesn't get sick that would have otherwise?

Tai Chi that junk in your brain Cheby...flip it around...you are a weapon of analgesia...

 

[kbv]

Are you aware of how thin the needle is? The standard is 22-25G IM. You can hardly feel anything. For the skinny, go ahead and stab as hard as you can; you only experience the needle/pain thru the nerve endings, not bone.

 

[RxMarine]

Little kids are the worst...make sure to tell them not to look at the needle. Preferably, have an older sibling go first to show them how easy it is. Once they look at it, your f'ed!!! Before u give it, grab their shoulder/arm/back whatever to distract them and then stick them...most ppl can't feel it...

...if the kid sees the needle when you approach they're gonna jump and it ain't gonna be fun.

The benzocaine wipes really do work!

For most people...the muscle soreness is more painful than the shot itself. The old ppl who've been around the block will pop motrin a few hours before and after.

 

[UES Girl]

Thanks for all the great advice, I feel slightly better.

 

[TXPharmDStudent]

Little kids are the worst...make sure to tell them not to look at the needle. Preferably, have an older sibling go first to show them how easy it is. Once they look at it, your f'ed!!! Before u give it, grab their shoulder/arm/back whatever to distract them and then stick them...most ppl can't feel it...

I think little kids are the easiest to give shots to because you can fool them easily. All of my friends who've recently graduated tell me they distract the kids by getting them to look away and when they stick the needle in they just say "ok I'm wiping your arm and it might feel warm or funny, I don't have the needle with me" and they fall for it. Then you tell them you already stuck them and they giggle rather than scream.

But you gotta be skilled, you can't treat the child like a dog.

 

[Sparda29]

Little kids are the worst...make sure to tell them not to look at the needle. Preferably, have an older sibling go first to show them how easy it is. Once they look at it, your f'ed!!! Before u give it, grab their shoulder/arm/back whatever to distract them and then stick them...most ppl can't feel it...

...if the kid sees the needle when you approach they're gonna jump and it ain't gonna be fun.

The benzocaine wipes really do work!

For most people...the muscle soreness is more painful than the shot itself. The old ppl who've been around the block will pop motrin a few hours before and after.

The muscle pain after the shot is worse than actual shot IMO. When they gave me the Hep A shots, I remember walking around and my left arm felt twice as heavy as my right arm, but yeah, nothing that Ibuprofen can't stop.

 

[eventualeventer]

Are you aware of how thin the needle is? The standard is 22-25G IM. You can hardly feel anything. For the skinny, go ahead and stab as hard as you can; you only experience the needle/pain thru the nerve endings, not bone.

Wuh? I don't know how likely you are to hit bone in a skinny person (I'm more of a cat/dog/horse type when it comes to wielding needles), but the periosteum covering bone is very well innervated and any sort of disruption HURTS. I've stabbed my fingers multiple times thanks to spastic horses*, and I can tell you that all of the superficial pricks on the fingertips with 18G+ needles were nothing compared to the time a 23G needle hit the bone on the side of my finger.

*In case you were wondering how I manage to stab myself: When trying to use an IV or SPL catheter, the horse often thinks that you are going to stab it (or knows that the SPL meds sting) and starts flipping their head or otherwise freaking out until they learn that you are not actually sticking the needle in them. Veterinary medicine has yet to catch up to human medicine when it comes to keeping employees safe. At one place, they actually had needleless injection caps that I would put on the patients' catheters, but they always got replaced with traditional injection caps by other techs who claimed that the needleless one-way valve types were "hard to use".

 

[rx2010]

I've never given a shot before, but I think I'll be scared as well. I can't even look when I get a shot. I always turn my head... But I will have to give immunizations when I start working, so hopefully I can learn to be comfortable with giving shots.

Good luck and let us know how it goes.

 

[twester]

Remember to do it quickly. Quick insertion hurts less than sliding the needle in slowly.

And I try to grab the muscle a bit with my other hand and squeeze kind of hard. It helps to guide me to the landmark and it distracts the patient.

I love giving injections.

 

[kbv]

Wuh? I don't know how likely you are to hit bone in a skinny person (I'm more of a cat/dog/horse type when it comes to wielding needles), but the periosteum covering bone is very well innervated and any sort of disruption HURTS. I've stabbed my fingers multiple times thanks to spastic horses*, and I can tell you that all of the superficial pricks on the fingertips with 18G+ needles were nothing compared to the time a 23G needle hit the bone on the side of my finger.

*In case you were wondering how I manage to stab myself: When trying to use an IV or SPL catheter, the horse often thinks that you are going to stab it (or knows that the SPL meds sting) and starts flipping their head or otherwise freaking out until they learn that you are not actually sticking the needle in them. Veterinary medicine has yet to catch up to human medicine when it comes to keeping employees safe. At one place, they actually had needleless injection caps that I would put on the patients' catheters, but they always got replaced with traditional injection caps by other techs who claimed that the needleless one-way valve types were "hard to use".

"I don't know how likely you are to hit bone in a skinny person": I'm the skinny, and got hit to the bone by my partner during our certification.

"(I'm more of a cat/dog/horse type when it comes to wielding needles)": Isn't it rude and doesn't make any sense to compare human anatomy to animal anatomy?

"but the periosteum covering bone is very well innervated and any sort of disruption HURTS": Sorry to disappoint you, but my education and experiences are only involved in HUMAN Physiology/Anatomy. Have no idea about animal anatomy.

"and I can tell you that all of the superficial pricks on the fingertips with 18G+ needles were nothing compared to the time a 23G needle hit the bone on the side of my finger.": Wow, you do stand out from the normal me. A 23G/smaller size causes more pain than a 18+G/bigger size? Pls read "...The more draws, the smaller the wire and the higher the gauge number..." http://books.google.com/books?id=eE...epage&q=hypodermic needle gauge chart&f=false.

Besides, are you aware of where the injection site is? It's DELTOID, not your finger.

 

[twilightz]

Just do it. If you hurt them then you hurt them.


Even the best baseball players get hit by a pitch every once in a while. Just do it.

Sorry, I was thrown off by your analogy. You seem to be implying that getting hit by a pitch is a bad thing, please tell me that's not what you meant. You do realize that you get an automatic walk if you get hit by a pitch, and thats a good thing.

The best players will gladly accept being hit by a pitch, especially if it's in the playoffs.

 

[Sparda29]

Sorry, I was thrown off by your analogy. You seem to be implying that getting hit by a pitch is a bad thing, please tell me that's not what you meant. You do realize that you get an automatic walk if you get hit by a pitch, and thats a good thing.

The best players will gladly accept being hit by a pitch, especially if it's in the playoffs.

Yeah, I think he meant that sometimes even the best pitchers hit someone with a pitch. Unless of course it's on purpose.

 

[TXPharmDStudent]

Sorry, I was thrown off by your analogy. You seem to be implying that getting hit by a pitch is a bad thing, please tell me that's not what you meant. You do realize that you get an automatic walk if you get hit by a pitch, and thats a good thing.

The best players will gladly accept being hit by a pitch, especially if it's in the playoffs.

It's not a good thing when a 100+ mph fastball is aimed right at your head

 

[Pharmavixen]

Where I live, pharmacists aren't allowed to give shots. In the past, I was even chastised (not in any official way) by an inspector from the college for pricking peoples' fingers to demonstrate how to use a glucometer. But they're changing the rules. Can I use this thread to ask coupla questions?

1. What size/gauge needles do you use for the flu shots? The one for the Canadian market is given IM; I'm guessing your product is the same.

2. Do you use different needle sizes for different patients? How about a very thin old person, say; do you use a shorter needle?

 

[eventualeventer]

My responses in italics:
"I don't know how likely you are to hit bone in a skinny person": I'm the skinny, and got hit to the bone by my partner during our certification.

"(I'm more of a cat/dog/horse type when it comes to wielding needles)": Isn't it rude and doesn't make any sense to compare human anatomy to animal anatomy?

"but the periosteum covering bone is very well innervated and any sort of disruption HURTS": Sorry to disappoint you, but my education and experiences are only involved in HUMAN Physiology/Anatomy. Have no idea about animal anatomy.

Mammalian anatomy and physiology is markedly similar among species -- the differences are the exceptions, not the rules. Why do you think we are able to use veterinary models for so much human medical research, including research on the neurobiology of pain?

"and I can tell you that all of the superficial pricks on the fingertips with 18G+ needles were nothing compared to the time a 23G needle hit the bone on the side of my finger.": Wow, you do stand out from the normal me. A 23G/smaller size causes more pain than a 18+G/bigger size? Pls read "...The more draws, the smaller the wire and the higher the gauge number..." http://books.google.com/books?id=eE...epage&q=hypodermic needle gauge chart&f=false.

My point is that a) hitting the bone can hurt and b) the location of the needle can affect the amount of pain experienced as much as or more than the size used.

Besides, are you aware of where the injection site is? It's DELTOID, not your finger.
Being the recipient of many vaccines, including some within the last year, I am aware of the injection site for vaccines in people. I was trying to make a point about pain sensation associated with disruption of the periosteum.

“The extensive plexus of fibers investing the periosteum and joints gives bone the lowest pain threshold of the deep tissues.”

Google Books Link

Anat Rec. 1984 Jul;209(3):297-9.
Innervation of human bone periosteum by peptidergic nerves.

Grönblad M, Liesi P, Korkala O, Karaharju E, Polak J.

Nerves exhibiting substance P-like immunoreactivity were demonstrated in the human periosteum. A network of nerves showing substance P-like immunoreactivity was seen in the periosteum, while finer strands of immunoreactive nerve fibers were present immediately beneath the surface of the periosteum. Enkephalin-like immunoreactivity was also studied but could not be demonstrated. Substance P has previously been suggested to be involved in the mediation of the sensation of pain. The clinically observable marked pain sensitivity of periosteal tissue might be explained by the peptidergic nerves described in this paper.

Bolding mine. PubMed Link

 

[ForcedEntry]

Great resource, but how much damage could the point of a 25G needle do to the periosteum?

 

[Chancery]

Not a big deal after the first 50 or so. Bigger deal is needle sticks. Please be careful. Most people are not infected with any blood pathogens, but some are. You are only one stick away from Hep or HIV. Keep your eye on that needle all the time!

 

[BanBidil]

Wuss...

I signed up to volunteer to administer H1N1 and now I am deathly scared.

I guess, I am scared of hurting a patient or causing someone physical pain. During our immunizations trainining, we had to administer a shot to our partner in class in front of the whole class and our preceptros. I got so nervous and worried that I might hurt my partner, I just started crying in front of everyone.

The idea of another human being experiencing potential pain/discomfort as a result of my doing is nerve wrecking. Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

 

[RxWildcat]

Does anyone have any tips how I can mentally prepare myself ? I specifically signed up for this volunteering to get over my fears.

Suck it up, you're not going to hurt them. Go stick an orange at home 2-3 times and then have at it.

 

[Sparda29]

Not a big deal after the first 50 or so. Bigger deal is needle sticks. Please be careful. Most people are not infected with any blood pathogens, but some are. You are only one stick away from Hep or HIV. Keep your eye on that needle all the time!

Something I've had an idea about but I don't know if others have came up with it already, biodegradable needles. You administer the vaccine, press a button and the needle detaches from the syringe and stays inside the person and dissolves.

 

[Pharmavixen]

Something I've had an idea about but I don't know if others have came up with it already, biodegradable needles. You administer the vaccine, press a button and the needle detaches from the syringe and stays inside the person and dissolves.

Those cause autism

At the jail, the nurses use Vanishpoint syringes. Anybody use those? When you finish giving the shot, you press a bit with your thumb, and the needle springs up into the barrel. So the syringe becomes its own sharps container.

They cost a lot more than regular syringes, but with a population that's 12x more likely to have Hep C, and 5x more likely to have HIV, and 25% with a major mental illness, the vanishpoint syringes pay for themselves in eliminated needlestick injuries.

And if an inmate got hold of one somehow, he'd only be able to use it once.

(Edited to add: cool idea, biodegradable needles. They'd make them out of the same material as those dissolvable sutures?)

 

[Garfield3d]

I was definitely spooked the first time I volunteered at a flu clinic. I observed the first few shots and obsessed over things like 1.) How deep to push the needle, 2.) How fast to push the plunger, 3.) Exactly which spot on their skin should I hit, etc.... Honestly, all of those details are rather trivial. You don't have to hit the perfect spot, and you don't have to have a surgeon's hand. You can be inexact and the patient won't even notice. And by the 3rd or 4th shot that you do, it will be just like clockwork, and you'll be doing great!

--Garfield3d

 

[sunineyes]

It's a little weird the first few times you do it, but then you get pretty good at it quickly. I've hit bone on several people (unfortunately) and none seemed to know the difference.. My instructors for vaccination lab say that it happens all the time and that no one ever seems to think it hurts more than any other time. Of course, who knows, maybe they get stabbed in the bone every time they get a shot.

A good thing with the scrawny old ladies, or anyone skinny, is to really grab as much muscle as possible before injecting.

Most people don't even know you stuck them, unless they're watching.

 

[aelephant]

Hit the bone on a tiny little Korean lady and she was practically crying.

Have had a couple screaming kids try to pull away from me.

The VAST majority are easy.

Careful with the auto-retracting syringes though, sometimes they don't work and I feel like they take waaaay too much force to get them to click back in sometimes.

 

[genesis09]

We used to auto-retract syringes. A couple of times when trying to get out the flu vaccine, I got over zealous and retracted the needle. Fortunately, no vaccine was lost.

 

[KARM12]

I loved the retractable syringes....I loved the "pop" noise they make.

 

[stkyrice]

Cheburashka:

After seeing you today in class after you did the H1N1 clinic, you made me feel a lot better as I was heading out to give shots. I was freaking out because I forgot the protocol, but I do feel a lot more comfortable giving shots. Helps that the preceptor was incredibly patient!