I was a brand new nurse in the summer of 2002.
Fresh out college, filled with all the wisdom of a college graduate, drunk off the excitement of passing my NCLEX board exam (on the first try!) and landing my first job in the hospital as a Registered Nurse.
I worked in Neuro-Trauma, Med-Surg unit (injuries to the brain or spinal cord. And healthy enough to not be in Intensive Care). A nice little floor of 30 rooms, with 4 intermediate beds for new stroke patients. The patients that were had diagnoses like Motorcycle Versus Tree, Multiple Sclerosis Exacerbations, Cerebral Vascular Accident (stroke), and Traumatic Brain Injury.
It was a sleepy unit. The nurses were fun to work with. Everyone charted in little take-down units outside the doors. Mind you, this was before computerized charting existed; we did have little locators that we wore to help find each other since the unit was rather spread out.
I was bored that night.
I know, I know.
Why would a nurse be complaining about being bored?
Ahh, the hubris of the youth.
As it is in all hospitals, the sickest patient gets the room closest to the nurse’s station. In this room was a sad case.
Not all suicides are successful.
One usually hears about the people who want to commit suicide and they are stopped. Then you hear about the people who do and die. But you never hear about the really bad failed attempts.
This patient was one of them. He tried to take a gun to his head, but his aim was off. Instead of hitting the brain stem, he hit part of the brain and his eyes effectively destroying his vision and his ability to comprehend.
I was still in orientation that night and casually mentioned to the nurse I was working with, “Wow, it’s a quiet night here. Is it always like that?”
You should have seen their faces! Sheer horror came over their countenance and quickly they told me never, ever say that again. I laughed at them. I was not superstitious at all, and I wasn’t worried.
Ten Minutes Later (I’m not joking!)
My patient woke up. Completely disoriented and mobile! He was wanting out the hospital now!
Out of the room he came. He stumbled and reached a small chair that had been sitting outside of his door and began to climb up it, as I and two other nurses began to wrestle him down off the chair.
One hollered out to me, “Go get Haldol!” I ran to the Pyxis and quickly inputted my login information. Out popped the vial and I quickly threw a needle on the preloaded syringe.
Now you must remember, I was fresh out of school.
I had been taught the 5-step method of giving the proper IntraMuscular injection technique by firm drill-sergeantesque instructors. In case you’ve forgotten, here’s the official way.
To find the correct location, place the heel of your hand on the upper, outer part of the thigh where it meets the buttocks. Point your thumb at the groin and your fingers toward the person’s head. Form a V with your fingers by separating your first finger from the other 3 fingers. You will feel the edge of a bone along the tips of your little and ring fingers. The place to give the injection is in the middle of the V. Drugs.com
This is a wonderful technique when you have a willing patient, but not when you have a scared, blind, disoriented 300-pound patient climbing a chair. I visualized my location and threw the needle in.
Quickly, I attempted the aspiration and plunged the Haldol into his hip. (I’m not sure if I was supposed to give it slowly, but that night it didn’t matter. He got it fast and furious.)
Carefully, we led him back to bed and calmed him down. I had no idea how fast Haldol worked, but that night it was quick. In ten minutes, he was sound asleep and the unit returned to it’s sleepy, quiet state.
Sixteen years later, I still remember that night.
I’m still not a superstitious person. I like black cats, I walk on cracks. I never throw salt over my shoulder, and neither do I worry about knocking on wood.
But I, however, I learned a valuable lesson. I would never, ever, ever use the “Q” word again at work.
Years later when I worked in the emergency room, a new graduate also said the “Q” word and I looked at her with the same horror that I was given.
Resources: “How To Give An Intramuscular Injection (IM Injection).” Drugs.com, Drugs.com, www.drugs.com/cg/how-to-give-an-intramuscular-injection.html.
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