Reflectionlog

I will use a reflective model to discuss how I have achieved the necessary level of competence in my nurse training programme. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). The clinical skill I have chosen to reflect on is the administration of Intramuscular (IM) injections. I have chosen this as within my first clinical placement this was a widely used method of drug administration and I became involved in the process of IM injections. I therefore researched the topic of IM injections and my knowledge within this area developed. The site used in the IM injection was the gluteus maximus, this the most commonly used site for the administration of IM injections (Greenway 2004, Workman 1999). The gluteus maximus area is both thick and fleshy with a good blood supply (Watson 2000). It is located in the hip area and forms the buttock (Watson 2000). It has been noted by Watson (2000) that the gluteus maximus is near the sciatic nerve and Greenway (2004) suggests that this presents a risk of threat of injury in the administration of IM injections. When I administered the IM injection to the patient, I injected into the gluteus maximus muscle, as the evidence stipulates this is best practice. The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient via IM injection. I had observed this clinical skill on a variety of occasions and had previously administered an IM injection under supervision. On this occasion I was being observed by two qualified nurses, one of which was my mentor. The drug had been drawn up and was ready to be administered and the patient consented to have a student administer the injection. My mentor was talking me through the procedure step by step and informed me that I should use an alcohol wipe to cleanse the injection site, when the other nurse interrupted and said that this was not necessary. This was in front of the patient, who then requested that the alcohol wipe was omitted as on previous occasions this had caused a stinging sensation. My mentor said that this was acceptable and I continued to administer the injection, omitting the use of the alcohol wipe. On the previous occasions when I had administered IM injections I had not cleansed the site and had never been instructed to adopt this practice.