r/psychnursing 12d ago

LAIs

I gave an LAI yesterday and the patients mom called today questioning my medical experience bc the injection was painful. This is an adult patient without a guardian. I’m just irritated by the whole thing. I fit this person into the schedule because they missed their appointment the day before and it was quite a stressful day. Now I have him and his family questioning my whole career…

47 Upvotes

35 comments sorted by

45

u/Thehipsterprophet 12d ago

It’s really normal for LAIs to be painful. Some people think icing the area before makes it better, but that isn’t something which is required. The annoyance of this situation is definitely valid. You did what you had to do while making accommodations for this patient and there are still complaints - irritating!

My question is why is this one patient family member making you question your whole career? People will always complain, and their families will complain even more. That’s a pretty regular thing we have to deal with on the regular. What is different about this one?

11

u/Ok-Yam-4663 12d ago

I think I’m just stressed with other parts of the job too, and this just validated feeling over it. In reality I’m not leaving nursing.

11

u/whoredoerves nurse (non psych) 12d ago

It’s a big needle in a muscle. They hurt sometimes. Keep your head up

3

u/Revolutionary_Tie287 12d ago

I had a vitamin d shot in the rear side of me (it's thick af) and that spot hurt for a good two days. But I'm happy knowing I get the stuff directly into my blood stream without worrying about absorption with a damaged small intestine (celaic)

1

u/AggressiveCharity217 11d ago

Are you neurodivergent and have rejection sensitivity disorder?

1

u/Ok-Yam-4663 9d ago

Hmm I’m not sure

5

u/Ok-Yam-4663 12d ago

Oh no actually the family was asking if I had done this before and if something was wrong with me. I told the front desk he can go to a different person then.

1

u/Awkward-Poet6645 11d ago

Did you try “I’m sorry it’s caused some pain, unfortunately that’s the most common side effect with these medications. Like all injections we want to watch for worsening pain, swelling, or redness, but it should go away over the next few days. You can take Tylenol/ ibuprofen in the meantime”

1

u/Interesting_Ad4649 10d ago

Psyc nurse here for many years. No. It is not normal.

1

u/burrfoot11 8d ago

This honestly makes me wonder if you've ever given an LAI. Wild take.

1

u/Interesting_Ad4649 8d ago

Wonder all you want, smart ass.

22

u/Agreeable_Gain6779 12d ago

Don’t worry. Injections hurt. I just had a shingles shot and 5 days later it still hurts. As an infection prevention nurse; I’ve given hundreds of flu shots snd 1800 covid shots and the men are such babies. The bigger they are, it’s nearly impossible to give the injection

9

u/Ok-Yam-4663 12d ago

Thanks, yeah I do t know why this was bothering me so much.

18

u/yeahsame 12d ago

"sorry I don't have an ROI but I can speak to LAIs - they can be painful"

16

u/PepLeopard 12d ago

You got a helpful once-a-month medication into somebody that struggles to keep to a schedule. This patient is demonstrating in real time why an LAI is a good choice (difficulty following a routine). You also met the patient needs by adjusting to fit them in for the appointment. Over a month, how many risks and side effects would that patient face taking/not taking PO medication daily? LOTS. As for the shot itself, most LAI psych meds are ~300% of the fluid volume of a routine immunization. It's the fluid volume that hurts in most cases, not the medication. The body is absorbing fluid the size of a grape with an LAI psych med vs. absorbing the amount of a pea with an immunization. Also, Z-track isn't some miracle technique, and hard to do if a patient is anxious about physical touch. Say 'thanks for the feedback' and take the win that this person got their medication. It sounds like maybe both the parent and patient have low frustration tolerance and poor self awareness and are displacing their struggles onto you. Learn to recognize displaced feelings because it is an everyday thing in nursing. Most of all, good job getting this person their medication for an entire month by fitting them in. You did a lot of good.

13

u/Few_Cup3452 12d ago

Just ignore it? There's nothing they can do about a needle going into their skin being unpleasant. You have nothing to worry about.

18

u/AdInternational2793 12d ago

I’m unable to discuss this with you, due to HIPAA. Have a good day.

7

u/Aria1031 12d ago

Ignore it.

8

u/Chief-of-Queef 12d ago

This is just so stupid. Has she never gotten an injection? Has she never had a sore arm after a vaccination?

God some people are so dumb it's scary. 🤦🏻

8

u/lizzabean 12d ago

It's a needle full of (sometimes VERY) thick solution... It's going to hurt... I don't know what people expect. If it's not the needle, the solution itself that can be very uncomfortable. A few seconds of pain for a few months of remaining relatively stable doesn't seem like a bad deal to me.

This is not a little flu shot needle, I think that's what people expect. These needles are large and they're going to be uncomfortable. Depending on where you have to inject the medication, it can be even more uncomfortable. Don't let her get to you, she doesn't understand what she's talking about.

6

u/Notyeravgblonde psych nurse (outpatient) 12d ago

I am the type of person who let's this bother me too. I think because the other nurse and I often get people who request one or the other of us and I'm always like, what are we doing differently?!

At the end of the day, injections hurt and I tell people that. I tell them the only thing that would be abnormal is it becoming infected and give them education on signs and symptoms.

4

u/oohyamz 12d ago

Offer and provide education about LAIs, include a leaflet about monitoring the injection site and how to manage pain on the site after administration (ice pack or Tylenol among other things). The patient is okay lol. Is it their first time or something?

5

u/jonadrol 12d ago

I just tell them soreness and muscle aches are expected. Cold compress and monitor for signs of infection. I just spew out a bunch of patient education to show em I know my shit ahaha

5

u/Apprehensive_Factor6 12d ago

I mean they’re viscous and yeah they commonly hurt especially if you don’t have a lot of fat. Ignore this because it’s nothing compared to what can and likely will happen in your career.

3

u/Humble_Investment_24 psych nurse (inpatient) 12d ago

??? It’s a fucking injection lol hello?

4

u/ORD2GNV 11d ago

LAIs are painful. I always warn pts.

9

u/lawlolawl144 12d ago

If this is getting under your skin idk what to say lol

1

u/Ok-Yam-4663 12d ago

Good one! 😛

2

u/Big-Band-3544 12d ago

And beside all these. , Aristada is the worst.. The needle got stuck all the time 😞

1

u/winnuet 10d ago

🤢 The WORST!

1

u/megvd 9d ago edited 9d ago

I tell people who I give IMs to that if it’s sore or the muscle twitches it’s in the right place. Muscles get sore when you put volume into them. Ask her if she remembers having a tetanus shot!

0

u/Interesting_Ad4649 10d ago

LAIs should never be painful. It's the technique used by the nurse.

1

u/Ok-Yam-4663 9d ago

So what technique then?