NURSING REFLECTION: A Critical Analysis of IM Injection Experience

This report presents a reflective analysis of a nursing student's experience with an intramuscular (IM) injection practice, utilizing the Gibb's reflection cycle. The student describes the practical assessment, detailing the steps involved and the specific instances where aseptic techniques and proper patient positioning were overlooked due to nervousness and anxiety. The student reflects on the feelings experienced during the assessment, including initial nervousness and a sense of achievement, followed by disappointment upon realizing the errors made. The evaluation highlights the impact of these mistakes on patient safety and injection accuracy, referencing relevant literature on infection control and proper technique. The analysis identifies the risks associated with the errors, emphasizing the importance of safety and hygiene in nursing practice. The conclusion expresses satisfaction with the overall performance despite the identified shortcomings, and the action plan outlines strategies for improvement, including a reflective journal and a plan to enhance safety standards. The report provides a comprehensive overview of the student's learning process and commitment to refining clinical skills.

Running head: NURSING ASSIGNMENT
NURSING REFLECTIVE ASSIGNMENT
Name of the student
Name of the university
Author note

1NURSING ASSIGNMENT
Reflection is a strategy using which nursing professionals can retrospect their own
practice and then find out the areas which needs improvement (Husebø, O'Regan&Nestel,
2015). In this paper, I would be reflecting upon one of my practical experiences of
intramuscular (IM) injection and in this aspect, I would be using the Gibb’s reflection cycle
for this reflection.
Description
In the recent practical session occurred in the lab, I performed a practical assessment
related to intramuscular injection. I had knowledge of this process from the theoretical
sessions in the classroom however, this was the first time I was about to practice this skill. I
was continuously reminding myself with the steps and strategies one nursing professionals
should comply with while providing the patent with intramuscular injection. The steps
included, preparing the medication dose, maintaining aseptic condition and maintaining a
step by step conversation with the patient so that I maintained every clinical aspect of the IM
injection but I missed sanitizing my hands throughout the process. Besides this, I also did not
raise the bed for patient due to which the posture of the patient was improper during the
process. Finally, due to nervousness and anxiety, I located site for intramuscular injection
improperly and did not comply with the actual process, thereby it decreased the accuracy of
my practice.
Feelings
I was very nervous during the practical assessment as this was the first instance when
I applied my learnings related to IM injection application and hence, with nervousness, there
was a sense of achievement that increased my confidence. I was aware of each of the steps,
and strategies that should be implemented prior to apply the intramuscular injection however,
I was concerned about the fact that I would be able to comply with all the steps perfectly or

2NURSING ASSIGNMENT
not and hence I was repeating all the steps in my mind prior to perform the action. Hence, all
the feelings were associated with my sense of achievement and fear of failing to my own
expectations. In the course, even tried to delay the situation, but then I collected all my
courage and determination and went inside the lab to perform the IM injection. However,
after completing the task I realised that I forgot using sanitizer, locating site for IM injection
properly, raising the bed prior to apply the injection, all crucial aspects. This felling affected
me badly however, the realisation that I completed all the crucial and critical step without any
mistake helped me to overcome this feeling of failure.
Evaluation
While evaluating my critical thinking and feelings that occurred during the lab
practical of providing IM injection, I could determine that as it was my first try of providing
IM injection to patients, I was anxious and nervous about the action. Even in the paper by
Esler and Schwarz (2016), it is mentioned that when we try to perform something, which we
never done before, a strange feeling mixed in anxiety and nervousness occurs. Further, the
incident of not using sanitizer in the process of IM injection or raising the bed for
administering injection were critical to patient’s safety from infection. Similarly, locating
injection site improperly decreased the accuracy and reliability of the entire process.
Therefore, this mistake was of high level as Munoz-Price et al. (2019) mentioned in his paper
that not application of proper technique of injection, sanitizer or hand hygiene technique or
not maintaining proper posture could affect patient and their chances of recovery.
Analysis
As per Murray, Sundin and Cope (2018), safety should be the first priority of nursing
professional while providing care to patients with medication either through oral route or
through intravenous or intramuscular route. Hence, it was my target as well while providing

3NURSING ASSIGNMENT
IM injection, as I did not performed hand hygiene and while assessing the muscle site where
injection would be applied I did not applied correct information and also forgot to raise the
bed for application of IM injection as similar risk was observed in the research of Megeus et
al. (2015). Hence, the analysis indicated the risk to be high to severe; however I was satisfied
with my abilities to achieve such result in my first lab practical of IM injection
administration.
Conclusion
While concluding the reflection paper I would mention that I am satisfied the way I
performed in the first try of the critical skill like administration of IM injection as Missen et
al. (2016) mentioned it as one of the critical skill that the nursing professionals learn within
several attempts. However, my inability to comply with the safety and hygiene standards
affected my confidence and I would further try my best to comply with this standard as well.
Action plan
I would try to develop a reflective journal so that I could write down each of my lacks
and mishaps that I perform in the practical or class room sessions and then would spend more
time on those topics to acquire the theoretical and practical knowledge about the process.
Further, I would develop an improvement plan for safety and safety standards so that with
each of such practical sessions, I would track my improvement and hence, could make my
practice skill free from mistakes to provide effective care to the patients.

4NURSING ASSIGNMENT
References
Esler, M., & Schwarz, R. (2016). Cardiac Psychology: Ancient and Modern
History. Handbook of Psychocardiology, 1-8.
Husebø, S. E., O'Regan, S., &Nestel, D. (2015). Reflective practice and its role in
simulation. Clinical Simulation in Nursing, 11(8), 368-375.
Megeus, V., Nilsson, K., Karlsson, J., Eriksson, B. I., &Andersson, A. E. (2015). Hand
hygiene and aseptic techniques during routine anesthetic care-observations in the
operating room. Antimicrobial Resistance and Infection Control, 4(1), 5.
Missen, K., McKenna, L., Beauchamp, A., &Larkins, J. A. (2016). Qualified nurses' rate new
nursing graduates as lacking skills in key clinical areas. Journal of clinical
nursing, 25(15-16), 2134-2143.
Munoz-Price, L. S., Bowdle, A., Johnston, B. L., Bearman, G., Camins, B. C., Dellinger, E.
P., ... &Prielipp, R. C. (2019). Infection prevention in the operating room anesthesia
work area. Infection Control & Hospital Epidemiology, 40(1), 1-17.
Murray, M., Sundin, D., & Cope, V. (2018). New graduate registered nurses’ knowledge of
patient safety and practice: A literature review. Journal of clinical nursing, 27(1-2),
31-47.