Reflective Practice in Nursing: Gibbs Model and Drug Administration

This assignment is a reflective journal entry detailing experiences related to drug administration, utilizing the Gibbs model of reflection. The author reflects on observations of peers administering intramuscular injections via the rectus femoris, subcutaneous injections on the upper arm leading to tissue damage, and the administration of oral medication to a child mixed with a sugary drink, which reduced efficacy. Feelings of anxiety, sympathy, and bitterness are discussed in relation to these experiences. The analysis delves into the rationale behind choosing the rectus femoris for IM injections and the negative consequences of repeated subcutaneous injections at the same site, as well as the impact of food-drug interactions on oral medication. The reflection concludes with an action plan for future practice, emphasizing the appropriate selection of injection sites, avoiding tissue damage, and refraining from mixing medications with sugary drinks.

RUNNING HEAD: PROFESSIONAL PRACTICE EXPERIENCE NURSING 1
Professional practice Experience Nursing
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PROFESSIONAL PRACTICE EXPERIENCE NURSING 2
Professional practice Experience Nursing
INTRODUCTION
In this assignment, I will utilize the Gibbs model of reflection o reflect on the different
experiences that I came across together with my two other friends (Williams, Woolliams, &
Spiro, 2012). The reflection is specifically about the routes of drug administration that include
subcutaneous, intramuscular and the finally the oral route.
DESCRIPTION
During one of my clinical practice, I realized that one my peers was good at
intramuscular administration of drugs. I realized that his preferred site of injection was the rectus
femoris. There was another scenario I came across where a friend of mine administered
medication using the subcutaneous route on the upper arm .I however noticed that he was
injecting at the same site of one patient for two weeks. This eventually led to tissue damage.
There was a situation where I was to administer oral medication to a child .I therefore mixed the
drug with a sugary drink so that the child could drink quickly .I however realized that the
efficacy was reduced.
FEELINGS
I felt very anxious since I wanted to learn and find out why he does not use the
dorsogluteal site that were taught in class .I felt very sympathetic for the patient. This is because
patients expect improvement when they visit nurses and we should not create other medical
complications. I felt very bitter since the child was in acute pain and needed immediate relieve.

PROFESSIONAL PRACTICE EXPERIENCE NURSING 3
EVALUATION
The aspect of introducing drug intramuscularly through the rectus femoris was quite
positive to me. This is because I learnt that using this site speeds up recovery since there is quick
uptake of drugs especially if the upper arm is used. The aspect of injecting the same site
frequently using the subcutaneous route is a negative aspect and should not be encouraged at all.
Introducing drugs in sugary food is not a good practice at all and nurses should not attempt it.
ANALYSIS
I later came to realize that the reason why my peer did not prefer using the dorsogluteal
site is that the site has a thick layer of adipose tissue and this therefore slows down the process of
medicine uptake (Owen, 2011).I also learnt that this site has many nerves and blood vessels and
could therefore pose a threat to the patient. Administering drugs through the subcutaneous by
injecting the same site can cause damage to the underlying tissues due to the frequent
disorientation of the tissue by the needle (Meyer, Krohne, Charbel Issa, Liu, & Holz, n.d.). Oral
administration of drugs with food affects the efficacy of the drug due to food drug interaction
mechanisms.
CONCLUSION
The rectus femoris is the best site of injecting IM drugs .This is the site that I will always
use in future. It is wrong to inject the same site in the subcutaneous frequently according to the
second case. Nurses should not introduce drugs together with drugs as it reduces their efficacy.

PROFESSIONAL PRACTICE EXPERIENCE NURSING 4
ACTION PLAN.
In future, whenever I meet a patient who is in need of an intramuscular injection or
administration of drugs, I will also utilize the rectus femoris so that the patient recover quickly as
there will be quick uptake of the medicine (Cassidy, Oyedele, Mickle, Guenther, & Budman,
2017) .In future when I meet a patient in need of subcutaneous injection, I will change the site so
that I can avoid damage to the tissues. In future, I will never introduce drugs and sugary at the
same time in children however bitter the drug might be.

PROFESSIONAL PRACTICE EXPERIENCE NURSING 5
References
Cassidy, T. A., Oyedele, N., Mickle, T. C., Guenther, S., & Budman, S. H. (2017). Patterns
of abuse and routes of administration for immediate-release hydrocodone
combination products. Pharmacoepidemiology and Drug Safety, 26(9), 1071-1082.
doi:10.1002/pds.4249
Meyer, C. H., Krohne, T. U., Charbel Issa, P., Liu, Z., & Holz, F. G. (n.d.). Routes for Drug
Delivery to the Eye and Retina: Intravitreal Injections. Developments in
Ophthalmology, 63-70. doi:10.1159/000431143
Owen, P. S. (2011). Book Review: Handbook of Drug Administration via Enteral Feeding
Tubes, 2nd EditionHandbook of Drug Administration via Enteral Feeding Tubes, 2nd
Edition By WhiteRebecca BSc(Hons) MSc MRPharmS (I Presc) and BradnamVicky
BPharm (Hons) ClinDip MBAopen MRpharmS. Published by Pharmaceutical Press,
London, UK, 2011. ISBN 978-0-85369-928-6. Paperbound, xix + 614 pp.(21.5 × 13
cm), $74.99. www.pharmpress.com. Annals of Pharmacotherapy, 45(4), 549-549.
doi:10.1345/aph.1p775
Williams, K., Woolliams, M., & Spiro, J. (2012). Using a framework for reflection: Gibbs’
reflective cycle. Reflective Writing, 90-102. doi:10.1007/978-0-230-37724-0_16