How Clinicians Can Correct the Nasal Spray Mistakes Patients Make

99% of Patients Use Nasal Sprays Wrong

(Here’s Why It Matters)

By The Nurse Practitioner APRN | Mel NP 

If I had a dollar for every patient who told me their nasal spray “just doesn’t work,” I’d have a lot of dollars — because likely nine times out of ten, the medication never had a chance to work in the first place.

Why? Because nearly every patient uses it wrong.

I’m Mel, a primary care nurse practitioner for over 14 years, and I’m passionate about teaching providers how to have effective, clinically relevant conversations — the kind you don’t learn in school but need in everyday practice.

By the end of this post, you’ll know:

• The correct nasal spray technique (with a step-by-step patient teaching script)
• Why it matters for safety, outcomes, and antibiotic stewardship
• How to turn a quick conversation into a huge patient win! 

Watch the full video here ⤵️  Prefer to read instead? Keep scrolling — I’ll break it all down below.

The Common Mistake: “Tilt, Squirt, Sniff” 

Here’s the scene you’ve seen a hundred times:

Your patient comes back two weeks later, frustrated. They’ve used their nasal corticosteroid daily, but they’re not better. You ask to see how they're administering their spray. They tilt their head back, insert the bottle deep, spray, and immediately sniff.

Where does that medicine go?
👉 Straight down the back of the throat.

They’re still congested, maybe have nosebleeds or a nasty taste, and now they think the medication “failed.”

The truth? It was never absorbed properly.

This simple technique error leads to avoidable treatment failures, unnecessary antibiotic prescriptions, patient frustration and maybe even loss of trust.

Why Proper Technique Matters

Better Patient Outcomes

If the medication never reaches the nasal mucosa, it can’t do its job. Whether it’s Flonase, Nasacort, Astipro, or Afrin, getting the medication to the right spot determines whether the patient feels relief.

Safety

Incorrect angle or sniffing can cause irritation, bleeding, or taste disturbance — especially in patients on anticoagulants.

Antibiotic Stewardship

We often label these patients as “treatment failures” and reach for an antibiotic unnecessarily. In reality, the steroid or antihistamine just never got a fair shot. 

Patient Trust

When you take an extra couple of minutes to teach proper use, you build confidence, credibility, and trust. Patients feel seen and cared for — and they get better.

The Correct Nasal Spray Technique (Step-by-Step)

Here’s how to teach it in your next visit:

Step 1: Gently blow your nose.
Clears mucus for absorption. Emphasize gently — forceful blowing worsens swelling.

Step 2: Shake the bottle.
If it’s a new bottle, prime it twice before the first dose to get consistent medication delivery.

Step 3: Positioning.
No head tilt back! Instead, tilt slightly forward.
Pull gently on the side of the nose (the nasal labial fold) to open the nostril.

Step 4: Aim correctly.
Insert the nozzle just inside the nostril and aim toward the eye, not the septum.
This coats the outer mucosa and prevents nosebleeds.

Step 5: Spray once, gently sniff if needed.
Full pump down, no strong sniff. A light sniff is fine if it feels like it might drip.

Step 6: Repeat on the other side.
Same technique — tilt forward, aim toward the eye, gentle sniff.

Step 7: Post-care.
Don’t blow your nose or lie down for at least 15–30 minutes.
Clean the nozzle under warm water and dry.

The 2 minutes or less Patient Script 🗣️ 

Here’s the quick version you can use in clinic:

“Okay, Sarah, today we’re going to fix your nasal spray technique so it actually works.
Gently blow your nose first — not hard, just clear it out. Shake your bottle, and if it’s new, pump it twice to prime.
Keep your head slightly forward, pull on your cheek to open the nostril, aim toward your eye, spray once, and don’t sniff hard.
Repeat on the other side, and don’t blow your nose for 15–30 minutes.
Use it this way, and you’ll finally start to feel the relief you’ve been looking for.”

Encourage them to teach it back to reinforce retention.
Then, remind them it may take 3–7 days of consistent use to notice results — set expectations upfront to reduce frustration and follow-ups.

Real-World Impact 🔄 

 By reframing a “simple” teaching moment into a powerful micro-education, you:

• Reduce unnecessary antibiotic use
• Improve treatment success rates
• Strengthen patient relationships
• Save yourself time (and inbox messages)

Technique education isn’t extra work — it’s smarter work.

Free Download for Clinicians 🙌

Want help saying no to unnecessary antibiotics — without awkwardness or conflict?

Download the free guide:

👉 10 Patient-Approved Phrases" to Say No to Unnecessary Antibiotics

These are real, effective phrases you can start using today in clinic to improve outcomes and preserve patient trust.

Coming Soon 🧭 

I'm creating patient education videos you can link in MyChart or embed QR codes in the after-visit summary — so you can save time and still reinforce technique.

Imagine saying:

“Hey Sarah, check your MyChart for a short video I sent on nasal spray technique. Watch that tonight before you use your spray again.”

Faster, consistent education for every patient — without cutting corners.

Let’s Raise the Bar, Together! 

If this kind of practical, real-world teaching helps you in practice, hit subscribe on YouTube! When you download the free guide, you'll receive notifications when new resources are available! 

Together, we can elevate everyday patient care — one conversation at a time.

🔗 Quick Links

📹 Watch the YouTube video HERE

📘 Download your free “10 Patient-Approved Phrases” guide

🩺 Tell me what other topics you need!