Dilaudid IV Push

  1. Administration as started allowing physicians to order dilaudid IV push (& other opiates) in the Intake area of our Emergency Room. These patients are receiving this in a rapid treatment area with no monitoring/proper reassessment & no "one" specific staff person assigned to the patient. (patients are seen by multiple RN's in this area... one for triage, one for IV, one for meds, one for results, etc) This news was sent to us in the form of an email from administration with no policy attached. Some employees have asked to see the policy or something in writing from Risk Management, but to date no one has received anything. Anyone else experiencing this in their ER's? Anyone have any protocols addressing this issue? We fear if a sentinel event occurs as a result our licenses could be at risk. Who would be liable?
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    About hdreserve

    Joined: Aug '10; Posts: 3


  3. by   brandi devine
    Refuse to administer the medication IV push, until Policy is viewed, you have every right as a NURSE.
  4. by   netglow
    Trouble, trouble, trouble. Awesome for an event. Awesome for the seekers. You are gonna be popular.
  5. by   Finally2003NP-C
    I agree with 2ndwind, this is totally insane. IV push Dilaudid with no direct nursing observation, no intervention/followup is just asking for a lawsuit. As usual another administrative directive with little (none) thought attached.....
  6. by   nurse2033
    Yikes! If you are asked to do something by your employer that violates safe nursing practice, you should refuse and explain why. Then put your concerns in writing and send it to everyone, your boss, risk management, the CNO, CMO ( did I miss anyone). This CC strategy should make them all feel accountable and generate a policy.
  7. by   nurse2033
    Also, once the seekers learn about this, they can get their shot, then just get up and leave.
  8. by   getoverit
    what prompted your administration to make this decision?
    Like others have posted, I bet you guys will be swamped with seekers. At least you'll be able to meet some interesting, new people.....
  9. by   AprilRNurse
    Bad idea. Patient's can go bad quick with Dilaudid. I've seen young, strong men's sats drop without notice 10 minutes after getting dilaudid push.

    It started getting popular for the MD"s to order on the med/surg floor, and admin had to review the policy and change the computer system so they could no longer order 1-2 mg IV push. It's too much for most people, and I ALWAYS throw them on cont ox if I dont (and rarely do) have time to sit with them after I push it.
  10. by   hdreserve
    We have formed a committed to look at what we can do. Trying to collect as much evidence based data as possible to help us devise a solution to present to management that will need to be addressed. If anyone knows of any EBP data to help support us for this particular problem, Please forward. Thanks so much everyone!
  11. by   MAISY, RN-ER
    Hell No! There is no way this should be happening! Where is your facilities legal department? Good way to lose a hard-earned nursing license....let the PA do it...they are under the doctor's license...watch how fast the idea goes away!
  12. by   errn911susan
    Who would be liable?
    The person administering the medication! Doctors and admins can bark orders all they want, but good nursing judgement dictates that you know it is not safe to administer one of the strongest respiratory depressing opiates out there to patients who are not monitored by pulse ox at the very least and one RN with full monitor at best.

    You know in your gut this is not ok!
  13. by   AndyLyn
    That's ridiculous. Not only have they not had their MSE, they're not monitored, med recs haven't been done, and I bet you a billion kazillion they elope with their saline locks intact! No thanks, no matter how much admin thinks it'll improve patient satisfaction! (and we all know that's the real reason!)
  14. by   iluvivt
    NO WAY would I ever do this. There are several problems here. It seems like an adequate assessment has not been completed,including an allergy history and complete pain assessment. The Joint commission (TJC) their new name, states there must also be an assessment after the administration to detemine effectiveness..are those policies in place...is there a nurse assigned to each of these patients????? How will the patient be monitored for drug hypersensitivity and/or side effects such as respiratory depression??? Is it even feasible to start an IV in a crowed intake area and keep the area clean and free from bodily fluids and exposure of these to other pts....YUCK. It seems to be another way to keep the customer "HAPPY" instead of fixing the problems of our overcrowded and improperly used EDs