NS at 125 ml/hr is not an ER order

Specialties Emergency

Published

Pet peeve.

Tolerating PO, maintenence rates of ns are just silly in the ER. Anything under 500 ml/hr is silly. If you really think they need 125 ml an hour, I'll be happy to bring them an 8 ounce glass of water every couple of hours.

I am not refering to the dehydrated LOL with CHF. I am talking about the garden varity pt who is going to get a bunch of pointless tests and then get sent home with an ambiguous dx.

OK, I feel better.

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Specializes in Med Surg/Tele/ER.

Frequent flyer that had no business being there to start with????

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Specializes in ER, Trauma.

Agreed! But it does jack up the acuity upon which the hospital and doctor base their billing. Money is more important than life it seems latlely.

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Specializes in ER.

Thank you :yeah: for the much-needed chuckle today.

I have a new doctor we're breaking in who continues to order rates of 125, 100, last night I got 75cc/hr order on a 30 something belly pain. Really, dude? I've been breaking out the dial-a-flo more times in this past month than in my entire ER career.

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Specializes in Emergency Medicine.

Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

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Specializes in ED/ICU/TELEMETRY/LTC.
Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

Wow, it was just an observation. Why so hostile?

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Specializes in ER.
Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

I actually do care. For the patient with a 2 hour workup in the ER, I am giving them about 150ml of fluid. They were drinking water at triage, will likely go and drink water after discharge, and they needed 5 oz of IVF? How much does a liter bag of NS cost? Do we need to continue wasting liter bags of fluid that I empty down the drain just so we can charge someone for IV hydration?

I care about the orders that are written quite a bit. I'm not a trained monkey that just says "yes, doctor, whatever you say, doctor, you're a freakin genius, doctor." Perhaps I needed to vent, too. :smokin: Ehem. I think I'm good now.

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I always laugh at D5W at 50 or 75 an hour...Some seriously over priced sugar water!

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Specializes in Emergency Department.

Maybe the doc just wanted the frequent flyer to have the joy of being stuck with an 18 gauge needle? Preferably by a newbie nurse.

I know I always like to pretend like I don't know how to insert an IV every time I get a faker. :D

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Specializes in ER.
Maybe the doc just wanted the frequent flyer to have the joy of being stuck with an 18 gauge needle? Preferably by a newbie nurse.

I know I always like to pretend like I don't know how to insert an IV every time I get a faker. :D

Oh, don't worry. They're still gonna get stuck. ;) A heplock will work just fine.

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Specializes in ER, Trauma.
I actually do care. For the patient with a 2 hour workup in the ER, I am giving them about 150ml of fluid. They were drinking water at triage, will likely go and drink water after discharge, and they needed 5 oz of IVF? How much does a liter bag of NS cost? Do we need to continue wasting liter bags of fluid that I empty down the drain just so we can charge someone for IV hydration?

I care about the orders that are written quite a bit. I'm not a trained monkey that just says "yes, doctor, whatever you say, doctor, you're a freakin genius, doctor." Perhaps I needed to vent, too. :smokin: Ehem. I think I'm good now.

You are the nurse I'd want for me or a family member, thanks for restoring my faith in humanity. Unfortunately, for hospitals and too many advanced practitioners, it's all about the Benjamins, and checking off "fluid management" means higher acuity and more money for ER docs.

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Specializes in ER.

dthfytr,

That's the nicest thing someone has said to me in quite some time! Thank you so much - I may print that out just to give me a boost on those rough nights. :hug:

I think I'm blushing now. :D

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