Well, that would make it impossible to titrate the Dopamine. At my faciility, if he was DNR and NOT on monitors, then he would not be on Dopamine. He would be a comfort care pt and probably be on a Fentanyl drip instead of Dopamine.
From my experience, someone can be DNR and still wish to be treated with pressors. I would never ever ever ever ever initiate a dopamine gtt w/o cardiac monitor. i check bp's q 5 mins. i titrate up to acceptable bp q 5-1o mins. generally speaking...the md order should give you all the info for titrating. "dopamine 5mcg/kg/min and titrate to b/p greater than 90 systolic"
It is extremely weird to me that a patient would be on a dopamine gtt without having to be on a cardiac monitor. First I would want to know why is the patient on dopamine, is it for renal perfusion (a low dose 1-5 mcg/kg/min) or is it for the blood pressure (dose can be anywhere from 5-15 mg/kg/min, max dose 20mcg/kg/min). I would ask the doctor for a cardiac monitor and then I would make sure that I have parameters for the dopamine gtt (to know when to call the doctor, what is the max dose, when to shut it off ). Personally, I check vital signs every 5-10 minutes when I first start the gtt, then every 15 mins until they are stable. Then I would check every 30min-1hr, depending on the situation. Since you are on a floor, maybe every hour, but if that patient is that sick and it isn't safe for you to monitor that patient on your floor, then the doctor needs to choose a different med or transfer the patient to ICU. Hope that helps.