Got fired for changing fluid rate - page 5
I was on orientation on days and then got moved to nights which is what I was hired to do. It was my first night on orientation with a preceptor and I was not feeling the best, was very tired got an admission at 2 am and was up... Read More
- 2May 8, '13 by blondy2061h, MSN, RNI believe OP said this is telemetry. In my facility, a BP of 70/40 is completely acceptable for a tele floor as we have about a 1:4 ratio and are privileged to run vasopressin, dopamine, and neosynephrine drips. Before judging that the admission was inappropriate, understand that not all facilities are run the same way.
- 4May 8, '13 by psu_213, BSN, RNQuote from RoyalPrinceI totally agree with the sentiment you are expressing with your first question....totally disagree with your second sentence.Pt on a Med/Surg Floor comes with a BP of 70/40 and no Rapid Response is called? you should be fired.
- 6May 8, '13 by SionainnRNQuote from CrazierThanYouI'm an ED nurse and bolus is always wide open. If its on a pump it's at 999 mL/hr if its on gravity it's unclamped.
So, when they said "wide open" that means run the bolus full speed on gravity? I've asked nurses at work about bolus speed and have gotten a range of answers, mostly 250 to 500 mL/hr but never wide open on gravity.
- 0May 8, '13 by nrsang97Quote from blondy2061hI believe OP said this is telemetry. In my facility, a BP of 70/40 is completely acceptable for a tele floor as we have about a 1:4 ratio and are privileged to run vasopressin, dopamine, and neosynephrine drips. Before judging that the admission was inappropriate, understand that not all facilities are run the same way.
Most tele floors I have been worked on do not allow titration of Neo, Dopamine, or to run vasopressin. This was a truly inappropriate admission. The pt should have been stabilized further or sent to the ICU for further management. This was a bad judgement on those ER nurses for letting that pt go up to the floor before the bolus being finished.
- 0May 8, '13 by jtmarcy12OP: You ARE NOT a lost cause!! But never ever practice outside of the nurses scope of practice. Your preceptor should not have allowed that patient to come to the unit until her BP was more stable and her bolus dosing was complete. That is why she was percepting you so that "any problems" that arise she can intercept and advise you accordingly. Did your preceptor get reprimanded? The patient should never have left the ER in her condition and I would have called the doctor and refused to take report until I knew the patient was more stable. Best wishes to you in the future!!
- 2May 8, '13 by hiddencatRNQuote from Sun0408Me too. This whole situation doesn't quite add up.OP, I'm sorry but I went back and read some of your other posts. You are not a new nurse and seem to have past issues, I think this incident was the straw that broke the camels back as they say.. You wanted to go back to school, so here is your chance.
I do wish you the best
- 3May 9, '13 by J-SwishYou know who's at fault? EVERYONE.
The OP's story doesn't quite add up and practiced outside her scope, that ER was using the M/S Floor as a dump, that preceptor did not intervene, these people on the AN forums shouldn't be critiquing the OP based on previous posts (I think post history should be disabled), and last but not least those folks who say she deserves to be fired. Shame on you.
This does not represent professional nursing.