Got fired for changing fluid rate - page 4

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... Read More

  1. by   Esme12
    Quote from CrazierThanYou
    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.
    I have been an ER nurse a LONG time!!!!!!!!! We run gravity boluses ALL the time......we will also place pressure bag on fluids if necessary and the vitals require it to replace volume. Open the clamp and let her rip...while the patient is monitored for failure and vitals.

    However.....even if it is a liter bolus.......I wait until the bolus is infused in the ED for the floors just do NOT have the staffing capacity to monitor these patients.....
    from ChristineN
    I am an ER nurse and we always run our boluses "wide open" and will often bring pts to the floor with a bolus still infusing. The difference is I would never send a pt to med-surg bed with a pressure like that
    How long does it take to really infuse and ensure that patient is stable....that was a ER dump and they should be ashamed for transporting an unstable patient to a inappropriate unit.
  2. by   blondy2061h
    I 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.
  3. by   Sun0408
    Page 2 the OP said it was a med/surg floor... Several other posts said tele, who really knows.
  4. by   psu_213
    Quote from RoyalPrince
    Pt on a Med/Surg Floor comes with a BP of 70/40 and no Rapid Response is called? you should be fired.
    I totally agree with the sentiment you are expressing with your first question....totally disagree with your second sentence.
  5. by   SionainnRN
    Quote from CrazierThanYou

    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.
    I'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.
  6. by   netglow
    "How long does it take to really infuse and ensure that patient is stable....that was a ER dump and they should be ashamed for transporting an unstable patient to a inappropriate unit." -Esme

    Yup, it walks like one, and quacks too!
  7. by   itsnowornever
    Quote from Sun0408
    Page 2 the OP said it was a med/surg floor... Several other posts said tele, who really knows.
    Because the OP also states elsewhere that he/she works tele

    Posting from my phone, ease forgive my fat thumbs!
  8. by   nrsang97
    Quote from blondy2061h
    I 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.
  9. by   jtmarcy12
    OP: 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!!
  10. by   hiddencatRN
    Quote from Sun0408
    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
    Me too. This whole situation doesn't quite add up.
  11. by   J-Swish
    You 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.
  12. by   uRNmyway
    Quote from J-Swish
    You 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.
    I beg to differ. Post history can be very useful. How we respond to someone with 20+ years of experience vs. a brand new grad will be different. Or if we look at their history, notice that there are 15 posts in the last month about mistakes that he/she made, well, it certainly affects the whole 'Should I have been fired?' response.

    Do I think that OP should have been fired for this drip rate issue? No. Reprimanded, given in-service and stern reminders of scope of practice, definitely. BUT...given past issues about being rude to patients, unsafe practice, etc. That perhaps explains being fired a bit better.

    And you know what else I just realized? Since posters started commenting that things don't make sense with post history and all, we have not heard from OP. Jus' sayin'.
  13. by   evolvingrn
    I would have done that.

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