I said "No Way, No How" would you?

  1. Friday at 18:30 we had a CT Abdomen/Pelvis w/contrast show up at the outpatient center. We close at 1900 and they had not been prepped orally or we would have gone ahead and done it our radiologist is there until 0200.

    I called the hospital and told them this patient would be right up to begin his prep. The CT tech asked me to go ahead and start an IV to help him out and save him the trouble. Um...like "no I won't". Start an IV on a patient and then let leave them and drive up over to the hospital? "I don't think so fella". I didn't know this person they could have been a druggie and left and shot up with a nice 20g in place. He thought I was being unreasonable and lazy. I think he was being unreasonable. Would you have started that IV?

    His doc was so sure it was a ruptured appy that he called the on call surgeon to come in, the surgeon had the OR crew called in, everything was ready and the CT was "completely" normal...not even a diverticulum in sight.
    •  
  2. 13 Comments

  3. by   JBudd
    I'm with you. That was his responsibility, and for anyone to leave a facility with an intact IV requires an MD order.
  4. by   bill4745
    Totally agree with you.
  5. by   elizabells
    I'm with you, DutchGirl. No telling what could have happened after that pt left your facility.

    I got reamed the other day for not calling in transfer report to the receiving hospital on a pt whose transport team wasn't even on the floor yet at shift change. I know people don't want to, like, do work and stuff, but WE are responsible for things we do/document, and if there's a reasonable possibility things could change/go awry, we have a responsibility to our patients and our licenses to minimize potential adverse outcomes.

    Wow. Did that make any sense? Nyquil, you make my brain all squidgy and my fingers all fumbly!
  6. by   TazziRN
    I have started IVs and sent people home with them to return the next day for meds or a procedure, but each case was discussed long and hard between doc and nurses before the decision was made. A request from a tech, with no order and no discussion? I don't think so!!!
  7. by   oldiebutgoodie
    NO WAY would I have started an IV on this person. As other people have said, the patient might have decided to do a little premedicating with that nice venous access in place!

    Oldiebutgoodie
  8. by   morte
    especially suspect, since it proved to be nothing....(at least so far,lol)
  9. by   nghtfltguy
    i woudn't have done it either.... you made the right call...

  10. by   Medic2RN
    Heck NO, I wouldn't have started that IV!! He thought YOU were being unreasonable and lazy?? Just the opposite!!
  11. by   showbizrn
    Bravooooo!
  12. by   nrsang97
    No way would I have done that. That was for the CT tech to do once the pt arrived to the hospital just prior to the test.
  13. by   GadgetRN71
    Quote from DutchgirlRN
    Friday at 18:30 we had a CT Abdomen/Pelvis w/contrast show up at the outpatient center. We close at 1900 and they had not been prepped orally or we would have gone ahead and done it our radiologist is there until 0200.

    I called the hospital and told them this patient would be right up to begin his prep. The CT tech asked me to go ahead and start an IV to help him out and save him the trouble. Um...like "no I won't". Start an IV on a patient and then let leave them and drive up over to the hospital? "I don't think so fella". I didn't know this person they could have been a druggie and left and shot up with a nice 20g in place. He thought I was being unreasonable and lazy. I think he was being unreasonable. Would you have started that IV?

    His doc was so sure it was a ruptured appy that he called the on call surgeon to come in, the surgeon had the OR crew called in, everything was ready and the CT was "completely" normal...not even a diverticulum in sight.
    It's rare, but I've been in on surgeries where the CT scan was "normal" and it turned out to be a bad appendix. I think in these cases the CT scan was read incorrectly.:troutbecause some of our ER docs were morons) That being said, I wouldn't have started the IV either...easy enough to do it at the hospital.
  14. by   DutchgirlRN
    Quote from WitchyRN
    It's rare, but I've been in on surgeries where the CT scan was "normal" and it turned out to be a bad appendix. I think in these cases the CT scan was read incorrectly.(because some of our ER docs were morons)
    We have radiologists 24/7 who read everything coming out of medical imaging, even XR's done in the ED.

close