Saline flush without a physician order? - page 6

Let's say a patient has a saline locked IV. The nurse knows that it is best practice to flush saline locked IVs with saline every 8 hours. Can she do this without a physician order?... Read More

  1. Visit  Hospice Nurse LPN profile page
    4
    Just finished reading all of the posts! What a hoot. The OP's profile states he's a nurse, but I'm thinking not.
    Esme12, SlightlyMental_RN, joanna73, and 1 other like this.
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  3. Visit  wooh profile page
    11
    I just don't think it's safe to have a standing order for a saline flush. I mean, what if the patient's sodium shot sky high since flushing before the antibiotic, it could KILL the patient if we just flush willy nilly after the antibiotic too. I just don't think I feel comfortable ever flushing saline without a bedside assessment by the attending MD complete with a dosage and rate before every single flush. This is a safety issue people!!!
    MPKH, KelRN215, anotherone, and 8 others like this.
  4. Visit  wooh profile page
    16
    And before you call the MD to get your order to flush with normal saline, make sure you take the national certification test. The Institute for Normal Saline Accession by Nurses Idiotically Technical and Yokel-like has a test that you should pass to prove that you are capable of safely flushing with normal saline. So be sure when calling the MD at 0300 for an order to flush the IV with saline to assure him that you are certified and calling to uphold the safety standards of I.N.S.A.N.I.T.Y.
    MPKH, anotherone, jelly221,RN, and 13 others like this.
  5. Visit  xtxrn profile page
    0
    Quote from wooh
    And before you call the MD to get your order to flush with normal saline, make sure you take the national certification test. The [I]Institute for Normal Saline Accession by Nurses Idiotically Technical and Yokel-like[/I] has a test that you should pass to prove that you are capable of safely flushing with normal saline. So be sure when calling the MD at 0300 for an order to flush the IV with saline to assure him that you are certified and calling to uphold the safety standards of I.N.S.A.N.I.T.Y.
    Oohhhhhhh...... you are GOOD !!!!
  6. Visit  That Guy profile page
    0
    Quote from wooh
    I just don't think it's safe to have a standing order for a saline flush. I mean, what if the patient's sodium shot sky high since flushing before the antibiotic, it could KILL the patient if we just flush willy nilly after the antibiotic too. I just don't think I feel comfortable ever flushing saline without a bedside assessment by the attending MD complete with a dosage and rate before every single flush. This is a safety issue people!!!
    Serious? God I hope my sarcasm font is just not showing up tonight
  7. Visit  diva rn profile page
    3
    Quote from wooh
    And before you call the MD to get your order to flush with normal saline, make sure you take the national certification test. The Institute for Normal Saline Accession by Nurses Idiotically Technical and Yokel-like has a test that you should pass to prove that you are capable of safely flushing with normal saline. So be sure when calling the MD at 0300 for an order to flush the IV with saline to assure him that you are certified and calling to uphold the safety standards of I.N.S.A.N.I.T.Y.

    BRAVOs...when KUDOS are just not enough!!!!!
    anotherone, joanna73, and xtxrn like this.
  8. Visit  xtxrn profile page
    3
    Quote from That Guy
    Serious? God I hope my sarcasm font is just not showing up tonight
    Might wanna get that font tuned up
    joanna73, That Guy, and wooh like this.
  9. Visit  rn/writer profile page
    7
    Quote from wooh
    I just don't think it's safe to have a standing order for a saline flush. I mean, what if the patient's sodium shot sky high since flushing before the antibiotic, it could KILL the patient if we just flush willy nilly after the antibiotic too. I just don't think I feel comfortable ever flushing saline without a bedside assessment by the attending MD complete with a dosage and rate before every single flush. This is a safety issue people!!!
    Perhaps it would be best to ask the MD to come in and observe you giving the flush, just so you are doing everything the way the doc wants it done. So what if it's 0300. Safety never sleeps! So why should the doc.
    DalmatiaRN, anotherone, joanna73, and 4 others like this.
  10. Visit  xtxrn profile page
    5
    It could be prudent to keep the saline flushes in with the controlled substances- one can't be too vigilant with such an unpredictable injectable substance. IDK...maybe it should be limited to PhD-level nurses, who haven't been out of the classroom in years- they would obviously have more knowledge about the potential risks of a product that is obviously a major liability.... Forget the clotted saline locks- we can just keep sticking the patient for every dose- much better than just keeping a perfectly good one patent

    But we MUST follow the I.N.S.A.N.I.T.Y. guidelines - very critical
    Last edit by xtxrn on Aug 14, '11 : Reason: add
    joanna73, ohioSICUrn, diva rn, and 2 others like this.
  11. Visit  wooh profile page
    16
    The more I think about it, I'm not sure nurses should be allowed to inject saline. I remember this one time. I flushed the IV. That patient DIED. And that's not the only patient that has died sometime after receiving a dose of normal saline to flush an IV. You'll think your patient is fine. It can happen YEARS later. One of my coworkers, she flushed an IV with saline almost two decades ago. That patient died last year. It just proves you are never safe from the effects of renegade nurse with normal saline in his or her pocket.
    But it's not just renegade nurses. There are care techs at my hospital that are bathing patients with dihydrogen monoxide. And from what I hear, you can now get dihydrogen monoxide over the counter! I've heard that ingesting it into the lungs can cause respiratory failure! When I took my concerns to my manager, she wasn't concerned. She said they've been using it for years. Like that's an excuse! Just because it's been done for years doesn't mean it can't kill someone!!!
    MPKH, KelRN215, rn/writer, and 13 others like this.
  12. Visit  xtxrn profile page
    1
    Quote from wooh
    The more I think about it, I'm not sure nurses should be allowed to inject saline. I remember this one time. I flushed the IV. That patient DIED. And that's not the only patient that has died sometime after receiving a dose of normal saline to flush an IV. You'll think your patient is fine. It can happen YEARS later. One of my coworkers, she flushed an IV with saline almost two decades ago. That patient died last year. It just proves you are never safe from the effects of renegade nurse with normal saline in his or her pocket.
    But it's not just renegade nurses. There are care techs at my hospital that are bathing patients with dihydrogen monoxide. And from what I hear, you can now get dihydrogen monoxide over the counter! I've heard that ingesting it into the lungs can cause respiratory failure! When I took my concerns to my manager, she wasn't concerned. She said they've been using it for years. Like that's an excuse! Just because it's been done for years doesn't mean it can't kill someone!!!
    Bwaaahaaahaaaaa I'm finding problems with having too much dioxide in my apartment. Especially when it has to have some type of seasonal temperature regulation.... the thermal issues alone are concerning
    wooh likes this.
  13. Visit  Aurora77 profile page
    4
    I can't believe I read the whole thread. Now I'm curious what the point is.

    I'm also terrified. You see, I gave morphine IV twice to a pt tonight. The IV was saline locked. I flushed a couple CCs before and after said administration. Do you think I'll still have my job when I go back??
    jelly221,RN, wooh, Hospice Nurse LPN, and 1 other like this.
  14. Visit  diva rn profile page
    6
    Quote from Aurora77
    I can't believe I read the whole thread. Now I'm curious what the point is.

    I'm also terrified. You see, I gave morphine IV twice to a pt tonight. The IV was saline locked. I flushed a couple CCs before and after said administration. Do you think I'll still have my job when I go back??
    Sadly, No.

    You see, there is now a whole movement brought on through the joint efforts of OSHA, JCAHO, and HIPPA (not HIPAA-this is another agency entirely) the Hospital Inspection of Potientially Poisonous Agents....and Saline is the Chief culprit!

    In fact, this agency was started just because of the soaring number of deaths and attributed to saline lock flushes.
    THis movement is to route out those indiscriminate nurses who think they can infuse such dangerous agents all WITHOUT a DOCTOR'S ORDERS!!!

    I myself, have had a patient die after having a saline flush...it was just terrible...and I just found out about it...you see, I flushed a saline lock back in 1995 on a patient in ICU...and I found out he just expired last week.....he was, wait a minute while I collect myself.....only 92!.... But I am sure the residual effects of the saline caught up with him....I am now waiting to hear from the BON.

    What are we going to do?

    I suggest we all stop flushing...and now demand that only licensed MD's flush those saline locks...it's just not worth losing your license over
    KelRN215, wooh, xtxrn, and 3 others like this.


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