Saline flush without a physician order? - page 7

by stephenfnielsen | 18,432 Views | 104 Comments

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. 2
    I'm thinking either that or someone got grief for letting a saline lock clot off and is trying to justify why they didn't flush it on their shift.
    Hospice Nurse LPN and wooh like this.
  2. 2
    We just automatically flush saline locks, no order needed. We also flush CVP's with hepaline after it is inserted twice/day. It's policy, and if we had to wait for the docs to write orders for all these little things we'd be waiting 'til christmas! They just assume that the nurses at our facility know how to care for these lines... and they are right! As for other CVAD's, again we have a policy with an algorithm to follow with when/how/what to flush with line with (no order needed). The policy was created by RN's for RN's.
    Hospice Nurse LPN and wooh like this.
  3. 2
    I've never heard of anything more ridiculous as needing a doctor's order for a saline flush. The care of your lines falls within the nurse's rôle and scope of practice. You esteem your line needs a saline flush - you just do it.

    Is this a cultural difference between the US and some European countries? Do we perhaps have a more autonomous rôle than US nurses? It's a question, not a supposition.
    JennyMac and Hospice Nurse LPN like this.
  4. 7
    Quote from DavidFR
    I've never heard of anything more ridiculous as needing a doctor's order for a saline flush. The care of your lines falls within the nurse's rôle and scope of practice. You esteem your line needs a saline flush - you just do it.

    Is this a cultural difference between the US and some European countries? Do we perhaps have a more autonomous rôle than US nurses? It's a question, not a supposition.
    No- this is a thread started for the sake of arguing.... It is ridiculous
    ObtundedRN, Altra, Esme12, and 4 others like this.
  5. 25
    Today I was in the ER and thought about this thread...

    I thought about my 3 rooms, one had lasix ordered, one had clindo ordered, another had morphine ordered. And i thought how ridiculous it would be if I went up to the doc and said,"Um, can you order two flushes on each of those drugs so I can flush pre and post meds?"

    Ten dollars says I would get fired for being an idiot.
    Last edit by A&OxNone on Aug 13, '11
    anotherone, RNKPCE, DavidFR, and 22 others like this.
  6. 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.
  7. 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.
  8. 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.
  9. 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 !!!!
  10. 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


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