I have been a med/surg Nurse for nearly 20 years and have spent nearly 30 years at the bedside all together. I left nursing over a year ago because I was burnt out and very disheartened at the way things were going. My last job before accepting my present position was in a dialysis clinic which lasted for 6 years. I just recently went back to work in the hospital setting on a med/surg floor. While I am enjoying being back in the hospital setting, there is something that concerns me greatly... replacing electrolytes and minerals (K+,MgO4, Ca+, and PO4) according to a protocol. Almost every pt who is admitted to the hospital is placed on these protocols(even the pts who are known to be ESRD). I am concerned because even when the pt's lab value falls within normal perimeters, we are to give them supplemental po or IV K+ to bring their level up to 4.0. There have been instances where a pt was given supplemental K+ and their creatine wasn't checked by the nurse giving the RX.
It just seems like docs have become too agressive in treating something that may resolve on its own. The protocols give the nurse the directions to give these supplements w/o having to call the doc. I consider this playing with fire and gasoline. I would rather see the docs looking for the reason(s) why the pt's levels are low rather than trying to fix something that may not even be broken. Of course labs are drawn every day on these foks, but it just seems like maybe it's becoming a way for the hospital to make money.