Dilemma situation! I'm not a nurse, but is this common practice??

  1. Resident had an iv catheter to have morphine administered subcutaneously via a butterfly needle on the abdomen. Before the nurse administered the morphine, he mentioned out loud that he had to get the heparin first (referring to the flush). I then witnessed the nurse flush the iv butterfly with the heparin, then the morphine, followed by the heparin flush.
    Last edit by Nursing617 on Oct 17
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  2. 39 Comments

  3. by   chare
    And your question is...
  4. by   EllaBella1
    I have a feeling the flush was just saline and the nurse (probably a nurse who has been around for awhile) called it heparin because that is what flushes used to be. Otherwise that procedure sounds 100% correct.

    What is your role in this situation and why are you so concerned with it?
  5. by   ober99
    The iv is flushed with normal saline before and after the morphine. Not heparin. Unless you have a central line, such as a picc line. Then you would use "SASH"; saline, administer med (abx for example), saline, heparin. Such are used in most nursing homes, per protocol.
  6. by   Nursing617
    My role is a concerned employee. Need I say more? And he's been a nurse for a couple of years. If this was your loved one and something didn't seem right, you would be concerned too. It was Heparin
  7. by   Emergent
    Quote from Nursing617
    My role is a concerned employee. Need I say more? And he's been a nurse for a couple of years. If this was your loved one and something didn't seem right, you would be concerned too. It was Heparin
    You sound like you don't know what you're talking about at all. You don't administer IV medications subcutaneously.

    If you think someone is doing something wrong then bring it to their manager's attention, after you are unsatisfied with the response you got from directly asking the person in question.

    In this case I suspect that because you are not trained, you don't know what you are seeing. There's no harm in asking questions to expand your knowledge.
  8. by   Wuzzie
    Quote from Emergent
    You don't administer IV medications subcutaneously.
    This is actually quite common in the ECF/home setting. A small gauge butterfly is inserted SQ and a Tegaderm placed over it.
  9. by   Emergent
    Quote from Wuzzie
    This is actually quite common in the ECF/home setting. A small gauge butterfly is inserted SQ and a Tegaderm placed over it.
    Wouldn't that then be a sub Q medication?
  10. by   Wuzzie
    Quote from Emergent
    Wouldn't that then be a sub Q medication?
    Oh for heaven's sake. It's the IV form given sub Q through a needle commonly used for IV therapy or venipunctures. The OP referred to it as an "IV butterfly" which is technically correct.
  11. by   EllaBella1
    I just don't get what part of this is setting off a huge red flag for you. If you're that concerned take the issue to the charge nurse for clarification.
  12. by   cleback
    Quote from Wuzzie
    Oh for heaven's sake. It's the IV form given sub Q through a needle commonly used for IV therapy or venipunctures. The OP referred to it as an "IV butterfly" which is technically correct.
    I would encourage people to be kind in their responses. These kinds of reactions may be why the OP is asking an anonymous forum instead of addressing the concern at the time.
  13. by   Wuzzie
    Quote from cleback
    I would encourage people to be kind in their responses. These kinds of reactions may be why the OP is asking an anonymous forum instead of addressing the concern at the time.
    I wasn't responding to the OP I was responding to another poster AEB the fact that I quoted her. And seriously? "For heaven's sake" is about as mild as it gets.
  14. by   BeckyESRN
    There are times when certain types of lines/ports/and other placements are ordered to be flushed with heparin or have heparin instilled after use to keep the line patent. Heparin flushes are ordered, rarely in my personal experience, but not unheard of. You can always ask! "Hey nurse person, I heard you say that you're flushing that with heparin. I've never seen that done before, do you know why they've ordered that instead of saline?" As long as you approach from a standpoint of wanting to expand your knowledge and not a "hey you're doing this wrong" standpoint, I don't think a normal person would react badly

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