Ativan, insulin, alcohol drips on floors?

BugRN · May 28, 2002

Thanks for the info on Chemp pt.s on PP, But a note on the Heparin drip pt.'s, they were not post partum moms...I could see if they were and would not want to seperate mom and babe, but these were overflow med/surg pt.'s. I didn't feel safe with them. I know this is an old debate, but I worked OB so I didn't have to do Med/surg... I know, I know Not including our post op's and Hyst's. I mean geriatric pt.'s on PP. Give me healthy post part's anyday. Including the Mag's and C/S, Please this is not meant to be a debate on a nurse is a nurse is a nurse.......

mattsmom81 · May 28, 2002

I would enjoy working a mother baby unit if it was closed and I did not have to float...there generally isn't lifting (much) on this unit either...so it may be something I can work up to eventually when I'm recuped from my surgery.:)

Medsurg and critical care are back breaking areas to work so I know that will definitely be out for me!

Do most mother baby units today require LD cross training as well, BugRN? Just curious. :)

BugRN · May 28, 2002

Dear Mattsmom,

When I did L/D we were cross trained, in fact I was most often on L/D because I had a lot of exp there. Big city hosp. sometimes have their own staff for each unit and don't cross train, I've also done that. In the end it's a good thing to have a core of really good, exp. L/D nurses as well as those that can cross train. "Cause when the s***t hits the fan, it's usually an L/D nurse you need.

NurseLKY · Jun 6, 2002

I work on a med surg unit and we do insulin, alcohol, and morphine gtts. Even though we are busy vitals and accu checks always get done. We work together very well.

susanmary · Jun 6, 2002

NurseLKY -- how many patients do you have on each shift? What is the frequency of vitals on the drips you mentioned?

mattsmom81 · Jun 6, 2002

Sorry, Bug, I guess I didn't word my question well.

What I meant to ask: have you seen units where nurses can work with postpartum Moms and the newborns and NOT have to do labor and delivery?

Or is it pretty much expected that the mother/baby nurse float to LD too?

NurseLKY · Jun 7, 2002

susanmary

I work on a floor with 26 patients. We have 5-6 nurses working day shift. So it comes down to about 5 patients. On insulin drips accu checks and urine ketones are checked q 1hr. Then it depends on how sick the patients is to when vitals are done usually q2-4 hr.

BugRN · Jun 25, 2002

dear Mattsmom,

I have seen it both ways, depending on the size of the unit. Larger hospitals will have seperate L/D staff. Post Part will too as well as nursery. I have worked both. I kind of liked doing all areas, a nice change, but I always loved Labor best.

deespoohbear · Jun 26, 2002

In our small county hospital, Cardizem, insulin, and nitro gtts go to the ICU. A couple of times a doc has tried to talk us into taking a insulin gtt on the med-surg floor but I absolutely put my foot down. When I have 6 or 7 patients, q1 hour accu-checks are a fantasy, not reality!! We do dobutamine and dopamine as long as it not be titrated and is lower than 5mcg/kg/min. I have seen Ativan gtts used in our ICU for vent pts, and a couple of very combative pts. We have heparin gtts all the time on med-surg. Heparin gtts don't scare me as much since the titration window is usually q6 hours. I give MS and Ativan both IVP on med-surg. Depends on the patient and the reason I am giving it whether I check the VS before administration. If the pt is in the process of beating me and the rest of the staff senseless, I figure their B/P is fine and give the Ativan. I agree with the poster who said if a pt is requiring q1hr anything, they are probably better served in an ICU or step-down unit. I have no problem speaking out about assignments that I believe are unsafe. Very interesting thread.