Drips on the Floor

[sergel02, BSN]

Hey everyone. I just finished my pediatric rotation, enjoyed it, but had a few questions I hope you can shed some light on.

At your facility, do you ever start drips on the floor, or is that a PICU thing? Same thing with titrating the drips.

I ask because when I was on the adult floors, I would see one or two drips on a patient occasionally, like dopamine, cardizem, insulin, and heparin. Usually never more than 2. I saw 3 once, but it was on an oncology floor with a 3:1 ratio. On the peds floor, I never saw anything IV except for fluids, antibiotics, blood, and chemo (I did see a morphine PCA though). I was wondering if it was my facility, my experience with the rotation, or if it's something more common in pediatrics, or perhaps just the adult floors I've been on. Thanks in advance :)

[DiscGolfNurse, BSN]

I think it depends on the unit that you are on. In ICU patients can be on many drips (pressors, heparin, pain and so on). I know on my unit (med/surg, oncology, palliative care unit) we can only hang pain drips, ativan, fentanyl, blood, chemo, and heparin, that I've seen. Hope this helps!

[brownbook]

I've only floated to peds, and that was a smaller hospital, lower acuity patients.

Drips on the floor can vary per institution.

Many years ago when dopamaine drips first started being used on our med/surg unit some nurses had a fit. "Isn't that against policy?" No policy is going to specifically list drips or drugs that can or cannot be used, just vague general generic guidelines. And of course the dopamine drip was just for renal perfusion, the drip did not need to be titrated to patients blood pressure, just left alone at whatever it was ??? 10 mcg per minute ?? (I can't remember).

I'm curious why you ask?

[sergel02, BSN]

I've only floated to peds, and that was a smaller hospital, lower acuity patients.

Drips on the floor can vary per institution.

Many years ago when dopamaine drips first started being used on our med/surg unit some nurses had a fit. "Isn't that against policy?" No policy is going to specifically list drips or drugs that can or cannot be used, just vague general generic guidelines. And of course the dopamine drip was just for renal perfusion, the drip did not need to be titrated to patients blood pressure, just left alone at whatever it was ??? 10 mcg per minute ?? (I can't remember).

I'm curious why you ask?

I remember having a patient on dopamine for that. First time I saw dopamine running too.

I ask partly to satiate my curiosity but also just thinking about the future. I recall enjoying the heme/onc/BMT floor I was on last semester (except it was a bit too quiet for my taste), but one thing I loved is the more mid acuity of it compared to med surg floors or ICUs. I love peds so I got curious about peds heme onc, but the two major hospitals in the area seem to send their kids to the icu if they need drips or have trachs.

Now picu is interesting to me as well but I like the long term aspect of heme onc. A lot of the picu nurses aren't certified to hang chemo even, and usually the floor nurses have to called if they need it.

[~PedsRN~, BSN, RN]

In my facility, titrating drips (heparin, insulin, etc) were always done in PICU, but could be transferred to the floor once there was no titration involved.

[sergel02, BSN]

Having asked around with friends precepting it seems like as long as there not titrated they can be in the floor. I have to wonder how many non titrated drips is too many. Both major hospitals for kids in the area have heme/onc patients on their floors, but the ratio for them is 3 to 1. But even some of those patients might have blood, antibiotics, pain meds, and fluids running the same time. Then again the one next door might be saline locked.

[Jamuhh]

We never have drips. That could always change, though...