Fentanyl bolus question

Kaysmom8 · Mar 28, 2013

How in the world is she going to justify the fact that she took easily took out at least 8 bolus doses that we saw? The bag will run out before its time?

MendedHeart · Mar 28, 2013

Yea thats a lot..I only saw them to it once.

Esme12, ASN, BSN, RN · Mar 28, 2013

How in the world is she going to justify the fact that she took easily took out at least 8 bolus doses that we saw? The bag will run out before its time?

I have no idea. The is always "waste" that can't be accounted....for example flusing the tubing. However, Many pumps these days allow you to flush the tubing on the pump...so I have NO idea how she accounts for the missing meds.

If anyone checks she's in A LOT of trouble.

akulahawkRN, ADN, RN, EMT-P · Mar 29, 2013

The other reason for not giving fentanyl boluses is that bolusing is a great way to cause one of it's known side-effects: rigid chest. Fent's a great drug for a number of reasons, but you have to be careful with it. Use with proper caution, it's good stuff.

dah doh, BSN, RN · Mar 29, 2013

To the OP: the nurse should have been calling the doctor for additional pain meds! Pulling drugs from the line to give boluses of pain medication is practicing medicine without a license and is out of the scope of practice for a nurse. It is most likely grounds for termination as well! Hopefully no harm comes to that patient!

morte, LPN, LVN · Mar 29, 2013

Don't remember seeing/hearing it till here on AN. Spelled out and in context, I figured it out. But shortened to "DL", wouldn't have.

Lol..the phrase "DL" has been around a lot longer than computers and text talk hehe

NicuGal, MSN, RN · Mar 29, 2013

I was thinking the same thing! What if that patient developed chest rigidity???? How are you going to explain that if you haven't documented any boluses??? That is just bad practice and a good way to get yourself fired! Use your pain and sedation scores to justify the need to go up on the gtt or increase the PRN boluses!

psu_213, BSN, RN · Mar 29, 2013

Don't remember seeing/hearing it till here on AN. Spelled out and in context, I figured it out. But shortened to "DL", wouldn't have.

I first heard "DL" used on an episode of the show ER back in the 90s. In the context they used it, it is a quite unsavory topic.

Esme12, ASN, BSN, RN · Mar 30, 2013

I was thinking the same thing! What if that patient developed chest rigidity???? How are you going to explain that if you haven't documented any boluses??? That is just bad practice and a good way to get yourself fired! Use your pain and sedation scores to justify the need to go up on the gtt or increase the PRN boluses!

Absolutely right....even though chest rigidity is mostly prevalent in the pedi/neonate population.

nurseprnRN, BSN, RN · Mar 30, 2013

Lol..the phrase "DL" has been around a lot longer than computers and text talk hehe

:) I consider myself pretty well-read and have been to more than one rodeo, and it's not familiar to me in this part of the country. Thanks for enlightening me...and I still say that abbreviations like this are discouraged here. :)

MendedHeart · Mar 30, 2013

:) I consider myself pretty well-read and have been to more than one rodeo, and it's not familiar to me in this part of the country. Thanks for enlightening me...and I still say that
like this are discouraged here. :)

My bad..didnt know

Kaysmom8 · Mar 30, 2013

The nursing instructor watched the nurse give the bolus doses several times. This makes me very uneasy to learn that the nurse shouldn't have been doing this in the first place and the instructor choose to ignore it. I know I don't feel safe on clinical now and our group got together to talk with our advisor and we got nowhere. I'm willing to bet the advisor will tell the teacher and things will be 10 times worse for our group...