Ativan, insulin, alcohol drips on floors? - page 5

For those of you who work in med-surg, do you do ativan, insulin, or alcohol continuous infusions on your floor? If so, how do you handle the frequency of the vitals you need to do, as well as... Read More

  1. by   Enabled
    As far as the Ativan, Alcohol and other drips, which the facility did not have one on the alcohol they had a rolevice that was suppose to work just as well or ALMOST as well as a pump. You still had to figure the number of drops per minute and set the roller to the closests amount. The reason my patient was on it was that they did not want him going into DTs either before or after surgery. I have given Ativan IV but not as a drip. We do insulin drips with a protocol as how often bs were done by fingerstick as well as by lab. We always kept the glucagon and DW50 tape over the headboard in the event there were additional problems. I have given Ativan IV and have recieved it IV but I have not hung it. I would onlly give cardiac meds without a complete inservice of the meds so that I don't have to stop at the last minute to look it
  2. by   BugRN
    Anyone ever hear of heparin drips on Post partum??? That 's the point when I quit. 1 RN w/ and aide or LPN w/ 10-14 post partums, post-ops, antepart's, surgical hyst.'s etc...Oh but we did get a 20 min inservice! That was also the same time they started sending us Chemo pt.s too, Infection control said it was OK, amazing isn't it!!
  3. by   Enabled
    BugRN, the only reason I can see a heparin drip is if the mother had develop a DVT but she should be exercising her legs during the post partum period. I would not want it on the floor, but would you want to seperate the mom and baby by being on different units. I can see why they have chemo on your floor as there is little ristk of diseases as I would think the fresh deliveries and post ops would be considered a clean floor. We had our chemo patients on the surgical floor at one end. Anyone who developed and infection was sent to one end of the floor and put on contact precautions as a reminded for infected materials. That way hopefully there won't be cross contamination
  4. by   RNinICU
    We use ativan, fentanyl, and diprivan drips on vent patients for sedation. Depends on the patient's condition and diagnosis which one we use. Hourly vitals of course. Insulin drips for DKA or hyper glycemic patients.
  5. by   mattsmom81
    Our post partum wing doubles as a clean female overflow they are expected to know how to care for medsurg patients. Most of the nurses there also float to medsurg to keep their skills up.

    So yes, a Heparin drip would be an OK standard procedure on my's only q 4-6 PTT parameters and a fairly low risk procedure. Our chemo patients go EVERYWHERE ...the only stipulation is a chemo certified RN must initiate the chemo and be available to the staff for support/questions.
  6. by   caroladybelle
    I personally think that chemo patients should be on a designated floor so that chemo nurses can teach and observe for dangerous or uncomfortable/detrimental side effects. At my current facility, unless on the vent, they all go to Oncology. However, I am aware that the suits in nursing do not think this necessary (a nurse is a nurse is a nurse, etc.) The oncos in this area however require (if at all possible) that chemo patients go to a hospital/unit designated for oncology.

    Any chemos on other floors (including the unit), are initiated by a chemo nurse. If continious, monitored q2 hours or more often by a chemo nurse. All ports accessed by a cancer nurse - since an incident in the area, where a port was accessed w/a coring needle. And we frequently go to ER/L&D to give methatrexate for OB/GYN or rheumatoid arthritis patients. The OB nurses pay us back when we need fetal heart tones on one of ours. Team work is wonderful.

    We also frequently advise or assist with IV Ganglicyclovir (requires chemo precautions)
  7. by   moonshadeau
    I don't think that IV insulin gtts is such a big deal. Of course though we are used to having a very aggressive Endocrinologist that writes all kinds of screwy orders. The insulin gtt we do checks q1 hour until sugar stabilizes and then it goes to q2-3 hours. We don't do the bedsides, the lab does them. That helps. But then we are also used to having to recover angio caths that require hours of frequent vitals so that might be a part too. Time management is everything! Ativan, ETOH and NTG, Cardizem are all upper care units. I work on a tele floor that is closer to a step down some days, but day and evening ratio can be 1: up to 6 and noc 1;10.
  8. by   fiestynurse
    Never heard of Alcohol or Ativan drips. Insulin drips are done in the ICU only - Never on Med/Surg floor. However, got a doctor in the community who started doing Insulin drips in the Urgent Care at the local Clinic. Now that was scary!

    I have done Heparin drips and Caffeine drips on the postpartum floor. Caffeine drips work great for spinal headaches.
  9. by   BugRN
    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.......
  10. by   mattsmom81
    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 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.
  11. by   BugRN
    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.
  12. by   NurseLKY
    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.
  13. by   susanmary
    NurseLKY -- how many patients do you have on each shift? What is the frequency of vitals on the drips you mentioned?