IV Lopressor on the med/surg ward?

[country bumkin]

Hi, I would like to know if anyone has been giving IV lopressor on the med/surg floor. Our surgeons have decided recently that the nurses on my unit need to give IV lopressor to post-op pt's. The pt's are to be put on tele and monitored by ICU nurses one floor below us. WE have to do VS q 5min x15min, then q15 min x30,then q 30min. The order is to give q 4hrs, so you are constantly in the pt's room. Our nurse pt ratio is 6-1, so this is very difficulty. I have been a nurse since 1981 and I have never been expected to do this on the ward.My experience has always been these pt's need to go to the ICU. And on top of this the pt was on an insulin drip as well, which in my experience that the pt's on insulin drip need to be in the ICU as well. Has the standards of practice changed??

[jenrninmi, MSN, RN]

Hi, I would like to know if anyone has been giving IV lopressor on the med/surg floor. Our surgeons have decided recently that the nurses on my unit need to give IV lopressor to post-op pt's. The pt's are to be put on tele and monitored by ICU nurses one floor below us. WE have to do VS q 5min x15min, then q15 min x30,then q 30min. The order is to give q 4hrs, so you are constantly in the pt's room. Our nurse pt ratio is 6-1, so this is very difficulty. I have been a nurse since 1981 and I have never been expected to do this on the ward.My experience has always been these pt's need to go to the ICU. And on top of this the pt was on an insulin drip as well, which in my experience that the pt's on insulin drip need to be in the ICU as well. Has the standards of practice changed??

When I was doing med/surg, we gave Lopressor IVP as well. It was also a tele unit, but yes, you are constantly in the patient's room.

[brandnewjerseyrn]

We give Lopressor IV as well on our med/surg floor, and insulin drips are very common for us. For IV lopressor to be given the pt must be on tele. I always check VS before giving it and then 20-30 minutes after. I wouldn't feel safe giving Lopressor IV if my patient wasn't hooked up to telemetry. We have a 5:1, sometimes 6:1 ratio.

[chenoaspirit, ASN, RN]

I also work med/surg floor and have given lopressor IV. We do not have insulin gtts though. I have had up to 10 patients and I dont feel I have the time to monitor like needed. 10 patients - too many.

[cardiacRN2006, ADN, RN]

If I had to have a pt in the ICU who's only reason for being there was lopressor, then I'd be a very bored nurse, and a lot of real ICU patients would not get a bed because we'd be full with med-surg pts.

I'd start looking for another ICU to work in.

Insulin gtts-I can see those coming to the ICU. Our floors don't even take heparin gtts. But they can still take lopressor.

[lsyorke, RN]

We use IV Lopressor all the time. Patient must be on tele...first dose has to be given by a doc(usually a resident) and parameters are followed on subsequent doses. We use a harvard pump to infuse it over 20 minutes. No big deal. Our ratio is 6:1.

Insulin drips are all in the ICU, due to the q 1 hour blood sugars.

[wooh, BSN, RN]

If I had to have a pt in the ICU who's only reason for being there was lopressor, then I'd be a very bored nurse, and a lot of real ICU patients would not get a bed because we'd be full with med-surg pts.

Well, it's not that the particular patient needs 1:1 or 1:2 monitoring, it's just that they need more monitoring than can be provided under 1:6,7,8,9,10 care that's being expected of med-surg nurses these days. And at a lot of hospitals, there's just no in-between for these patients. And instead of recognizing that the ratios are too high in med-surg, management and MDs just say to monitor those patients more, and question your competency when you say you can't do it all (which in my mind, knowing what you cannot safely do is actually a sign of being very competent). And as long as nurses keep trying to do it all, it's going to keep happening. Until enough nurses band together on a unit to say enough is enough, it's going to keep happening.