Interpret This Order For Me Please

[guest1143647]

IV 1000ml D5 1/2 NS 60ml x 24 hours

I read it as D5W 1/2 NS at 60ml hour. Total volume to be given is 1000ml. However, 60 x 24 hours is 1440. So after 1000 was given I hung an extra bag to cover the 440ml

[Rose_Queen, BSN, MSN, RN]

I would have called for clarification. That is not a properly written order.

[Jedrnurse, BSN, RN]

47 minutes ago, Rose_Queen said:

I would have called for clarification. That is not a properly written order.

Exactly. Why just assume the extra 440 ml...?

[guest1143647]

Because the doctors  do not like us to call them at night unless an emergency. 
I got written up for calling a doctor about a fall that didn’t result in injury. 

I asked supervisor and she stated the 1000 meant the volume in the bag. That didn’t make sense to me either.

[ladedah1, BSN, RN]

10 minutes ago, Runsoncoffee99 said:

Because the doctors  do not like us to call them at night unless an emergency. 
I got written up for calling a doctor about a fall that didn’t result in injury. 

I asked supervisor and she stated the 1000 meant the volume in the bag. That didn’t make sense to me either.

 

Maybe if you started calling them in the middle of the night, they would start paying more attention to how they're writing them in the first place ?

Wait! Totally missed the "written up" thing.  Written up for calling a doctor?  Seriously?

[Jedrnurse, BSN, RN]

23 minutes ago, ladedah1 said:

Wait! Totally missed the "written up" thing.  Written up for calling a doctor?  Seriously?

I know! See what happens when you don't call for a fall...

[Daisy4RN]

On 1/19/2022 at 7:38 AM, Runsoncoffee99 said:

Because the doctors  do not like us to call them at night unless an emergency. 
I got written up for calling a doctor about a fall that didn’t result in injury. 

I asked supervisor and she stated the 1000 meant the volume in the bag. That didn’t make sense to me either.

I agree with others that I would have called for clarification as the order is not clear. Or, if you asked the supervisor and they said it was OK I still would have said to them…I am still not comfortable so either you start it (and chart) or call the MD and get a verbal order. If the supervisor is willing to tell you the order is OK then they should be willing to put their name in the chart. 

[MunoRN, RN]

It's nonsensical.

I would call, middle of the night or not, but start by clarifying that you normally wouldn't be calling in the middle of the night but this is clearly an emergency, either the ordering provider was having a stroke when they put the order in, in which case someone should check on them, or someone mugged the ordering provider and used their badge to enter orders pretending to be them, in which case someone should also check on them.

[JKL33]

Maybe just where I've been but the 1000ml would mean hang a 1000 ml bag. And the order is D5 1/2 NS @ 60 ml for 24 hrs. So I agree with what you ended up doing. Or at least it's exactly what I would've done.

I thought it was fairly annoying when POE really got going and they were all forced to choose that element....and they were given way too many options to choose from. Can't even tell you how many 500 ml bolus orders in the ED were written by first selecting NS 500 ml. Which is then what the dispensing cabinet wants you to take out.

Again, maybe just what I'm used to but I don't find  the order confusing.

 

[sleepwalker, MSN, NP]

why not just hang the 1000mL bag and set it to run at 60mL/hr then clarify the order in the morning since you'd still be well under the total volume even 8-10hrs later? 

[Daisy4RN]

On 1/21/2022 at 10:02 AM, sleepwalker said:

why not just hang the 1000mL bag and set it to run at 60mL/hr then clarify the order in the morning since you'd still be well under the total volume even 8-10hrs later? 

Because unfortunately in the nursing world today this would probably get you a write up for not clarifying the order prior to hanging (no matter how much sense that would actually make). 

[SonjaRRN]

I interpreted the order for : Administer 1000ml bag (available form of IVF is 1000 ml per bag) of D5 1/2 NS (not D5W) at 60 ml/hr x 24 hours. It is clear to me; however, when in doubt, check it out!