IV drop rate in the real world?

BellsRNBSN · Nov 6, 2010

I'm a new nurse on a busy progressive care unit but I am posting this in this area because I don't know where else to post it. My problem is that I'm having some difficulty with nursing school vs. real world nursing, and a recent problem I've had is that I had to hang an IV without a pump and as I was calculating the gtt/min a nurse looked at me like I was crazy and said "you just open it all the way, there is no need to calculate that!!!" So my question is, what drugs is it acceptable to just open the line all the way, and what drugs do I need to be more careful about calculating the correct gtt/min for? Any help is appreciated.

Was it not indicated in the MD's orders? At the hospital I'm doing my clinical at, the infusion rate for medications is always included on the MAR.

healthcare4life · Nov 6, 2010

I'm a new nurse on a busy progressive care unit but I am posting this in this area because I don't know where else to post it. My problem is that I'm having some difficulty with nursing school vs. real world nursing, and a recent problem I've had is that I had to hang an IV without a pump and as I was calculating the gtt/min a nurse looked at me like I was crazy and said "you just open it all the way, there is no need to calculate that!!!" So my question is, what drugs is it acceptable to just open the line all the way, and what drugs do I need to be more careful about calculating the correct gtt/min for? Any help is appreciated.

I think you did the right thing by calculating drip rate. If you open the line all the way it can possibly cause excess fluid or other complications for the patient. Did you check MD orders? What that nurse said is like saying "oh you have an IV pump, you can just set it at any rate and you're good."

Always follow your gut, IMO. :)

nurse2033, MSN, RN · Nov 6, 2010

You are not wrong to do it the right way. Most piggybacks will not hurt the patient, but it is sloppy and bad practice. I'll assume you know that vasoactive drugs (and many others) must be on a pump. Vanco is one antibiotic that has rate issues. If you are new I would keep a drug reference and check each tme. I love Epocrates for example. Good luck.

anonymousstudent · Nov 6, 2010

Oh crap, open it all the way? I hope I'm never in that position! Good luck to you, just do it the way you know is right and try to avoid that nurse!

greenfaery · Nov 7, 2010

I didn't use a pump here, it was gtt/min. I guess maybe I should have just grabbed an extra pump. Next time I'll do that because the MAR did have the ml/hr, I guess that's easier. I couldn't piggyback it because it wasn't compatible with the heparin drip (which I could not hold either). Thanks for all your advice, I'll try to do what is right and not listen to others when my gut says it's wrong!

iluvivt, BSN, RN · Nov 7, 2010

Of course her advise is incorrect unless you had an order to give a bolus. What were you administering? Yes you still need to count if you are not using an EID (electronic infusion device). This may happen during an emergency when you do not have a pump available...disconnecting a pt for an MRI......no pump readily available and a med is due urgently.

SummerGarden, BSN, MSN, RN · Nov 8, 2010

being a new nurse, you are still thinking like a student nurse (doubting your abilities). stop! doubting your self will get you into trouble! if you feel it is necessary to calculate the drip rate, then do so. if a more experienced nurse yells at you to do something you think is dangerous then look at him/her and say, "thank you for your advice. are you going to administer this medication or shall i? if not, i will calculate the rate."

by the way, there is a forum that can help you and is filled with new nurses plus experienced nurses. the first year after nursing licensure: https://allnurses.com/first-year-after/