IV Push Ativan

Updated | Posted
by ILoveHorses RN ADN ILoveHorses RN ADN Member

Specializes in NICU/Telephone Triage. Has 33 years experience.

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ILoveHorses RN ADN

ILoveHorses RN ADN

Specializes in NICU/Telephone Triage. Has 33 years experience. 16 Posts

2 hours ago, JBMmom said:

I am so sorry if you've been carrying around guilt related to this conversation. Clearly this nurse was wrong. I have pushed IV ativan hundreds of times. No matter what, as you pointed out and logically understand, it's the cancer that tragically cut your mother's life short. You were doing your absolute best as a daughter and caregiver. Give yourself grace, hoping that happy memories can bring you peace in difficult times. 

Thank you so much. I have been upset about how quickly the Ativan worked since she passed. I question myself off and on for asking for the Ativan. Then when this nurse said you can't push Ativan I wasn't sure if I heard her correctly! I am my own worst enemy sometimes. 

3 hours ago, RNperdiem said:

In ICU, we push all kinds of meds like Ativan, midazolam, hydromorphone, morphine and fentanyl. We are giving these drugs for a specific purpose. In 25 years of doing this, I have rarely had a problem.

In my Dad's final week with cancer, the hospice nurse gave us a bottle of concentrated drops containing ativan that helped my Dad's terminal agitation and gave him a more peaceful exit. 

It is so important to keep people comfortable during their departure from life.

LovingLife123

LovingLife123

1,570 Posts

I push Ativan multiple times a day in pacu. I also pushed it often in ICU, especially in comfort care situations.  That nurse had to have misunderstood you, I know they push it often in the ED.

Yes it can be used in gtt form.  It’s rarely used due to the fact it takes forever to get out of the body.  But I’ve used it on patients who are withdrawing, in status ellipticus, and to sedate a patient prior to being paralyzed. I also had it in a CADD pump on a comfort care patient.  
 

The Ativan I’m sure helped in the comfort of your mom.  Do not ever blame yourself.  

JKL33

6,319 Posts

3 hours ago, ILoveHorses RN ADN said:

Then when this nurse said you can't push Ativan I wasn't sure if I heard her correctly!

Quite bizarre, that statement of hers. The majority of my experience is in the ED and I couldn't begin to estimate the number of times I've pushed ativan for a variety of situations.

Hard to understand why people are willing to fly off with comments like this when it's clearly a sensitive situation and also...they weren't there! Not sure if your acquaintance is just out of touch or doesn't really have the experience she said she did. I've also sometimes seen people comment inappropriately when they are very anxious about the sensitive nature of the topic (e.g. someone's grief/loss). But boy, she could not be more wrong, so please just don't let her 100% factually incorrect statement complicate your grieving or keep you from finding peace and comfort.

 

Edited by JKL33

Jenni Binford

Jenni Binford

Specializes in Med/surg, oncology, telemetry staff RN. Has 32 years experience. 1 Article; 8 Posts

I am sorry that you have been carrying around these thoughts about the Ativan. It's never given on a pump. It is always slow push. I would dilute with 1-2 ml saline, and slow push. I have given it many times over the course of my career. ETOH withdrawal was a big reason and depending on the size (and ETOH intake) of the patient an Ativan drip was required. I can remember having several withdrawing patients on the swing shift and having to do these pushes many times throughout the evening. That was a time when ETOH withdrawal was very prevalent on the medical unit. Back in the late 90's early 2000's. 

You Mom was surly exhausted, and the pain meds along with Ativan helped her to relax. Watching our parents suffer is so hard, you were there for her and a blessing to her, keep the loving memories and keep letting go of the painful ones. Hugs to you!

 

ILoveHorses RN ADN

ILoveHorses RN ADN

Specializes in NICU/Telephone Triage. Has 33 years experience. 16 Posts

23 hours ago, LovingLife123 said:

I push Ativan multiple times a day in pacu. I also pushed it often in ICU, especially in comfort care situations.  That nurse had to have misunderstood you, I know they push it often in the ED.

Yes it can be used in gtt form.  It’s rarely used due to the fact it takes forever to get out of the body.  But I’ve used it on patients who are withdrawing, in status ellipticus, and to sedate a patient prior to being paralyzed. I also had it in a CADD pump on a comfort care patient.  
 

The Ativan I’m sure helped in the comfort of your mom.  Do not ever blame yourself.  

Thank you so much

 

ILoveHorses RN ADN

ILoveHorses RN ADN

Specializes in NICU/Telephone Triage. Has 33 years experience. 16 Posts

I want to thank all of you who replied and helped me feel better. I wish I would have posted about this a year ago. I've rehearsed the Ativan scenario in my mind since my mom passed. This bizarre comment from that nurse just confused me even more. It's so nice to have everyone here supporting me. thank you!

canoehead, BSN, RN

Specializes in ER. Has 30 years experience. 6,837 Posts

I've pushed it in multiple hospitals. I think she got relief from her nasty symptoms and was able to finally relax. 

Mergirlc, RN

610 Posts

On 7/15/2022 at 3:45 PM, ILoveHorses RN ADN said:

It is so important to keep people comfortable during their departure from life.

^^^^ THIS.   100% this.

DavidFR, BSN, MSN, RN

Specializes in Oncology, ID, Hepatology, Occy Health. Has 36 years experience. 515 Posts

Condolences on your loss. Mothers are very special and we only get the one.

I know you've already had the confirmation, but I will just add my voice: I have given IV Ativan as a push and yes, it's perfectly acceptable.

Karen504, BSN, RN

Specializes in Travel IMC Nurse. Has 14 years experience. 1 Post

You should not beat yourself up. Ativan is pushed at many facilities I have worked at but some are moving away from it for whatever reason. My dad had terminal heart failure and they gave him Ativan for agitation. He slept and within hours passed. I was angry for a long time that they gave it to him cause I didn’t get a chance to talk to him more but I know he was more comfortable in the end and it was more for myself to have time with him. I pray you find peace with the situation. 

Nicole5128

Nicole5128, MSN, RN, APRN, NP

Specializes in Emergency Medicine. Has 8 years experience. 63 Posts

Having been in ED for 8 years I'm not sure how your friend said we don't push Ativan because we definitely do. I've pushed it probably hundreds if not thousands of times for alcohol withdrawal patients, seizing patients, panic attacks, help with muscle spasms, agitated grannies (I know it's not recommended), oh and the good old B52 (Benadryl, haldol and Ativan) for our combative people in certain situations like involuntary psych holds who try to fight us. 
So sorry for your loss, I hope this helps. 

Edited by Nicole5128

meRNu?

meRNu?

2 Posts

Pushed lots of ativan on all age groups with all sorts of diagnoses and comorbidities.  If you push it over a couple minutes there's no issue.  Been doing it for over 22 years and haven't lost a patient yet doing it this way.  Your grief is understood and your 'survivor' guilt is evident.  Your mom had a caring child and many in this life aren't as fortunate.  Take care