Meds in TPN bag?

Posted
by girlr6RN girlr6RN Member

Specializes in Critical care, private duty, office peds.

Does anyone know if medications can be added (premixed)to a TPN bag? I'm not talking about a IV push or piggyback. Also, when you've scheduled a shift, are not orientated to the patient (don't know what kind of situation is going on), and go to the house, how are you to decline the shift if you feel you're not properly trained/qualified to take care of the patient? I'm under the impression, once you get report, it'd be considered patient abandonment if you decide to leave.

Help!

ArwenEvenstar

ArwenEvenstar

Specializes in med-surg, teaching, cardiac, priv. duty. 308 Posts

Does anyone know if medications can be added (premixed)to a TPN bag? I'm not talking about a IV push or piggyback. Also, when you've scheduled a shift, are not orientated to the patient (don't know what kind of situation is going on), and go to the house, how are you to decline the shift if you feel you're not properly trained/qualified to take care of the patient? I'm under the impression, once you get report, it'd be considered patient abandonment if you decide to leave.

Help!

Regarding TPN and adding meds - it would depend on compatibility of the TPN ingredients and the med. Pharmacy would need to clarify that...

Regarding your second question. I am wondering what kind of agency you are working for if they would send you to a home with no orientation of any kind?? A reputable agency should NOT be sending a nurse into a situation blind!!! Scary! Very scary!

At my agency, this is what would happen BEFORE you work a shift on a new case: Someone in the office would verbally tell you the bare basics of the case to see if the case interests you. If you are interested, then a nurse in the office would go over the patient's care plan with you and make sure you understood it properly. You would also have to go to the home once for a brief visit to meet the patient/family to make sure that BOTH the nurse and patient/family feel comfortable with each other and the situation. If you were lacking certain qualifications (such as ventilator experience),you would have to receive the proper training before working the case. Then, and only then, would the nurse be scheduled to work on the case.

My last agency was similar as above.

I would REFUSE to even be scheduled for a shift on a new case without getting a orientation of some type first, and stopping by the home for a quick visit to check the situation out! BOTH you and the patient/family should feel comfortable with each other. If the nurse is not qualified/properly trained for a certain case, that should be known long BEFORE the nurse is sent there!

If your agency is sending you blind into a case, and without proper training, that is very wrong. You don't want to jeopardize your license! And the agency is asking for a lawsuit! I would personally start looking for a new agency pronto!!!!!!

Silverblitzen

Silverblitzen

Specializes in OR, ICU, Tele, Psych, LTC, Palliative. Has 21 years experience. 71 Posts

Arwen,

Well said. I couldn't add any more than what you stated.

Sue

girlr6RN

girlr6RN

Specializes in Critical care, private duty, office peds. 20 Posts

I feel like an idiot for not going with my instinct. I've done private duty for about a year, and never ran into this situation before. I started with this agency about 2 months ago, and wouldn't recommend them. Meanwhile, I've been trying to get a job at the hospital working Med-Surg, but no response from the unit mgr. Ugh.

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