NS at 125 ml/hr is not an ER order

Published

Pet peeve.

Tolerating PO, maintenence rates of ns are just silly in the ER. Anything under 500 ml/hr is silly. If you really think they need 125 ml an hour, I'll be happy to bring them an 8 ounce glass of water every couple of hours.

I am not refering to the dehydrated LOL with CHF. I am talking about the garden varity pt who is going to get a bunch of pointless tests and then get sent home with an ambiguous dx.

OK, I feel better.

crb613, BSN, RN

1,632 Posts

Specializes in Med Surg/Tele/ER. Has 7 years experience.

Frequent flyer that had no business being there to start with????

Specializes in ER, Trauma. Has 30 years experience.

Agreed! But it does jack up the acuity upon which the hospital and doctor base their billing. Money is more important than life it seems latlely.

Sanuk

191 Posts

Specializes in ER. Has 8 years experience.

Thank you :yeah: for the much-needed chuckle today.

I have a new doctor we're breaking in who continues to order rates of 125, 100, last night I got 75cc/hr order on a 30 something belly pain. Really, dude? I've been breaking out the dial-a-flo more times in this past month than in my entire ER career.

EmergencyNrse

632 Posts

Specializes in Emergency Medicine. Has 17 years experience.

Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

Specializes in ED/ICU/TELEMETRY/LTC. Has 20 years experience.
Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

Wow, it was just an observation. Why so hostile?

Sanuk

191 Posts

Specializes in ER. Has 8 years experience.
Who cares what was written? You're not the doctor...

Want a change? Go be a provider and write your own orders.

I actually do care. For the patient with a 2 hour workup in the ER, I am giving them about 150ml of fluid. They were drinking water at triage, will likely go and drink water after discharge, and they needed 5 oz of IVF? How much does a liter bag of NS cost? Do we need to continue wasting liter bags of fluid that I empty down the drain just so we can charge someone for IV hydration?

I care about the orders that are written quite a bit. I'm not a trained monkey that just says "yes, doctor, whatever you say, doctor, you're a freakin genius, doctor." Perhaps I needed to vent, too. :smokin: Ehem. I think I'm good now.

SweetseRN

199 Posts

I always laugh at D5W at 50 or 75 an hour...Some seriously over priced sugar water!

Specializes in Emergency Department. Has 4 years experience.

Maybe the doc just wanted the frequent flyer to have the joy of being stuck with an 18 gauge needle? Preferably by a newbie nurse.

I know I always like to pretend like I don't know how to insert an IV every time I get a faker. :D

Sanuk

191 Posts

Specializes in ER. Has 8 years experience.
Maybe the doc just wanted the frequent flyer to have the joy of being stuck with an 18 gauge needle? Preferably by a newbie nurse.

I know I always like to pretend like I don't know how to insert an IV every time I get a faker. :D

Oh, don't worry. They're still gonna get stuck. ;) A heplock will work just fine.

Specializes in ER, Trauma. Has 30 years experience.
I actually do care. For the patient with a 2 hour workup in the ER, I am giving them about 150ml of fluid. They were drinking water at triage, will likely go and drink water after discharge, and they needed 5 oz of IVF? How much does a liter bag of NS cost? Do we need to continue wasting liter bags of fluid that I empty down the drain just so we can charge someone for IV hydration?

I care about the orders that are written quite a bit. I'm not a trained monkey that just says "yes, doctor, whatever you say, doctor, you're a freakin genius, doctor." Perhaps I needed to vent, too. :smokin: Ehem. I think I'm good now.

You are the nurse I'd want for me or a family member, thanks for restoring my faith in humanity. Unfortunately, for hospitals and too many advanced practitioners, it's all about the Benjamins, and checking off "fluid management" means higher acuity and more money for ER docs.

Sanuk

191 Posts

Specializes in ER. Has 8 years experience.

dthfytr,

That's the nicest thing someone has said to me in quite some time! Thank you so much - I may print that out just to give me a boost on those rough nights. :hug:

I think I'm blushing now. :D