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Nursing knowledge please!

Nurses   (1,048 Views 7 Comments)
by tolerantgirl tolerantgirl (New Member) New Member

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If you have a patient that scd's ordered, would you have venous dopplers done before applying them to make sure the patient does not have a blood clot? I asked this question to a CV nurse practitioner and she rolled her eyes at me and told me she had been a nurse forever and had never heard that before. I am confused because that is what I was taught in school. Now I feel like an idiot for asking the question.

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LPN_2005/RN_10 has 5 years experience and specializes in Cardiac Care, Palliative Care.

6,133 Visitors; 296 Posts

At the facility I'm at, doppler's are used if the pt have s/s of a DVT or a pulse cannot be found, blood work will also be done. But at my facility we don't do doppler's on every single pt before applying SCDs. But maybe every facility is different......

Your instructors probably teaching students to avoid any liablity before applying SCDs, if the pt is found to have a DVT that wasn't found earlier.

Don't feel like an idiot for asking a question: It's called covering your butt-even if others do think it's a stupid question.

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miss81 has 8 years experience as a BSN, RN and specializes in Surgery, Tele, OB, Peds,ED-True Float RN.

8,329 Visitors; 342 Posts

I've seen the same as the PP. If no S/S of VTE/DVT SCD's are applied. But check your units policy for SCD's. If it doesn't say that one needs to be done first it probably doesn't. BUT... if I have a pt that is exhibiting S/S of a DVT of course I wouldn't apply them! And maybe I should be charting when I apply the SCD's that there are no S/S of a DVT before application! That's NOT a stupid question, at least you're thinking critically!

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2 Articles; 26,082 Visitors; 7,255 Posts

You asked a valid question. Just because the other person did not know the answer is no reason to make you feel stupid.

Also, just because it is/is not covered in a policy does not mean nursing judgment should be set aside. You do what you think is best. You are the patient advocate.

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mappers specializes in Med/Surg/Tele/Onc.

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But are we allowed to order that without a Dr.'s order? I don't think we can at my facility.

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miss81 has 8 years experience as a BSN, RN and specializes in Surgery, Tele, OB, Peds,ED-True Float RN.

8,329 Visitors; 342 Posts

You asked a valid question. Just because the other person did not know the answer is no reason to make you feel stupid.

Also, just because it is/is not covered in a policy does not mean nursing judgment should be set aside. You do what you think is best. You are the patient advocate.

True, but I'm sure that a doc is not going to order a doppler on EVERY pt that is wearing SCD's, so that is where the policy comes in. I'm not saying don't use your judgement, but doing a doppler on everyone before applying SDC's shows no use of judgement either! If we had to do dopplers on every pt that would be probably 100 dopplers/day in many hospitals, a bit excessive??

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531 Visitors; 3 Posts

SCD's are for the prevention of DVT and VRE. If the Physcian thought the diagnosis was a blood clot, he wouldn't have ordered them, since they must be ordered by the doctor himself after the nurses' assesment :nurse:

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