Is it wrong to start infusion that will not finish till next shift?

Nurses Medications

Updated:   Published

A coworker had a one-hour antibiotic infusion scheduled for 0600. She opted to hang it at 0635 so it wouldn't finish at an inopportune time during the 0700-0730 shift change. Another coworker indicated that this was seriously inappropriate of her. They even said, "Well, it's your license on the line," implying that action could be taken against her license.

I'm really curious what could possibly be wrong with this. An antibiotic scheduled for 0600 can be started any time between 0500 and 0700 (at this hospital at least) and still be considered on time. I don't see any reason why the person who hung the antibiotic has to be the one to saline-lock afterwards. It's not like you have to stay with and continuously monitor the patient during antibiotic infusions. If that were the rule we would have a 1 to 1 nurse-to-patient ratio.

Does anybody agree with this other nurse? Is there something I'm missing that makes what the nurse did horrible?

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Specializes in Critical Care and ED.

There is absolutely nothing wrong with hanging an infusion that crosses into the next shift. I suspect your coworker is a lazy person who can't bothered to take down an empty bag. I would remind her that nursing is a 24/7 job and she is perfectly capable of ending an infusion. If she feels it is out of her scope you could suggest some remedial re-education for her. That would shut that &^%$ down real quick.

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The nurse that hung the antibiotic is fairly new so I suspect they might be doing the thing where you make up an imaginary rule and pretend that the new nurse is some kind of moron for not knowing about it. I've seen this a lot.

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Yeah, the nurse who implied that her license was at risk doesn't know what she's talking about.

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This made me sad due to the fact of a lack of teamwork! Absolutley nothing wrong with hanging to finish. I just had a transfer from ER to me the other day and they had just hung rocephin.......the the other day I had a K+ that I had to leave for next ****. Teamwork and excellent pt care are first and foremost.

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Specializes in Critical care.

I'd be irritated if the med wasn't administered barring any issues (code/rapid response with another patient, pharmacy not sending the med, etc). If the med was there and there weren't any extraordinary circumstances I would fully expect the off going nurse to administer the med before leaving.

Also, if an appropriate KVO is hung to help get all of the med out of the tubing you shouldn't have to worry about getting the IV saline locked right away (possibly right during shift report). If the KVO finishes at a bad time just extend it for a bit- a KVO at 5ml/hr will not make a difference if you have to add 15 minutes to it (or even 30-60 minutes).

I agree with Rocknurse that some re-education definitely sounds necessary.

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That is the most ridiculous thing I have ever heard. The comment stating that their license is on the line is crazy and makes the nurse that stated that look stupid.

We often have antibiotics run over shifts. We often have say zosyn that takes 4 hours to run every 8 hours. So one dose may start at 0400, and would not end until the next shift.

It takes all of 30 seconds to spike a flush bag behind. And it saddens me that the teamwork on your unit is that poor. Saddens me for your patients because instead of taking care of the patient, people bicker and complain behind the scenes about what their job "doesn't" entail.

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Specializes in Pediatrics Retired.

Got it...does that mean you could lose your license if you left a foley in for the next shift to monitor?

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The only horrible thing about any of this is the crabbing and nitpicking and finger-pointing and criticizing.

I don't understand why (when no patient has been actually or potentially harmed or disadvantaged) it is so hard for people to worry about their own backyard. There's some psychopathology involved in constantly having to have something to say about the way a coworker has done things.

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I've worked with some petty people, but wow! It would have been hard not to laugh in her face. Did these people hate each other to start out with?

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Take it to a logical conclusion and you don't have to go far to see how ridiculous that is.

That said...I do think each shift should have a goal of completing their tasks if it is reasonable to do so. Unless I knew things went off the rails towards the end of shift, I'd be slightly annoyed if I still had a 6am antibiotic running when I came in.

If it can be planned to be finished by end of shift, then it should be. But it's not a big enough deal that I would ever say actually say anything. Just a minor annoyance.

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Specializes in Travel, Home Health, Med-Surg.

I cannot see why the nurse would think that unless you are leaving out some information. Was there a lab related to the draw (Vanco etc) and the nurse was worried it would not be able to get drawn on time, or was it an antibiotic that needed pre/intra/post meds (Amphotericin B etc), or did the particular patient need close monitoring for some reason (suspect possible allergy etc). If there was no other reason than somebody is mistaken and should be corrected.

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