Nikki Smith

Thanks for your response! When I scanned the pump it gave me a pop-up saying “error: medication rate greater than 999mL/hr” or something along those lines, and gave me the option to either manually change it (which is not allowed by policy, so that option was out) or override use of a pump entirely. I elected no pump and hung it wide open by gravity. today I was able to chat with one of the floor nurses and she said she would have done the same thing, which made me feel a lot better. Again, this isn’t something I’d usually question but I’m tip-toeing around new policies that I’m not used to and It’s totally making me second guess little things like this! I’m going to have a chat with a nurse leader next time I go in and make sure what I did was the best option per our policy ☺️

My questions here are: What do you do at your facility when an order comes through for a fluid bonus at 2000ml/hr? Do you run it wide open on gravity or just put it at the highest rate your pump goes? Do you know of any potential contraindications to running it on gravity (considering it is a young, stable patient at no risk for fluid overload)? Thank you for your help and time ? I just switched networks and I did this how I would have done it at my old facility, and at the time it felt like a no-brainer. Now I’m totally overthinking it. At the new hospital I work at we are never ever allowed to manually set our own pumps- it has to be linked by scanning the pump and having it wirelessly connected to the MAR. I had an order for LR 2000ml/hr (a liter over 30 minutes). I went to scan it into the pump but the pumps only go up to 999ml/hr (they are Alaris pumps, if anyone is familiar). So I just used gravity tubing wide open, which is what we would have done for that order at the old facility I worked at. However, this facility is super persnickety about using pumps instead of gravity as much as possible which is making me SUPER stressed that I’ll do something wrong in a situation like this. (Please keep in mind that I also couldn’t have manually set the pump to 999ml/hr because we’re not allowed to enter manual settings, although that’s an alternative I previously may have considered to give a fluid bolus) Now, this was a young and healthy patient not at any relative risk for fluid overload. If that wasn’t the case of course I would have questioned this in the moment. I know from experience that administrating the fluids in that manner would not cause harm to my patient, but I guess I want to hear someone else’s opinion on what they would have done in my situation.