Kowens

In my hospital, we have smart pumps. Any drug that is in the hospital pharmacy that can be infused, the drug name and dosage is already programed in the pump, this includes intravenous fluids. My practice is to hang everything on a pump, if one is available then use it. The pump have certain safety features that will alert the nurse if anything is wrong, ie dosage calculation, pt weight concentration of medications. We do have IV med books on the unit, but the pumps are so user friendly, I enjoy using them. We can change them from a GMF mode to ICU, NICU and so forth. The one thing that I do not give via pump is blood. One of the responders stated that hemolysis can occur due to the pump pushing the blood products through. Blood can be administered between 2 and 4 hours...no longer than for but no less than two..and we you have done this for a while, you can look at your bag to tell if you are in the time frame. You should watch your patient's blood transfusion closely anyway so you will be monitoring them closely. I do not hang more than one abx. due to the fact that if the patient has a reaction, you don't know which medication caused the reaction. Always know the compatibility of your drugs, call your pharmacy or use your reference books. For piggy backs, I use the NSS as my primary line and piggy back the abx through the y port. Nursing schools say the primary set(NSS) should be at least 12 inches lower than your secondary set (abx). All of the replies were great..hope this helps.

I work in a large inner city hospital in PA and have done some research in the area of different triage methods...ESI 4 vs. 5 level...no where in my lit reviews have I seen any mention of a law about RN seeing the patient first as a law. When we have been short staffed, management has placed technicians in triage(which I did not agree with) and they obtained basic complaints and vital signs and then the charge nurse would place them in a room. I am sure that "laws" ie a new hospital policy can come about for many reasons. Has anything occurred in the department, maybe a missed MI or CVA onset or something that could have prompted this change in policy. Always a reason why..just might not agree with it but has to be a reason. I feel that a nurse should be the first to identify the patient, atlease do your 3 second assessment, you can look at a patient and tell if they need assistance before the hang nail patient that is screaming to be seen now!!! :)

I have given and been given compazine in the past and had the pleasure of experiencing the wonderful side effects or shall I say extrapyramidal effects of this medication. So much that I was given several milligrams of ativan to ward off the effects. I always would mix the compazine in a 50 to 100ml bag of normal saline. I was recently told by one of the attendings in the ED that giving the medication via infusion too long will decrease the effects of the compazine. I will be doing a little research on this comment but wondered if anyone else has had an expereince with this medication and what you think. owens

I too have been given phenergan IVP and it took 2 weeks for the bruising, redness and soreness to resolve. I had a red streak that went from the IV insertion site to my AC. I would never take that medication again. I have had on a few occasions to give the medication and have diluted it in 10mg of NS, which made the infusion more comfortable for the patient. (careful giving dexamethasone too, causes burning at the insertion site and that hot flash feeling for the patient...diluting it too gives a better result for the patient. I think sometimes we have to go through things ourselves and be a patient in the ED to realize and believe what are patients are telling us and not just think of what your medication admin protocol says. If the patient has a complaint after med admin, believe him/her. Glad things are now okay with you and now you know right...

:yeah:If you want to be a nurse then go for it!! With technology and all of the resources that are out there for students to explore, you can do anything. Just remember to communicate with your instructors and don't be afraid to just ask for help when you need it. A lot of people wait until the last minute...when they are sinking and can't seem to find a way out from under the stress and paperwork, but nursing faculty what you to pass and do a good job. I love science and did well in it but math and I didn't really get along and still fight with each other once in a while, but I study and ask for help and have kept every nursing book that I bought and I have been a nurse for almost 10 years now..so go for it...don't tear yourself down...just go for it!!!