I recently followed a nurse (newer nurse). she is going to be WONDERFUL when she gets a year under her belt. Honestly...good nurse, but needs to pay attention to detail.
the patient i was recieving from her was on a lasix drip. when i got there the doctors note read "gentle diurese" as our plan.the patiet's orders for lasx drip read 0.5mg/min. Back of my mind, im like jeeeeeez thats alot! i mean think about it, thats 30 mg of lasix every hour...or nearly 720mg of lasix in 24 hours. The drip was running at 30ml/hour and was all set up correctly. We ahve titration orders to maintain urine output at 400ml in 4 hours. When i asked about ehr urine output the nurse was like "I haven't checked that in a while" and her urine bag was FULL FULL FULL. i mean full, backed up going to explode full!!! So our i/o was inaccurate, so i just monitored urine out put for the next hour. I got 1400cc IN ONE HOUR!!!! it had been running like that all day.
1400 cc in on hour as opposed to 100cc in one hour (what they wanted). I called the doctor, telling him "I can turn this down but im questioning if you really wanted this to run at 0.5mg/min."
He was like "WHHHHAT? i wanted it at 0.05mg/min"
Basically, its sad because the nurse DID follow the orders and its the doctors fault he put it in wrong. But i think a nurse with experience would maybe question that order and say "Are you sure?" and would recognize that .5mg/min is alot of lasix. and that 1400cc of urine in an hour is way to much. Nothing came of it, patient was fine...but man!!