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When I started charging on my former unit (medsurg/PCU), I was in constant contact with the individuals that decide bed placement. Through casual/ under the table conversations, I found out many things about the hospitals inner workings... One of which is: the flood of change of shift pts is *sometimes* related to the admitting physicians and their schedule. If the daytime hospitalist is nearing the end of their work day, they may delay certain things so that they don't have to assess and write admit orders for that patient. Aka- they want to leave it for the oncoming doc!

Thanks for some feedback. Many of my coworkers think I am weird for diluting, and seem to do most of what the patients want- so they don't have to discuss things / deal with someone becoming obnoxious. I guess I'm NOT the "only nurse that dilutes medication" after all!! I think diluting should officially be made "best practice" - so I can site a policy. * Manipulative patients don't realize this important inverse relationship: ... The more particular they are about their IVP meds... the longer I will stand there pushing your dose (Policy says over 2-3 minutes? Better make it 3 to be safe ;-] !!!!!) Oh, and I won't even THINK about giving that prn a little early. Not even ONE minute early. NOPE! *thanks forgetting me vent

I like it! It's all in the wording í ½í¸Ží ½í¸

Do you dilute your IVP narcotics? I always dilute morphine and dilaudid- the extra mls in the syringe help me to administer it slowly (over two minutes) - especially with a peripheral. With ativan, I dilute a bit more than the 1mg/ml recommendation. I have had so, so many experiences of patients bullying me about this practice/ my narcotic administration in general - I hear this constantly: * "no one has ever diluted my meds" * "it didn't help my pain- I think it is because you diluted it" * (with IVF running) "you have to flush afterward, or it won't work" * "it won't work if you push it that slow- two minutes is too long" I tell them that they are getting the same amount if medication. I tell them that I administer it at the speed per our policy, blah blah blah- but still- they are angry. I even had a 25 year old patients MOTHER reprimand me about this the other day. At what point do you cave in for patient satisfaction? I always give it over two minutes regardless of how upset they get... I guess I'm just curious how you all handle this situation. Thanks!!

Dee- I just read this thread, and your new job offer gives me hope that I will eventually find my first job too.... I have my BSN and I have been searching alllll over Ohio for an RN position (yes, I have even applied for LTC, home health, etc). After three months, 350+ applications, and only one interview opportunity- I was on the verge of giving up !!!!!!!!!! Anyway, thank you for the inspiration- and congrats!