Saline flush without a physician order?

[stephenfnielsen]

Let's say a patient has a saline locked IV. The nurse knows that it is best practice to flush saline locked IVs with saline every 8 hours. Can she do this without a physician order?

[elthia]

Ahh...I so needed this thread.

I have an orientee that I have been precepting that has been an experience.

She doesn't want to flush IV's without an order, because Saline flushes are medicine. Until I patiently explained to her...what are you going to do in an emergency, if the patient crashes, and that pretty looking IV is clotted off, and the doctor and the emergency response team looks to you and you say..."well I couldn't flush it, he had nothing IV ordered." THAT isn't going to save the pt, nor your butt when you get fired and reported to the board. It is much simpler to maintain an IV, or put another one in when the pt HAS a blood pressure to pump up the veins, vs trying to put one in urgently, or opening the crash cart for the IO drill. Policy and procedures state maintain the IV includes flushing before/after meds and q shift.

[xtxrn, ASN, RN]

Ahh...I so needed this thread.

I have an orientee that I have been precepting that has been an experience.

She doesn't want to flush IV's without an order, because Saline flushes are medicine. Until I patiently explained to her...what are you going to do in an emergency, if the patient crashes, and that pretty looking IV is clotted off, and the doctor and the emergency response team looks to you and you say..."well I couldn't flush it, he had nothing IV ordered." THAT isn't going to save the pt, nor your butt when you get fired and reported to the board. It is much simpler to maintain an IV, or put another one in when the pt HAS a blood pressure to pump up the veins, vs trying to put one in urgently, or opening the crash cart for the IO drill. Policy and procedures state maintain the IV includes flushing before/after meds and q shift.

Bless you w/your orientee :)

This whole thread reminds me of such things as..... (and yes, I know some of these are not putting something 'in' the patient )

-a Foley order, but no order to empty it

-an I&O cath, but no order to record the results

-asking for an order to inflate the BP cuff

-asking for an order to turn a comatose patient (with no ortho injuries)

-asking for an order to put a bandaid on a d/c'd IV site

-asking for an order to use a straw w/liquids (don't want gas, y'know)

-asking for an order to empty a JP, or hemovac

......ad nauseum....

[~Mi Vida Loca~RN, ASN, RN]

Hello, I am doing a bit of a research project and just need to know how different hospitals/states/countries differ and what they do. So my question is "do you need a Dr's order for saline flushes on the medication chart in order to flush a peripheral IV before/after IVAB's"? Where I currently work, we do need a Dr's order to be able to use saline 3-5mls to flush in paediatric patients. Can you please let me know your location/hospital. If you dont want to post this private info for everyone to see is there a way to contact me privately.

Thanks

I work in CO on a Pediatric unit and we do not need an order to flush.

[blue444]

thanks grasshopper. I think it is ridiculous needing an order. I am trying to change this in my hospital.

[This Jenn RN]

We dont have to have an order. We always flush before and after a med is given, when assessing the pt. to make sure it is patent, before starting and IV to make sure the line is open, etc. Now Heparin flushes are ordered and are usually only for PICC lines.

[jelly221,RN]

I know this thread is old, but it made me chuckle. Last week I had a pharmacist (per diem hopefully!) tell me that I "SHOULD have an MD's order to flush with NS". I told her that was ridiculous, as first off, NS isn't a medication in the 3mL pre-filled flushes, and second, it's our POLICY & PROCEDURE to flush SLs w/ NS Q8 hrs. One of our grumpier docs was standing close by and heard me tell her it was unimaginable to call an MD for an order to flush a SL, and he sincerely thanked me after I got off of the phone. He said I wouldn't believe the ridiculous calls he gets (of course, I would!) and that if I found a Doc that actually cared about a nurse flushing a SL, to call him.

[anotherone, BSN, RN]

I know this is an old thread, but, this is the true mockery of nursing.

[GitanoRN, BSN, MSN, RN]

unquestionably, i came at the end of this thread and to make it worse i was in a boring meeting, as i read through all previous post without me realizing i let out a loud burst of laughter, :rotfl: which in turn my colleagues asked if i wanted to share, so i did... everyone began to lol and all of a sudden the meeting got lively... i can always rely on my colleagues on an to make my day

[KelRN215, BSN, RN]

This thread gave me much needed entertainment after this week. :)