Solu-Sets, and Pain Scales

[perfectbluebuildings, BSN, RN]

Okay, I know these are two VERY different topics... but they are the two things I had most trouble with my last shift. (for those of you who don't know I am a very new grad)

I can't seem to grasp the physics behind Solu-Sets on IVs, and all our pts have them. Two of my pts yesterday got air in the lines and I think it was partly due to my incompetence with the sets, and one of them had an IV antibiotic running so I couldn't quite just run the air out you know? I asked another nurse to help me in both cases but then I was unable to see what they did to correct the problem as they asked me to go get something for them, and then corrected the problem while I was gone (I know I should have asked them to show me, that IS my fault!) I know you are supposed to have either the clamp to the outside port or to the hanging bag open and the other one closed at all times, but how do you know when to do which and are there other important things I should know about these IV sets? I will ask my preceptor tomorrow as well, but I wanted to hear from you all too, I respect your experience and knowledge. Thank you!!

The other thing is a doctor who said to me rather dismissively (in front of the pt and her mom) when I was telling him about a peds pt's pain as rated on the Faces scale that he "really doesn't think these kids this age understand" this scale. This is an 8-year-old who has been in the hospital for a while now. I wanted to ask about your opinions/experience with this scale and its usefulness and accuracy, and whether you think pts do understand it. I have the impression that they do but I realize that my limited experience does not give me a lot of clout in this area. I do realize that it's important to look at nonverbal signs of pain as well as the number rating. Thanks for any input!!!

[babynurselsa, RN]

If you open the clamp to the secondary line and put it below the level of the main bag IVF will back up this line and remove the air.

The FACES scale can be used as an Objective tool, it is made also for nonverbal children. Look at their face compared to the scale, look at the body language are they whimpering, or playing? what are their VS is HR and RR above baseline? It is also a good idea to observe these things before performing a hands on assessment as some children, especially young ones, have some anxiety related to staff. Listen to the parents also as they know their child.

Hardest of all because you are new and less experienced, and son't be intimidated.

[perfectbluebuildings, BSN, RN]

thanks very much!!! today was quite busy but I did feel a bit more competent. my preceptor is so supportive and helpful. i am glad she is so precise and makes sure I do things just right. i have been told on two separate occasions by a long-time PCA and a long-time secretary on the unit, quietly, that I have one of the best teacher-preceptors on the unit, and from the few shifts we have worked together I agree. she is awesome and very caring.. anyway, off topic. but thank you for the advice!! that makes more sense. take care!!

[babynurselsa, RN]

I am glad today went better. It WILL get easier. Be very thankful you got a good preceptor. hang in there and good luck.