OK Professionals!  I need your help. Let me set this up for you.  The protocol states the medication must be given via controlled infuser pump over a 30 minute period.  It further states that under no circumstance can this medication be given as a Bolus. 

Nurse X decided that since she did not have a pump to deliver the small volume, she would give it IV Push,  slowly.  Nurse X maintains that slow IV push is not Bolus.

What do you say?

Was this a medication error?

The nurse that pushed the med should have checked with the doctor first, and maybe a simple clarification order could be written. As is, this was a medication error, and should be reported to the pharmacy and nursing management.

Not knowing what the med was, I can only speculate. Maybe the protocol specified how the med is to be administered, but it could be that the dosage was adjusted very low for a renal patient and/or a pediatric patient. In that case, myabe it would be safe to give the med as an IV push, but again the doctor would need to write the order. Also, all other aspects of the protocol would have to be followed, ie vital signs, etc.

If the patient were to suffer an injury, the nurse would clearly be at fault. Jenny is right as to what should have happened. Make the doctor aware of the protocol and let it be the doctor's judgement call. I would not put my license on the line for that.

slow IV push is not a bolus? What the ?? Is it a Christmas tree then? The nurse was really stretching to rationalize not making a call to the doctor. That is what happens when nurses get in to a hurry and go WAY outside scope of practice.

good question - thanks!

peace

Walt

what is the medicine?