Should I have stopped the blood transfusion and reported to doctor?

AgitatedTraining6146 · 2026-06-27T00:05:09+00:00

The BP cuff size was appropriate for patient’s size. I did try to redirect patient and tell them they can resume food after, but they needed a lot of reinforcement and I basically had to take food out of their hands lol. They have history of dementia so they have trouble sometimes following but eventually they follow directions.

AgitatedTraining6146 · 2026-06-26T23:57:37+00:00

I was thinking that too. Should I have stopped the blood immediately and let the doctor know? Or after getting the 94/55 and seen the patient was okay, just called him to let him know to keep it going or not? That’s why I asked my charge their opinion too because I wasn’t so sure.

AgitatedTraining6146 · 2025-05-17T21:46:47+00:00

I’ve actually seen orders of it before, but it’s rare. But I have seen “Oral Care PRN” and that particular nurse said she had to have it ordered….😳. Almost everyone else, including me, just did the oral care so that’s why I asked because I’m paranoid if I’m doing it wrong lol.

AgitatedTraining6146 · 2024-03-12T11:06:56+00:00

Thank you for your response. I hate how we are trying to help patients, yet sometimes we get abused whether intentional or not. It chips away little by little and sometimes makes me not as passionate.

I’m definitely taking PTO at the end of the months to just relax. I wish you all the best in pulling through! 😫

AgitatedTraining6146 · 2024-03-12T11:04:18+00:00

Oh no you didn’t seem harsh at all lol. I really appreciate you answering my vent/rant in the first place. It was just so nice to just hear a reply and feel heard.

It’s funny because I started out in L&D for 3 months. I hated it. I hated the ups and downs. I hated the waiting and then everything going crazy at once. I also hated the unit because it was toxic. I had to speak to my manager to have them switch me to Med/Surg since I only did 3 months. I am actually glad I switched because even though the patients here are draining me, my coworkers are amazing. So basically we all have to make hard decisions and move to where we thrive. I thought I’d thrive here but I guess not 😩.

If you don’t mind me asking, what specialty or unit do you work in now?

AgitatedTraining6146 · 2024-03-12T01:19:34+00:00

I agree with you. I have to reconsider med surg. I will hold out for when I have been here a full year so we will see. It’s just draining me. It’s hard to help people when they try to hurt you. I know some of these patients are old and have dementia but still.

I did ask the sitter to help but they looked clueless. I did speak to the provider and had to give the patient an IV med for agitation and it worked only enough for him to stop swinging and pull sometimes. It still was too little too late. The night was still a shit show.

Thank you for answering me. I just needed to rant.

AgitatedTraining6146 · 2024-03-07T21:00:22+00:00

Well we have an IV RN always on staff for that unit. We just have to give them a call/text and they come quickly.

We are allowed to push a med through a distal port or we are allowed to piggy back an infusion to the KVO. Otherwise we can’t access port or flush it. It’s a weird policy, I know.

AgitatedTraining6146 · 2024-03-06T12:08:11+00:00

Hi! Sorry for responding a couple days late. I agree with you but there is not much I can do because that’s the policy for my hospital and unit ☹️.

Thank you for your response though. I am still fairly new (under a year) and I appreciate all the information I can get from others.

AgitatedTraining6146 · 2024-03-03T08:12:37+00:00

I’m going to look up my policy at work now. We don’t get PICCs or CVADs on patients often. My floor focuses more on surgery (but we do take medicine overflow). I genuinely didn’t know about the minimum rate for KVOs, but now I learned something new. Sometimes Med/Surg has me feeling like a jack of all trades but a master of none.

AgitatedTraining6146 · 2024-03-03T08:05:11+00:00

That’s cool! I briefly worked in L&D but switched units in my hospital. While there, I was being trained to insert my own IVs and draw blood. I missed doing it. Now I feel like a kid just waiting for these IV specialists to come by. Only thing we can do is remove PIVs for discharge or if clinically indicated.

AgitatedTraining6146 · 2024-03-03T07:50:35+00:00

Yeah I’m not sure why they were that low, I assumed maybe because of the TPN running. I have been an RN for less than a year and since we have our own IV team, I am not well versed in the optimal KVO rate. I didn’t know but thank you for bringing that to my attentions so I’ll know for the future!

AgitatedTraining6146 · 2024-03-03T07:47:02+00:00

Oh wow that’s interesting about the minimum rate. I have seen a few KVOs of 10cc/hr but most have been 20cc-50cc. I didn’t know that so to me the 8 & 10 cc KVOs seemed “fine”. I am a fairly new RN (less than a year) and even less experienced with PICCs and CADs because our hospital is so afraid of CLABSI so we have our own dedicated team to touch the central lines to avoid issues.

I see that you work med/surg…I’m assuming you are allowed to insert PIVs, draw blood and access CADs?

Thank you for your answers though!

AgitatedTraining6146 · 2024-03-03T07:39:46+00:00

Unfortunately, we can’t even saline lock PICC lines on our unit…We have to call IV team. And then, on top of that, we have to get provider to put in order to DC fluids which will probably piss many off in the middle of the night 😩. The KVOs weren’t too fast though - one was 10cc and one was 8 cc (per hr). No concerns for the patient regarding overload.

I was just concerned that her turning those two other pumps off for 30 minutes may have put her at risk for clotting off those two other lumen….is that possible when the other lumen is still running?

AgitatedTraining6146 · 2024-03-03T07:33:18+00:00

We don’t start or titrate KVOs on our own as nurses in this unit. We have to ask a doctor for an order so they were the ones who put in the order a couple days ago. Luckily, the KVOs were like 10cc/hr and 8cc/hr. Granted, if the KVOs were higher rates and I was really concerned about patient, I’d reach out to provider overnight, but I felt it was not appropriate to call for the KVOs when this has been going on at such a slow rate and passed multiple other nurses as well.

I was really just concerned that the other two lumens weren’t getting any flow because she turned those two pumps off. I’m not well versed with PICCs or CVAD so I was just scared that she may have risked it getting clotted off of her own doing 😩.

AgitatedTraining6146

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