Need some advice

[SJE RN]

I work on a Cardiac Stepdown unit. I work nights. My pt went for a PPM insertion. The day nurse had given the pt lovenox, asa, plavix prior to the procedure. After the procedure on my shift the pt bled out. It was a mess. The nurse manager came in the morning, I was not in charge that day but the charge nurse had told my manager what had happened. I had to fill out an incident report. I really did not want to because the patient was stable. Had to give a unit of blood. I felt so bad for the pt. She was such a sweet lady. She just kept saying I'm so grateful to be alive and you're doing such a good job taking care of me (it takes a lot for me to cry and I just started tearing in the room). I don't know why I feel so bad for filling out the incident report. The day nurse was probably busy and just made a mistake (we all make mistakes at one point or another). A lot people complain that she's lazy and is always on her phone but I'm usually the last one to report a person (it has to be life or death with me). I didn't report her just stated facts in the incident report. Any advice, thoughts? Just grateful my pt is ok.

[surferbettycrocker]

was this pacemaker really put in the patient in the OR? i would think that it highly unlikely. i would think holding plavix for a procedure and not an 'operation' is NOT standard. i would hedge a bet it was the lovenox that did it. would you give a heparin injection before your patient was going to have an invasive procedure? (no).

but someone with bad cad/vasc disease i would think holding plavix would have been a discussion made loooonngg before the day of the procedure. the nurses and/or docs (most likely it would fall on the nurses as we all know)...shoulda looked at what meds were given prior to the procedure too.....

its not clear did the patient get the lovenox AFTER the pacemaker placement? (i dont see a rationale for giving it either way). and is this an 'experienced' nurse that has or has not done this before? :redlight: