[youngever]

No, Mam!
IV was in opposite side hand to AV fistula.

[BBFRN]

I would ask to see their written policy on Heparin administration. Start questioning them, and they may back off of you. It does sound like you're being scape-goated for some reason. Don't let them get away with it.

[jmgrn65]

something is not right, just because the ns went in and heparin did not. That would not ruin a vein. I don't understand what her problem is, maybe there was an error in your part but not enough for all of the investigating.
Get a copy of your write up and see if there is someone to represent you, does your facility have anything like that?

[youngever]

Thank you so so much! guys!
I feel warm inside that there are still many people who care.
I will keep you posted.

[TazziRN]

If anything you should be counseled for piggybacking the heparin instead of running it as a concurrent line, but that's it and even that's a stretch. That is strictly an education point, nothing else.

[Emmanuel Goldstein]

Originally Posted by youngever

Thank you soooo... much for your replies.

Heparin dose was 26 cc/hr at the beginning, it was increased to 32 cc/hr based on next ptt. I have another RN to check the calculation and signed.
I piggybagged the heparin as a secondary with NS. DON said that the heparin did not go in, instead the NS went in and ruined pt's vein.

pt's fistula was clogged prior to admission and that was a part of reason him being in the hospital. He has a perm cath for dialysis.
pt is doing fine according to my coworker.
By the way, DON said that HR is investigating. I don't know how much there is to investigate when pt is doing well.

So, if I am being used as scapegoat, where do I go get an advice before hiring a lawyer. Is there a place inside of my hospital that determine the situation fairly? I really appreciate again for your supports. guys!

I'm trying to figure out why they'd be so bent out of shape over this...

Was the doc planning on placing a new graft in that arm? Did the IV infiltrate? Where is the permcath?

I think you need to get this clarified. The explanation you were given that NS 'ruined' the vein just doesn't make any sense.

[confused101]

I work on a renal floor. Most of these people have 22's in. For the heparin/saline thing. Most of the time we only have one access. I always program two pumps. I have seen it with one, but that isn't safe in my opinion. Both primary and then hook up the saline to the pt. as main and then put the heparin in the port next to the pt. The heparin don't burn and I have never had it infiltrate. IV's infiltrate that is a fact. But the way this sounds it is crazy to have a write up about it. If the pt. was getting labs off of the foot, then a picc or a central line needed to be in when they got admitted. Keep us posted. This in one of the reason's I got myself covered when I started nursing. Good Luck! If you don't know anything always ask!

[Angie O'Plasty, RN]

The only way this is making any sense at all to me is if the OP failed to open the roller clamp to the piggybacked heparin, causing the NS to go in but not the heparin? At that slow rate, the vein would've been "ruined" because it would've clotted off, as well as the patient not getting the heparin.

Even so, I agree; there's no way that either of the fluids ruined the vein, especially at the rates given, and I'm just confused at this point about the real problem.

Did you see any puffiness, redness, bleeding or leaking around the site? Did the patient c/o pain at the site? Or did the vein clot off because the heparin failed to run?

[cheshirecat]

This is really an educational issue. I think your DON is being very heavy handed. Are you in a professional body that would help you?

Have you got an educational facility at your hospital that would be able to help you?

Look after yourself. Thinking of you.

[earle58]

i agree that it sounds like heparin roller clamp not opened.

if this b.s. continues, get yourself an atty.
they're railroading you.
best of everything.

leslie