[elthia]

Originally Posted by RCHRTRN

RN75,

As stated previously, you should not be expected to read a surgeon's mind. However, I know from my experience with CV surgeons, nothing is ever his/her fault.
The policy of our CV surgeon is no elective procedure is performed unless the patient has been off Plavix for at least 5 days. (We learned this the hard way.)
During my time in surgery, the circulating nurse, CRNA, and the perfusionist checked the patient's medication reconciliation in the surgical holding area to determine if the patient had been on anticoagulants. If the patient had been on Plavix within five days of surgery, a call was placed to the surgeon to make sure he/she was aware.
I was the CV coordinator during my last year in surgery and I checked each patient's chart the day before to determine if the patient had been on Plavix and if so, was a platelet inhibition test conducted.
At my hospital, all patients on anticoagulants have a brightly colored label placed on the front of their chart that lists the anticoagulants and the time of last dose. (Your hospital may wish to consider something similar.)

Normal procedure at my hospital is to hold the plavix and start the pt on a heparin gtt if anticoagulation is necessary to prevent coronary stents from occluding. However, holding the plavix is not a call that a new cardiac nurse would be expected to make without an order.

Even if your nurse manager does not fire you, I would seriously consider resigning. She sounds very punitive, and unwilling to stand up for her staff. There is a learning curve in each specialty and she sounds like she is not willing to support you while you gain the experience you need to question these types of situations in the future.