I am new to home health nursing...but have been an RN for almost 10 years. I found out a few hours ago that one of my patients is being hospitalized for a PE. I admitted her to home health on 1/7. (She was actually my very first pt I admitted) I was going over her d/c summary from the hospital and nursing home (she was in short-term rehab. She'd had a mitral valve replacement 12/19) She had a prior history of DVT and had been taking Coumadin, but stopped it a week before her surgery. (So she hasn't been on it since 12/12.) I was going over her d/c summary, and the doctor had told her to stop taking Coumadin, and they didn't reorder it once she got home. Should I have caught that and called the MD and asked if he wanted to restart it? She had seen him at a follow up visit on 1/10, and it hadn't been reordered. Instead, she had been taking 325 mg Aspirin. I feel bad in that I think I should've caught that and called the doctor when I admitted her. AM I feeling bad over nothing? (I don't mean "nothing" cause having a PE is kinda a big deal) but I'm wondering if I'm being too critical of myself. Any thoughts would be appreciated. Thanks.
Jan 17, '14
You wrote the doc had seen the patient on 1/10/14 and didn't reorder the coumadin. Since the doc seems to have been fine with using aspirin post op the responsibility rests with him/her about drug choice. It isn't like there was no anticoagulant at all. IMO I think you are beating yourself up unnecessarily. None of us has an infalliable crystal ball regarding patient outcomes.
Jan 18, '14
I think you are being hard on yourself. The MD was ok with just ASA.
Jan 18, '14
I agree with you guys. I think I am being too hard on myself. Thanks for the responses. =)
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