I feel bad....should I have caught this?

Specialties Home Health

Published

Hey everyone,

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.

Specializes in Correctional, QA, Geriatrics.

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.

Agree with the above.

I think you are being hard on yourself. The MD was ok with just ASA.

I agree with you guys. I think I am being too hard on myself. Thanks for the responses. =)

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