INR results might get me fired

iluvivt, BSN, RN · Jul 20, 2013

That does not make any sense to me. The results are what they are! Perhaps she was trying to say that if the prescribeR thought they were drawn at 1400 as opposed to an am draw they may choose to adjust the dosage(s) differently.

I must say however. that you did know the test was drawn at 0900 and you could have just called the lab and asked them to amend the report to reflect the accurate draw time. They should be able to do this even if it had already been reported. If they refused I would have just notified the MD it was drawn in the am.

There are a few things that may cause the test results to be suspect but inadvertently putting the incorrect draw time would not change the actual result. it may change the recommendation of future dosing though.

Let;s see what others have to say as well perhaps there is some strange thing they are doing now in the lab that I am not aware of.

KBICU · Jul 20, 2013

Coumadin takes about three days to kick in, however if you gave the coumadin without a daily INR result that could be dangerous. Timed draws are not used for INRs at my facility. They can be with morning labs or if that gets missed, I can get a stat one anytime and have Coumadin dosed off that.

bevt · Jul 21, 2013

Thank you so much for your replies. I hope to meet with the owner of the home health agency I work for tomorrow. I will print your comments and take them with me. I don't know where my supervisor got his information, but he said the lab uses the draw time when calculating results. After the shock wore off, I realized myself that that did not make sense. Hopefully, I will get my job back.

Sun0408, ASN, RN · Jul 21, 2013

Please do not print this and take it with you, it will not do you any good. If you want to take resources with you please find something from a reference book etc. Taking this would only cause you more grief.

You made a simple mistake, just inform your boss that yes the lab was drawn at 9 yadda yadda yadda. Just make sure what you say is true.

Wait, you lost your job because of this??

Philly_LPN_Girl, LPN · Jul 21, 2013

Thank you so much for your replies. I hope to meet with the owner of the home health agency I work for tomorrow. I will print your comments and take them with me. I don't know where my supervisor got his information but he said the lab uses the draw time when calculating results. After the shock wore off, I realized myself that that did not make sense. Hopefully, I will get my job back.[/quote']
That would not make any sense or do you any good to print comments off of a message board. Just inform your supervisor that you made a mistake as far as the inr.

bevt · Jul 22, 2013

Ok, I wont print and take the comments with me. I am just desperate to prove that my mistake was not potentially harmful to the patient.

bevt · Jul 22, 2013

Yes, I lost my job. It is a small privately owned home health agency. My supervisor told me Friday that the owner said to "separate employment". I asked to speak with the owner but at this time am not sure if he is willing. I have had no other complaints from employer or patients. Termination seems harsh for a simple mistake. Cant help but think there may be something else going on.

nrsang97, BSN, RN · Jul 22, 2013

Yikes they fired you for that? You drew it in the morning. So have lab amend the time. We dose coumadin off what labs were drawn when it was drawn. I never heard it was time sensitive. Are you sure you want this job back?

mlbluvr · Jul 22, 2013

They've been just waiting for you to forget to dot an i, or cross a t, so they would have a reason to fire you, simply said.

RedSoxFan84 · Jul 22, 2013

A patient is taking Coumadin every evening at 7p and INR is ordered to be drawn. Would the results be the same if the blood was drawn at 9am as it would be if drawn at 2p? I drew the blood at 9a but for some reason wrote 2p the drop off time, on the lab slip. My supervisor said it could have been detrimental to the patient because time drawn is calculated in the results.[/quote']
I worked in the laboratory for a long time and we would not perform a PT/INR if the tube was older than 6 hours old because the results may be altered. That was our policy, at least.
Good luck to you,
Katie J

bevt · Jul 22, 2013

Unfortunately, I have to agree with mlbluvr. For some reason I was walking a fine line and didn't even know. I had my meeting with the owner today. He let me tell my side then repeatedly said "I hear what you are saying but the decision has been made". He would repeat that with everything I said in my defense. When I asked him to explain why I was fired when the facts show I did not do anything to potentially harm a patient, he said "I don't have to explain anything to you". Sadly, that is true. I was raised to have compassion and above all be fair and I guess I expected the same.

Thank you for all your comments. It was nice to know that someone was on my side. Now I worry that any potential future employer will never believe me. When you hear someone was fired, one automatically assumes they did something to deserve it.