It seems most newer nurses are confusing empathy with sympathy. It is very well possible for me as an experienced nurse to anticipate the needs of my patients, understand their feelings, and respond in a professional therapeutic manner all without feeling pity or sorrow for them (sympathy). After doing my job, I go home, shower and wash the shift away. And what does compassion look like for real? To me, it's letting the patient whose had a rough night sleep in a little, or advocating a way to minimize IV sticks in someone, you get the point. Compassion in nursing is being able to look at the big picture of what's going on, and making it a little better. Newer nurses may not fully appreciate just how compassionate experienced nurses can be...more often then not, we just show it differently. And no, I do not consider nursing a calling, but something I got pretty decent at.

Have a license number in hand before applying. The employer gets many applicants and I'm sure they filter. Also, you don't know for sure how long it may take to get the license, so it's best to have it beforehand.

Well, the doc ordered a cardiac (ACS) protocol, and pharmacy started it at max rate of 1000 units/hr or 12 units/kg/hr (arbitrary for the protocol). Both figures were listed on MAR for the initial start. Pharmacy also noted the pt weight to be used.

I agree it should be either or, and that this is an error waiting to happen.

I just needed fresh eyes to tell me if I am overthinking this or it really does look screwy.

"If possible, heparin drips should be set based on units/hour or units/kg/hour...not based on the drip rate"

I totally agree with you there psu.

If pharmacy is putting "increase by 150 units/hr (2 units/kg/hr) isn't the 2 units/kg/hr supposed to result in the same answer? The parenthesis comes across as if the two were equal to each other. This is where I feel something isn't right. If they are supposed to be equal then it should read:
Increase by 200 units/hr (2 units/kg/hr).

Yes, but the question is regarding what is in the patient's MAR: "If aPTT is 35-45 sec increase rate by 150 units/hr (2 units/kg/hr)" if you simply increase by 150 units/hr the result is 11.5 ml (1150 units/hr) or if you use 2 units/kg/hr it is 12 ml/hr (1200 units/hr). If you're supposed to increase by 150 units, then the weight-based answer of 1200 units/hr is 200 units more over the initial 1000...it's a difference of 50 ml/hr something doesn't compute...

The pump will not help in this case.

I'm not sure if my facility is using weight-based and non-weight based calculations. I've seen literature that states some hospitals use both or just weight-based.

It seems most newer nurses are confusing empathy with sympathy. It is very well possible for me as an experienced nurse to anticipate the needs of my patients, understand their feelings, and respond in a professional therapeutic manner all without feeling pity or sorrow for them (sympathy). After doing my job, I go home, shower and wash the shift away. And what does compassion look like for real? To me, it's letting the patient whose had a rough night sleep in a little, or advocating a way to minimize IV sticks in someone, you get the point. Compassion in nursing is being able to look at the big picture of what's going on, and making it a little better. Newer nurses may not fully appreciate just how compassionate experienced nurses can be...more often then not, we just show it differently. And no, I do not consider nursing a calling, but something I got pretty decent at.

I would triple like this thread if I could!

Most nights I'm a barista, plumber, chef, electrician, and NASA engineer (who else could fix a faulty bed?).

I go home & wash it all away!

So, I kinda cloned myself in order to clock out on time around here.

Have a license number in hand before applying. The employer gets many applicants and I'm sure they filter. Also, you don't know for sure how long it may take to get the license, so it's best to have it beforehand.

C'mon guys take it easy on the OP. It's easy for anyone to get freaked out or second guess especially if another nurse placed the idea in their mind.

Thanks guys! I've consulted with pharmacy, and will be working to get that changed.

I wasn't trying to calculate the initial rate, pharmacy already set that. This is for a rate change based on aPTT 6 hours after.

Oops duplicate post!

Well, the doc ordered a cardiac (ACS) protocol, and pharmacy started it at max rate of 1000 units/hr or 12 units/kg/hr (arbitrary for the protocol). Both figures were listed on MAR for the initial start. Pharmacy also noted the pt weight to be used.

I agree it should be either or, and that this is an error waiting to happen.

I just needed fresh eyes to tell me if I am overthinking this or it really does look screwy.

"If possible, heparin drips should be set based on units/hour or units/kg/hour...not based on the drip rate"

I totally agree with you there psu.

If pharmacy is putting "increase by 150 units/hr (2 units/kg/hr) isn't the 2 units/kg/hr supposed to result in the same answer? The parenthesis comes across as if the two were equal to each other. This is where I feel something isn't right. If they are supposed to be equal then it should read:

Increase by 200 units/hr (2 units/kg/hr).

This is where I'm lost.

The weight used was 86.4 kg by pharm

The math:

12 units/kg/hr + 2 units/hr is 14 units/kg/hr

14 units x 86.4 kg is 1209.6 units/hr

1209.6 units/ hr x 250 ml is 302,400 divided by 25000 units equals

12.096 or 12 ml/hr

Yes, but the question is regarding what is in the patient's MAR: "If aPTT is 35-45 sec increase rate by 150 units/hr (2 units/kg/hr)" if you simply increase by 150 units/hr the result is 11.5 ml (1150 units/hr) or if you use 2 units/kg/hr it is 12 ml/hr (1200 units/hr). If you're supposed to increase by 150 units, then the weight-based answer of 1200 units/hr is 200 units more over the initial 1000...it's a difference of 50 ml/hr something doesn't compute...

The pump will not help in this case.

I'm not sure if my facility is using weight-based and non-weight based calculations. I've seen literature that states some hospitals use both or just weight-based.