I just had a conversation with a patient's family about the patient's medications. The day before, the family had discussed weaning down meds with the doctor and accordingly, some meds had been dc'ed. Then I come in and administer her coumadin, where the dose happened to be titrated slightly above where it had been the day before. Family became very upset since they wanted pt to take less meds, not more.
I tried to explain that coumadin needs the dose adjusted to blood levels in order to keep it in a certain range. By increasing the dose, we aren't just trying to load pt up with more drugs, we are trying to keep pt from having a blood clot by maintaining a certain range. Family kept saying I am just arguing semantics, an increased dose is an increased dose and family had just explained to the doctor that they wanted pt to take less medication. Why is pt taking more?
I finally gave up and told her to talk to the doctor again, but I feel like I should have been able to explain why pt's blood is drawn daily to adjust coumadin levels. Is there anything else I should have said, or was this the right thing to do?