So I was working a tele unit today and I had a patient come up from the cath lab this evening. He had 4 stents placed in his left leg and iliac vessels. Cath site was left groin, which I observed was C/D/I in a gauze and tegaderm, no hematoma. Patient instructed to lie flat until 1730, which was about 2 hours from arrival to unit. At 1730 I allowed him to incline HOB to eat dinner. By handoff, groin site was still C/D/I, no hematoma, and patient VS were very stable taken per protocol.
At handoff, the nurse questioned me whether the femstop that was ordered was placed. I was confused, I said no (in my mind I was asking myself why as the site was not bleeding nor hematoma present). Mind you, I have never used a femstop before nor would I know how to use one, nor know what one actually looks like - but I know what one is for. I told her I was not sure why the femstop was still listed in the interventions (Meditech for anyone familiar with that EMR). Most all post-cath patients I have cared for have presented on the unit with hemodynamically stable groin sites and all I needed to do was monitor the site and assure stable VS. So I was confused why this nurse was asking me why the fem stop order was not executed by me. I thought this was all done in the cath lab (this unit has had some patients that require sheath pulls, but I have not done those either).
I am a nurse with 5 years tele experience and the nurse I handed off to probably seems like she has less than that (but more experience than me on the unit I am working on). I did approach the charge nurse afterwards about this and she seemed likewise confused as to what happened. She said she did not think he needed the femstop despite it being still ordered.
So I was wondering whether I was right in being confused. Granted I should learn more about femstops for future reference (and the charge said we would review policy next time we work together) but my instincts were telling me this was not needed at the time but the nurse was semi-insisting that it wasn't done, so I am like, am I missing something??
Oct 3, '17
Our cardiac telemetry floor only places a physician ordered femstop if there is a hematoma present. Hindsight being foresight, maybe the actual issue is that maybe you should have contacted the provider asking them to put parameters on the femstop order so that it would only be placed if a hematoma developed or to dc the order.
Oct 3, '17
Thanks! I guess the nurse I was handing off to didn’t understand that the femstop order was there only to be used if needed. It clearly was not needed at that time since the patient’s site was CDI and no hematoma present. But she seemed to insist why wasn’t it done. That is why I was confused. In my mind, I was like “why do I need to use a femstop at this time just because the order is there and the site looks fine?”