okay - so here is the situation: i'm a mid-level with a large nephrology practice - i do dialysis rounding. so...needless to say i order lots of heparin. situation came up that a pt who's been my pt for >2 years asks me if this is pork heparin. i say yes, and he goes off that this is against his religion (muslim) and i should have told him before i gave it to him.
so....my question is: do you guys tell your pts they are receiving pork heparin? btw this is as midwest as it comes. not much cultural diversity and to be honest, it just never occurred to me to ask.
Totally agree with both of you. However, do you discuss this with EACH pt?
That's where my problem came in - the pt knew he was receiving heparin - he just didn't know it came from pigs.
No -- as I said, I would discuss it with clients I knew had raised some objection (like dietary requests) to pork products. I wouldn't necessarily automatically discuss it with everyone. If this is something that comes up more than the occasional, isolated incident, would it be worth developing a handout about the heparin that could be given to everyone (rather than taking the time for a personal discussion with everyone)?
Ummm so if I do the math this issue has come up once in 40 np working years. Due to the lack of cultural diversity where you live I don't think I would discuss it with each pt, however out of respect for cultural values etc. I would discuss with your other providers their thoughts about adding something to your pt intake paperwork like check this box if you have religious or other views against the use of porcine products used in your treatment....I work in endocrinology and did not know that about 70/30 either....hmmmmm...whole new set of considerations for me on this issue as well, So I'd be interested to see how you resolve this. Please keep us posted
Wow. It never occurred to me to tell my patients this - and I've given heparin to countless Jewish patients and many Muslim ones. It really never occurred to me.
As well, I used to work at a Jewish hospital where things are kept under strict control, particularly during certain parts of the year, and heparin is continuously given when needed. I figured it goes with the "anything to save a life" rule.
I will be more aware of it from now on, but I don't work in active nursing much any more. Still, it is something to file away for future use.
I checked with my friend who worked in Saudi - they used regular heparin in dialysis and as one of the thrombosis-prevention interventions. She was surprised that it was an issue...
I think all patients should be advised that if their medicine comes from animal sources; remember it is not just Muslims & Jews that may want to avoid pork products. Vegetarian and vegans would also not be very happy, as well as Hindus and Sikhs, many of whom are vegetarian for religious reasons.
Where I work, patients are given a leaflet about clotting which advises the standard drug used is of animal origin. If they raise it as an issue, then an alternate drug (Arixtra, a totally synthetic fondaparinax sodium anti-coagulant made by Glaxo Smith Kline) is used.
If full disclosure, 100% PC, and all source awareness is the goal, you better get the legal office to prepare a 500 page booklet. Recall that we use things like salmon sperm, urine, fungi, etc to make meds...
:redbeathe:eek:.
traumaRUs, MSN, APRN
87 Articles; 21,287 Posts
Totally agree with both of you. However, do you discuss this with EACH pt?
That's where my problem came in - the pt knew he was receiving heparin - he just didn't know it came from pigs.