Heparin Drip!

Vent !!

Good day everyone! I want to share a very recent experience and hopefully get some feedback and reassurance. I have recently started working at a local hospital on the Telemetry floor and Love it! I love cardiac issues, the fast paced environment, ect.

I do have to admit that I am a bit of a perfectionist and always make sure all of my charting, my bedside charts and forms are completed, highlighted, and whatnot.

Recently I received a patient and report from one of the frequent charge nurses who is INFAMOUS for not giving a good report, not picking up doctor orders ( as in not picking up STAT orders that were written at 10AM and the 7pm shift has to do it) in addition to numerous other discrepancies.

Well I was told my patient has a DVT, and is going for a green-filter in the AM. I was not told they were on a heparin drip. Thank god I walk into all of my patients rooms after I get report on my patients to introduce myself and make sure they are comfortable. I notice the heparin drip right away! I look to the mar and to our Heparin drip protocol and order sheet. The mar says "heparin rip as per protocol, currently 10cc/1000 units an hour". I look to the protocol sheet which states PTT needs to be drawn every six hours and boluses, drip rate increase or decrease according to results and patients weight. Well I come one at 7pm and notice that the PTT was ONLY drawn once that day at 5 am, meaning it was not drawn at 12 noon, or 6 pm. The results from the morning were EXTREMELY BELOW therapeutic range! So I drew a new set, got the results. By the time all of this was done- OH WAIT did I mention I had a patient in severe pain, and another patient with severe confusion being physically combative and attempting to elope? Anyway by the time I got the results it was almost 12 am and the pharmacy closed, I called the supervisor to get me a new heparin drip because the one flowing was almost done!! I spoke to her expressing the situation and stating to file an incident report. I don't want to point my finger at anyone especially being new but I don't want to get fired or loose my license for someone others mistake!!

of course the next day I give report to the same nurse in the am stating I drew the PTT gave a bolus, and increased the drip. FYI before all the I called the MD just to confirm the orders and they stated to "follow the Heparin drip protocol". Later that day when I came back on the nurse was furious and said; "why did you go to the supervisor?!!??" I said

"I needed a new drip because the one you left me with was almost done, and p pharmacy didn't send a new one and she wanted to know why I needed a new drip and what occurred" She replies with: "well what goes around comes around"...........WHAT!! Now I am scared! I hope shes not out to get me...especially since I am still on probation!!

Advice please!!