Hailey.B

Thank you both so much for responding. I feel more relieved like a huge weight has been lifted from my chest. I'm gonna keep breathing, learn from this mistake, and try to move forward. I do hope my incident report where I made suggestions for change, can influence a change in the system. I will bring it up whenever my manager speaks to me. Our hospital has actually been making mistakes with heparin recently, and I wonder if the unclear MAR instructions is part of the reason. I will definitely make sure to go to pharmacy about any heparin infusions or boluses in the future, and just have the charge RN or a really experienced nurse check over me for any high risk med. Thank you again

I am a new nurse who has only worked for about 7 months. I work in the ER. Today I was helping another nurse with a ROSC patient who was having a massive heart attack and was intubated and all the things. She was started on heparin. Our hospital policy states to have an initial anti-Xa drawn before heparin administration, and the level is rechecked 6 hours afterwards, and that determines if the patient needs an additional heparin bolus or a change in the heparin rate. She was started on heparin and the initial bolus and rate were correct. The anti-xa was drawn. Two RNs must sign off on heparin. Well the anti-Xa came back 3 hours later (which is ridiculous) and the MAR was not specific on where to go from there. The nurse and I did not realize or see anywhere in the MAR about having to wait for the repeat anti-Xa before giving a bolus or doing a rate change if needed. Well we gave a heparin bolus, 5100 units. I called pharmacy and that is when we learned we made a huge mistake. I had to let the doctor and charge nurse know. I'm devastated. I can't believe I made such a huge med error. And I'm mad that the MAR did not specifically state to make no adjustments to the dose until after the repeat. Because it stated the policy like how we would make adjustments to the heparin right as we got the anti-Xa result. I wish an alert would have popped up or something stating that we couldn't give the dose, or that pharmacy needs to sign off or something. I also can't believe that not only did I make the mistake, but the other nurse made it too. I'm sick to my stomach. The patient was flown out for further treatment of her heart attack. But God I'm so worried that she will bleed out or something and then that big mistake will haunt me knowing that I killed her. I'm so upset with myself. I reported the incident and I expect that my boss will come talk to me and the other nurse about what happened. I just feel so irresponsible and I hate myself for what happened. I need some advice here. I just need someone to reassure me that nurses make medication mistakes and reassure me that I will be okay and not lose my license or go to jail. Just something please.