usRNs

I agree with everything. U just said jaldepn...:) thank u for the feed back...:) thank you all for the feed back... Not sure who stated earlier reg lovenox not affecting INR ur right the only way to monitor lovenox is to check Xa factor for what I read from med facts

INR was 1.4, sorry forgot to mention h&h 9.9 & 30.9

The bleeding was not severe... Her vitals where pretty stable SBP 120's HR 80's pt a&o x4... Mouthing words... The MD was informed by days shift and ordered to hold warfarin and aspirin (aspirin sch in am QD), and cont to administer lovenox... And I agree I think I should just called the md at night to get an official order... Although the order correlated w what I did I wish I had an explanation on my approach or my thought process...

Hello everyone I hope you guys can help.... At work I had a patient who was both on lovenox and warfarin... I held warfarin because the patient was bleeding "not profusely" it was dark red from her trach having a quarter of the canister filled and there was some on the foley as well... My thought was the patient is bleeding and though is not profusely if I give the warfarin which will remain 3-5 days in the system he will probably reach therapeutic INR level (it was 1.4) and I didn't want her to bleed much more, i administered the lovenox because my thought was well at least she will be anticougulated until the morning without lowering the INR so much, it only remains in the body 24-36hours and in the morning the primary can decide...I work at night so I was a little hesitant on calling the doctor for it... "My question is was my though process wrong?" I was told that I should have not held it because this two meds have two different pathways, I'm not sure on the pathways but I know they both increase INR. As I'm writing this post I realize more and more the things I could of done and the reason why, but I would like to hear from you. Tnx

Hello everyone I hope you guys can help.... At work I had a patient who was both on lovenox and warfarin... I held warfarin because the patient was bleeding "not profusely" it was dark red from her trach having a quarter of the canister filled and there was some on the foley as well... My thought was the patient is bleeding and though is not profusely if I give the warfarin which will remain 3-5 days in the system he will probably reach therapeutic INR level (it was 1.4) and I didn't want her to bleed much more, i administered the lovenox because my thought was well at least she will be anticougulated until the morning without lowering the INR so much, it only remains in the body 24-36hours and in the morning the primary can decide...I work at night so I was a little hesitant on calling the doctor for it... "My question is was my though process wrong?" I was told that I should have not held it because this two meds have two different pathways, I'm not sure on the pathways but I know they both increase INR. As I'm writing this post I realize more and more the things I could of done and the reason why, but I would like to hear from you. Tnx :)

I believe i saw it on indeed.com

Meant... Goodness phone...

I meat shut down.... But it felt like a "shot"

Yes it is quite difficult to get a job...& no I did not only apply to hospital Jobs... I applied to nursing homes and anything related to nursing. My applications were not sent to one or 20 but almost 100 different jobs... I applied to every single job that was offer to new grads and even to those who asked for yrs of experience. I went personally to employers and I got shot down, so I'm sorry to say this but my search was not limited to "hospital jobs." Btw I would like to share with all of you that I was finally offer a position. Mayb afer 4 different interviews I was finally able to master the interview proccess. I wish you all the best and if I can do it I'm certain u guys will too. Don't give up and dont let anyone bring u down especially when they have no clue of what us new RN's go through...

It is really good to hear from so many experienced nurses... And as NY lady mentioned "prudent action" is key... Thank you all for this information...

Tnx Roy :)

Congratulations... Job well done hopefully more from this thread get a call.. Best of luck everyone :)...

I'm very happy for u congrats... For both the interview & for ur job offer... Good luck in ur new job :))

First I would like to say gongrats to all of u who are now employed... I'm going to have to Agree w the fact that those who got hired deserved it... I know I've been complaining that I'm unemployed at this moment and that there are such limited positions for us new grads but as someone stated here b4 we were all given an opportunity to shine and maybe we fell short per CS standards... I know as I reflect on my interview; I must say I could of done better , a lot better (sigh)...I think everyone deserves a chance to be hired in any hospital if they have the necessary training and they are fluent in the language regardless of their legal status (as far as I know foreign students pay tons of money just to attend our schools they are trying to better themselves as much as we are they contribute to our society the minute they arrive to the US paying taxes on everything they buy as we do) I do however disagree w hospitals seeking for nurses out of the country (for what I heard this is happening currently)... That is all guys just wanted to give my 2cents... Good luck to all of us who are still hunting and great job to those who already have one :)....

Yes, tnx a bunch wildfl0wer; I would try & follow your advice. I really wanted to do this on my own but I guess it has come to that point... Tnx a bunch :)