I am helping out at a hospital some miles from my home while the staff goes through EMR training. There was a patient admitted for CVA was told the CT was negative and he was also going for MRI which is pretty standard. The MD ordered Plavic, Aspirin and Lovenox which I held. When the night shift nurse was taking report she insisted that I should have given the anticoagulants. I talked with her briefly about how terribly incorrect she was and she was defiant stating that hemp goes to one floor and ischemic goes to this floor. I asked her if she even knew about strokes converting to a bleed and she would not answer.
As an experienced nurse I wonder what my responsibility would be to this hospital. I am there only 4 weeks more. There are other issues as well but this is really dangerous for them to be doing.
Thanks for the thoughtful replies. And no, I was not mismatching details. This was a CT negative (reported by patient) who did not receive tPA. I had a talk with one of our neuro docs on the unit yesterday where interestingly enough we had a tPA pt. They agreed with me and disagreed. If the CT and MRI were negative the Plavix and Lovenox should be given but one should wait until the evidence is in. Since I had no access to the computer or reports, they felt it was prudent to hold. It was interesting here in one study which was quoted by me that Lovenox had a higher incidence of conversion. I notified my agency (I travel to this hospital one day per week to help with a EMR training) and they wanted to share my experience with the hospital. I agreed...but after I leave in four weeks.
Again thanks for your educated replies. It has been helpful for me and I hope for others.
lassenlake
31 Posts
Thanks for the thoughtful replies. And no, I was not mismatching details. This was a CT negative (reported by patient) who did not receive tPA. I had a talk with one of our neuro docs on the unit yesterday where interestingly enough we had a tPA pt. They agreed with me and disagreed. If the CT and MRI were negative the Plavix and Lovenox should be given but one should wait until the evidence is in. Since I had no access to the computer or reports, they felt it was prudent to hold. It was interesting here in one study which was quoted by me that Lovenox had a higher incidence of conversion. I notified my agency (I travel to this hospital one day per week to help with a EMR training) and they wanted to share my experience with the hospital. I agreed...but after I leave in four weeks.
Again thanks for your educated replies. It has been helpful for me and I hope for others.