Suggestions from IDDM nurses that are working with diabetes

Specialties Endocrine

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Chello everyone, I am just looking for suggestions from iddm nurses. I'm a new onset iddm(type 1).:crying2: I recently went to work at a busy LTCF, and had barely any time to pee, much less take my insulin and eat within 30 minutes of taking insulin. I'm on insulin 4 times a day so that drives me crazy. I barely have time to check my pt.s blood sugar(mine isn't even an option). I love nursing soooooooo much but how do some of u iddm nurses do it? I'm a nurse if just under 3 years, so any suggestions of what you guys and gals are doing at work. I'm no stranger to hypoglycemia :imbar attacks(bs goes down into the 30s -40s) Boy is that a panicky feeling. So please offer some good suggestions. I'm not at that LTCF, because there was no way to care for myself when I had sooooo many pts. to care for. It seems to be the same story everywhere I inquire about. Let me tell you, I've done alot of pt. education( on diabetes ) in home health, but until you are diagnosed you have no idea. I have alot more patience and empathy for my diabetic pt.s now. Thanx in advance, for any suggestions. Ps, I'm looking to work in the hospital enviorment, or LTCF. I realize, I may have to go to home health for more control over my scheadule, but I know I can't be the only iddm nurse out there. Thanx:) :) :)

Specializes in Emergency Dept, M/S.

I'm a nursing student also, and have been a Type 1 for 8 years now. I was also on MDI for 5 of those years, but have now switched to an insulin pump. I thought it would be really hard, but it has been a God-send. I don't have to eat - that is the best thing, because you know how erratic the times are that you can eat. When my basal rate is set correctly (and that takes several months of playing with), my blood sugar doesn't fluctuate more than 30 pts up or down. Then when I do get the chance to eat on my clinical days, I bolus for whatever I'm going to eat in terms of carbs.

The pumps are expensive, along with the supplies, but I'm lucky in that my endo got me approved quickly. I don't know how I would manage doing what I'm doing - even just doing clinicals a couple days a week - on MDI. Is it possible to set up a schedule of some sort with your employer, where you are given time and space to test/eat on a set basis? I know easier said than done, but it might give you a starting point.

In terms of testing, that has been a LOT harder to deal with on clinical days (same hours as a nurse though, so I do know how hectic that can be). I have a very small meter which fits in my pocket, and got one that tests in 5 seconds, but I don't bring my logbook. I just record from the meter later. It's a PITA to carry though, and sometimes with the extra weight of the meter and glucose tabs I feel sort of lopsided with my scrub top. I may get a simple belly pack for around my waist. I can't see why they wouldn't let me.

As for getting down that low, I've used the glucose gel (looks like the Cakemate gel frosting tubes) several times, and that seems to work a lot faster on a low than glucose tabs or regular juice/soda. I also find that non-diabetics have a very hard time understanding the feeling when you get that low. When I get into the 30's, I actually fall out of the "low" feeling of jitteriness and muddled thinking, and into a serene calm KNOWING I'm low and have to eat, but can't, because nothing looks good and I'm going to get fat and the bread is white and I only eat wheat....etc. It's downright SCARY after I come out of it, that all symptoms of the low had passed and people would think everything was alright, but I'm definitely not alright.

Please know you're not alone. A lot of what you go through will be trial and error - for quite a while, unfortunately. It may mean switching to a basular insulin like Lantus, then taking a short-acting like Novolog when you do get a chance to eat. I did that for a while before I went on the pump.

Feel free to PM me if you'd like.

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Specializes in LTC, med-surg, critial care.

I would imagine if people can work around someone who needs to take a ten minute smoke break every couple of hours you would surely be able to take breaks for snacks, blood sugar checks and insulin injections.

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Specializes in Nephrology, Cardiology, ER, ICU.

To the original poster - hope the above advice helps. I do echo though that on this board we try to help out. Perhaps if you only want to talk with IDDMs - a support board specifically for IDDM people might be more what you are looking for. Thanks and good luck...judi

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Specializes in Med-surg > LTC > HH >.
First of all, let me start off by saying that I'm a nursing student and a type I diabetic. Even though I'm not a nurse yet I'll give you a little insight as to what I do. First of all I am on the insulin pump so if this is an option for you, you might wish to consider it. This helps me to prevent excessive lows as well as making it easier to treat highs. For example if I start moving around a lot and know that my blood sugar will probably go low I suspend the insulin devilery and if it starts going high I just press a couple of buttons. The pump also gives you more flexibility with regard to your meals times. As for the fingersticks my only advice is to find the fastest meter you can...some only take 5 seconds to deliver a reading. I also carry glucose tablets in my pockets. If you don't like the idea of an insulin pump I would definitely recommend an insulin pen (it's quicker than drawing it up with the vial and syringe).

Best of luck to you...I know how devastating a diagnosis is (I found out in high school)...and just let me know if you need any more advice or someone to talk to.:)

THANK YOU SOOOOOOOOOO MUCH,nurseneesy, Krm6a and WannaBEanRN for the wonderful words of encouragement and suggestions. I had to quit the LTCF because I had 30 pt.s daily and there was no way to take any time to do the self care I had to do. I can't get a pump for 6 mos. to a year because my endo likes his patients to be very used to dealing with insulin injections long before we use a pump. Also I'm one of the 45million un-insuered people that the senator and president keep referring to in the debates. But I do sooooooo look forward to getting a pump, I always hear wonderful things. I guess when I start my interviews in the next week or two, I'll have to ask they can set me a time to do my accucheck,insulin and snack. I will get some of the gel you mentioned sure sounds small enough to carry in my pocket. I take reg. insulin during the day, and use nph and reg. in the p.m. I have the pen for the nph at bedtime and they are very neat. I don't know if they make them for reg. insulin but I will check on that. Does the pump hurt when you change the canula out? I will e-mail you soon because I would love to hear about the pump as well as your sick days. Thanx again soooooooo much for the advice:) :) :)
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Specializes in Med-surg > LTC > HH >.
I would imagine if people can work around someone who needs to take a ten minute smoke break every couple of hours you would surely be able to take breaks for snacks, blood sugar checks and insulin injections.
:rolleyes: I love this reply, I have never been a smoker but your right I should totally start taking my " smoke break" and do what I have to do(hee-hee). Hi traumaRus, I'm a member on yahoo groups for diabetics but I really need to relate with people that know exactly what my job responsibilities are and trying to fit the diabetic care in that chaotic and stressful yet wonderful job we do. Thanks again everyone that brought positive info to the table. Hairstylingtnurse:) :balloons:
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