[hhrhrn41]

Hello All,

Just a quick question..... I work with this NA who tells me she was diagnosed with "pre-diabetes" several years ago and that she was prescribed Glucophage BID. She says she takes the med for a little while and then eventually just stops taking it. Every now and again she will check her blood sugar while we are at work (she doesn't have one at home) and EVERY TIME it is above 200. Several days last week it was 350 and even 429 one day!! She came and told me "hey Tam, guess what..my sugar is 429! and then she proceeded to start laughing. ***!!?? People that are that ignorant and noncompliant about their diabetes makes my blood boil!! Anyways, I angrily tell her that she desperatley needs to call her MD and make him aware of these high sugars and to just be honest with him about her noncompliance. I go on to tell her that she needs insulin(she is not even on a sliding scale). The entire time i tell her this stuff and try to educate her she just laughs. So now to my question... Me being the charge RN... could I be held liable b/c I didn't notify the manager, occupational health nurse ect? Oh I forgot to add that she appears to be asymptomatic when her sugars are that high, b'c if she was having sypmtoms I definately would have done something. Plus I worry that she could be putting patients at risk by taking care of them with her sugar that high. Please send some advice my way. Thanks!!!

[Tweety]

Good question.

If indeed you feel patients might be in jeopardy, I think you are obligated to report her condition. However, since currently there are no symptoms you are o.k. and it's a sticky situation.

Here in Florida the nurse practice act is very clear about reporting impaired care providers. She is not impaired, but I don't know what it says about risks of being impaired due to noncompliance. That's a very good question.

It's her body to do with as she pleases, as you well know.

You might just run it by your manager or HR just in case. Staff should be physically and mentally capabable of performing their jobs.

Good luck.

[TachyBrady]

It sounds like this person has some big-time emotional problems and is using her diabetes as an attention-getting scheme. I agree that you should discuss it with your unit manager. If a person shows poor judgement in managing their own health, can they be trusted and relied upon to take safe care of others?

[DusktilDawn]

Have you suggested anything like "Diabetes classes." I've worked at 2 facilities that offered health teaching to diabetes for patients. It was set up like a classroom where a nurse taught diabetics about their condition. As a student I attended some of these classes because I was interested about what was being taught to diabetics in the community. I also encouraged a co-worker who started talking and asking me questions about her diabetes to see if our facility offered this type of teaching (I was new at this place at that time). She did look into it, and in fact because she was an employee it was available to her for free.

It sounds like you co-worker definately has a knowledge deficit in regards to her condition. I would talk to her first about becoming educated about her diabetes and address your concerns about how hyperglycemia and hypoglycemia can affect a person. You'd be surprised at how many diabetics are unaware of how serious this condition can be when it is not taken care of properly. In the long term you can lose your sight, limbs, wind up with renal problems/failure, etc. She really may be clueless.

I also agree that it might not be a bad idea to run the situation by your manager or HR.

[amlaboy]

Have you ever been present when she tested? She could be just telling you that it's high when it's not. Some people like the attention.

[grinnurse]

I think that I would share the information with your NM or someone. I don't know that you have the right to call her doctor and tell her, but some kind of report should be made just to possibly CYA against her possibly in the future should something happen. I tend to think like one of the other posters, that if she is noncompliant and taking care of patients this could pose a risk.

That's what I would do just to CMA. I would also like to know if she has ever taken her BS in front of you or if she is doing this to just get attention. I can't think of the name for it, but there is some psych term for people like that. Sounds like she's a little off kilter to me!! Good luck.

It is amazing how ignorant some people in the health care industry can be when it comes to their own health. They see the consequences of non-compliance all the time but still do nothing and then expect everyone to feel sorry for them when something happens.

[Nurse Ratched]

She shouldn't be using the work machine to check her BG (especially since it's just for giggles from her standpoint - emergency check is another thing.)

If she is exhibiting signs of being impaired d/t her sugar being out of control, report her to your manager immediately and do your best to get her to see a doctor, but advise her in no uncertain terms may she work impaired for any reason.

[carachel2]

I may be off base here, but I see this inappropriate response to her own lab testing as something that could actually put your patients in danger and I see it as reportable. I can totally see her checking a blood sugar and not reporting it as a significant value if it was oh say....250 or something. I can see her not following up on other patient care issues too.

[soliant12]

of course you are not liable because she has high blood sugars if she were impaired in some aspect then I would notify the manager of her impairment. It is not your responsibility to be "managing" this employees health.

[MIA-RN1]

I might get around the issue by mentioning to the NM that she's been using the bg monitor (at hospital's expense) like "Sally came up to me today and told me her bg was 350! I asked her how she knew and she told me that she checked it on the unit's machine"