I was just wondering, if a patient comes to your hospital and part of their history is diabetes but that is not part of their primary diagnosis, do you still check their fingerstick? I just found out that this is not protocol at my hospital (I don't work in the ED, but a close friend does). She said that they will sometimes look at the blood glucose level when a blood panel is drawn, but unless the patient is admitted for something diabetes related they don't check fingersticks. Well this caused a problem for me the other day. I had a patient admitted for PNA who was also diabetic. While in the ED, he had a sandwich and a few snacks (he's generally well controlled at home, knows his diet). No one ever bothered to check his fingerstick, so when I checked it at night it was 426!! At home he takes a large amount of NPH BID, but had not had any that day. Of course in the ED you can't just waltz in with your own meds and start giving yourself insulin, so this guy just went ahead and ate not knowing his fingerstick since no one checked. (I know he could have asked someone, but when your starving and can't get anyones attention, you can't help it) So, in addition to trying to get his blood sugar back to a normal level, I was also going back and forth with the docs because they had the orders all wrong for his insulin compared to what he takes at home. Anyone else experience situations like this in their hospital? Thanks for the input!!
Oct 8, '08
Quote from mpccrn
as unprofessional as it sounds, our ED nurses insist they are "not allowed" to do ANYTHING no specifically ordered by their docs.....not allowed to asses, not allowed to think, not allowed to troubleshoot. reports from them is a nightmare and frankly it's easier not asking questions because you know they won't know the answers. this has been a continuing fight between icu/sdu and the ED for as long as i've been here (5 years). the ED in not required to do anything that might be written on the admitting orders including hanging IV's even if the patient is down there for several hours because there is no bed available. i don't get it....don't understand how they hold onto their licenses, how they sleep at night, how they can go into work everyday and leave their brains and ethics at home. i couldn't do it.
I dont know where you work, but I am a great ER nurse, and I work with great ER nurses, and I will hang meds on the admitting orders, I assess my patients, and know more about them then the ER doc does!! So please dont bash all ER nurses!!! By the way I sleep well at night, and will have no problem holding my license.
Last edit by rn/writer on Oct 8, '08
: Reason: Removed unnecessary comment.