Glucose Competency: testing your own blood sugar?

[kaylee.]

I have a question regarding glucose competency and health privacy. I work at a medical center in CA and we just completed the module for glucose competency where we demonstrate doing the high/low controls and working the accucheck machine etc...

Then the other day, the person in charge of phlebotomy training is on our floor walking up to each nurse and asking them to do an additional competency, where we are to take our own blood sugar for him.

I was too busy that day so I didnt get approached but it felt a little uncomfortable. Why must I reveal an aspect of my personal health just to prove I can do the skill, on top of the California mandated competency?

I overheard a nurse saying, but I just completed the competency at the skills lab”, and he said, this is different, an additional validation”.

I have never seen this before at any place I have worked. Has anyone else had to do this? To me this seems rather invasive, to randomly approach people busy doing their jobs and request that they reveal their blood sugar to some random staff member…just wanted to get some thoughts on how normal this is is, whether they can legally enforce this, and whether you can politely decline. Thanks!

[mindofmidwifery, ADN]

In my hospital system, we test our own blood sugar for the competency tests.

[blondy2061h, MSN, RN]

Years ago, when I was first hired, we had to do this on orientation. One of the other people in the group and I both had insulin pumps. We were told we could be exempt if we wanted to. I participated. She declined since she had just finished eating.

[KelRN215, BSN, RN]

The only time I had to do this was when I was working as a CNA at a community hospital in the town I'd grown up in. Now that I think of it, in the same orientation with me was a girl who'd graduated from high school with my brother. This girl had been a type I diabetic since 2nd grade. I already knew that because I knew her but I imagine it may have been awkward for her when her blood glucose came up at 147- good control for a diabetic, but obviously a diabetic reading. Why should other people doing hospital orientation get to know this about her just so they can demonstrate competency on a glucometer?

[ixchel]

It seems reasonable to refuse to check your own. First of all, yes, this is your private health information. Second, you are intentionally breaking the integrity of your skin which, even for the most conscientious hand washer, can create a risk for infection unnecessarily. I would offer to either check his, or use the high/low control bottles. If you get resistance because it is the actual finger stick that they are assessing you do, and not so much the function of the glucometer, I can see why they'd like to see you actually stick someone. Maybe you could then offer to let them observe you get a finger stick on a patient who is due for it.

[Anna Flaxis, BSN, RN]

I can poke people with needles all day, but I have zero desire to be the pokee. I would hate this.

[Karou]

I think it's strange and has some potential issues.

One, for privacy. The lab director or whoever is observing the competency doesn't need to know if an employee is diabetic or if their blood glucose is high... Which would potentially show if a diabetic employee tested themselves

Also, infection control. We have on duty nurses pricking their finger, creating a possible portal of entry for infection. Not a high risk, but still.

I don't have to lancet my own finger to check my diabetic patients blood glucose, so why do I have to do it to myself to prove competency (in taking patients blood glucose). Weird.

I'd ask to use the controls, to test the evaluators bsg, or to fake a needle stick on myself without actually piercing the skin.

[KatieMI, BSN, MSN, RN]

"Gee, I am just from one MRSA dressing change, and heading into another one....so can I poke you instead?"

[~PedsRN~, BSN, RN]

No way, that is not how our competency is assessed. That's crazy talk, and honestly - in today's world of liability and fear, I am surprised it flies at all!

[llg, PhD, RN]

If you feel secure in your job ...

I would say, "No, I'm not going to give you my private health information. But if you would like me to test your blood sugar to validate my competency, I would be happy to."

[WookieeRN, BSN, MSN, RN]

I had to test my own blood for the competency in school a couple weeks ago.