There is talk going around work that management is thinking about requiring nurses to have another nurse double-check insulin doses, meaning another nurse would have to watch one draw it up, and sign that it's the correct insulin and dose. I'm assuming this is another check to prevent med errors.
I've heard about this happening at some hospitals, but this is LTC, where we have up to 30 residents. Plus, some nurses have had up to 9 fingersticks to do. If this becomes an actual rule, med passes are going to take even longer. I can't imagine trying to track down a nurse for 9 fingersticks.
Do you have this rule at your job?
If this rule is done for safety reasons, then why not have a second nurse around for other "risky" drugs, such as narcotic pain meds and coumadin?
Another question: some residents have orders for narcotic gels, such as Ativan, that are to be applied to different hairless areas of the body. I'm curious: should the nurse clean the particular area of the body before applying the gel, such as the inner wrist? The instructions don't mention anything about washing the area before applicaton.
In addition, would the drug would lose potency if it was applied to the left inner wrist twice a day without washing that area between applications? I wanted to apply it on the upper back, just to rotate sites, and a nurse said it should only be on the wrists. I thought that as long as the area doesn't have hair, it's okay to apply the gel there. Am I wrong? Thanks.
I know, don't use logic against me
I can titrate massive hemodynamic drugs, insulin drips, push adenosine and run a code without a second wittness, but dare I give one unit of insulin??? We double check heparin as well, even sub Q, not lovenox though... argh I could go on and on.
While I obviously understand the safety reasons, and sure as snot someone here will lecture them, if I'm not competent to give sub Q heparin, then don't trust me with a wall of drips running 10 plus IV's and repositioning a swan while managing a balloon pump.
So yes, double check insulin
dancing off the soap box
Last edit by Zookeeper3 on Jan 3, '10
: Reason: sppellin