No More Fingersticks for Techs!! - page 2
by pagandeva2000 13,156 Views | 134 Comments
Is this happening where you all are? I live/work in New York City and work in a city hospital, and in the past few months, the BON sent a mandate stating that techs, CNAs, PCAs, etc...can no longer do fingersticks...this is... Read More
- 7May 25, '09 by catshowladyOhio here - I did them as a PCT for my nurses, and my techs do them for me now that I am an RN. I am OK with this. I can repeat the test or ask the tech to repeat it in my presence if I need to. I see little difference between an accucheck & VS as far as that goes - the tech does them and reports to the nurse.
- 4May 25, '09 by ChristineNThe hospital I work at now (level one pediatric trauma center) allows PCT's to do fingersticks. All the other hospitals in the area that I did clinical at when I was in nursing school also allowed PCT's to do it. As a nurse working on an endocrinology floor, I am very comfortable with letting PCT's do blood sugars. They know the protocals, if it's high/low recheck immediately, if low let nurse know, and treat with 4oz of juice. We check blood sugars every 3 hours on my floor, so having PCT's to help is a Godsend.
- 15May 25, '09 by woohWe can't even let techs do our first set of vital signs, because our facility decided that we have to do a set before we delegate them according to a pump and pearl's interpretation of the practice act. It's getting to where the techs can't do anything. If the armband is scanned, then you can check who the blood sugar "really" belongs to. I can come up with a worst case scenario for anything that we delegate. That doesn't mean that we have to start acting like techs are incapable of doing things. And taking tasks away from the techs will NOT get us more nurses, it will just give more work to the nurses already there. Believe me, I watch it everyday at my hospital as we take away things the techs are allowed to do, but the ratios keep going up even as the workload goes up.
ETA: Agree with above, it's just like VS. If the number doesn't make sense for the patient, I can redo it myself. What's next, I can't trust the lab with my CBC? Do I need to go to the lab and run the bloodwork myself? Nurses CANNOT do it all! We have to trust other people to help out in caring for our patients.
- 7May 25, '09 by boggleTechs do fingerstick glucose checks here. Thank goodness! There are far too many to do at busy times in the shift for nurses to get them done without the tech's help. The computerized system helps avoid communication problems about who's blood sugar was what.
The glucometers are linked to the computer system. The glucometer scans the barcode on patient's writstband, so "Right Patient" is not a problem. Once the glucose checks are done, the glucometer is "docked" in it's holder. That's linked to the computer. The glucose reading, time, and patient is all immediately recorded in the patient record. Of course, the techs report their findings to the nurse, but the nurse verifies all glucose readings on the computer. The judgement of what to do about the Blood sugar reading is the nurse's responsibility.
Our techs do a great job. They use correct technique. (it's pretty hard to mess up a glucose finger stick!) Facilities need to work on making it easier to communicate the findings accurately, not add more tasks to the nurses shift.
- 4May 25, '09 by WalkieTalkie75% of our patients in the ICU have Q1-2 hr glucoses, and if they are not Q1-2, nearly all patients have at least Q4-6 hr ones. Thankfully our techs do them. I couldn't even imagine trying to keep track of everything else I do and be doing hourly finger sticks. I certainly don't mind doing them if the techs are busy, but there are simply too many, especially when my patient is on an insulin gtt.
The techs take competencies/training on this, and know when to alert the nurse, and most of them are very good about this. The glucometer is also uploaded wirelessly and its results will show up under our patient's lab values in the computer. The techs also write them on a strip of paper taped to the inside of the patient's door. I rarely have problems with techs taking glucoses, and they are able to do them in a much more timely manner than I would be able to do... especially if one of my patients is occupying a lot of my time.
- 0May 25, '09 by katgirl46806I use to think that this was okay until last Friday.I was working with another nurse and a QMA which for those that dont know is a cna who has undergone training on passing medications and has passed examination by the BON to be able to do so. I usually pass meds from 2 med carts and it is known to be the heavier med pass with numerous blood sugars, blood pressures, breathing treatments and a couple of gtubes,and temps that have to be done.I was responsible for her and they are suppose to notify the nurse of the blood sugars.Well I work in LTC and is reponsible for about 25 and about 8 blood sugars that get coverage,and are done before meals.She did 2 blood sugar checks. She told me of one but she left to help in the dining room I stayed on the floor to finish passing meds. I work evenings and dinner is served at about 545.She comes back at almost 630 and says oh by the way sos and so blood sugar was over 400 about 439 to be exact. My mouth about hit the floor.I know i should have been on top of that but i got extremely busy and i know thats no excuse but anyone who works LTC can attest.So I had to call the doctor and explain and she was thinking that the lady was having a hyperglycemic reaction which thank god she wasn't because of when i had called. So Ive learned my lesson and its fine to let them do that but it all depends on how competent that tech or QMA and if they understand the parameters involved.
- 4May 25, '09 by TaitOur techs do the fingersticks here in Metro Atlanta.
Our accucheck machines then report it to the computer, and our techs write it on the BG flow sheet.
I understand the concern over miscommunicated BG's, however then the same can be said for a misscommunicated BP, like I had tonight, and other vital signs.
My patient was written down at 114/61. When I went in with 80mg of Micardis for him he informed me that the first BP she had taken was 91/56! So I called and got parameters and held the med.
Same thing with a person reporting a BP of 180/78, for example, because they didn't have the person relax their arm on the bed, or because they used the wrong cuff, or because they startled the person at 0400 by flipping on all the lights instead of approaching with respect, and I go in and cover with Hydralazine, when thier natural BP may have been below the set parameter.
If no one is expected to have responsibility and accountability for thier job, all tasks will eventually fall to the first person with a liscence...the nurse.
I personally favor the idea of eliminating techs/cna's/pca's and employing more RN/LPN's to improve continutity of care, but until then we need to raise the bar on our expectations and make sure ancillary staff realizes the importance of the role they play in patient care.