We had our first insulin gtt a couple of months ago-- at least the only one I've ever heard of in my past 10 years on med-surg. The patient wasn't in full-blown DKA, but his blood sugars were all over the place, and generally high. When I worked the weekend he was still a patient, the insulin gtt had been stopped for a day or so, and I was under the impression that we weren't supposed to have insulin gtts on the floor. Q1h Accuchecks and 6-7 patients is just too much. Never had an inservice or went over protocol, but when I inquired later, a nurse educator said yes, we could have insulin gtts on the floor. The patient also had a potassium of 6.2 I had to deal with, was morbidly obese, and his roomate was on a heparin gtt with DVT's throughout his body-- a veritable time bomb, IMHO.
BUT, there were no beds on telemetry or ICU. (When we asked the Cardiologist about the DVT patient being transferred, he responded, "There are no other beds. You know CPR, don't you?" :angryfire ) When I had to call the diabetic patient's doc the 2nd time in the shift about a blood sugar >400, he wanted to re-order the insulin gtt to which I responded, "I'm not even sure we're allowed to have them on med-surg" and of course he was surprised since the patient had had one a day ago..... :stone He ended up giving us SQ insulin orders after I explained the nurse-patient ratios and the acuity of this patient (treating hyperkalemia, etc.).
I'm still not totally sure what the policy is, but I'll be calling my manager on Monday to clarify-- Thanks for reminding me, and sorry for being so long-winded!