Which shift covers AM insulins?

[RainMom]

When there are morning insulins to give, does your night shift nurse give before leaving or does the day shift nurse give it? I work nights & give report about 7-7:15. Where I work, the night shift nurse gives the insulin before going, but breakfast doesn't get to the floor until 8:00 or so. I'm always a little wary about giving it (almost always Humalog) unless I have charting left to do after report in which case I'll finish that before giving the injections so that it is as close to breakfast as I can make it. If I'm running on time though, ready to leave by about 7:15, I'll take in some crackers to the patient just in case. I was just curious how other facilities handle this task.

[Dazglue, ADN, BSN, MSN, RN]

Our morning shift CNA's check the blood sugars and the morning nurses give the insulin because breakfast doesn't come until 7:45-8:00.

[NotFlo]

Thankfully our current MDs are moving away from sliding scale coverage before each meal (this is rehab/LTC NOT acute care by the way). There was an awful time when we'd get report and hit the floor running at 7:30 and I'd be in a frenzy trying to do all the accuchecks and all the sliding scale coverage before the trays went out at 7:45 or 8am. Some days I'd have up to 10 or more accuchecks and insulins to do. It was awful and people always ended up ****** if I got to them after they had one bite of food in their mouth (and I would get frustrated too).

Now they usually only do QID accuchecks with a sliding scale for a week, then they adjust the longer acting insulins (NPH, Lantus, 70/3o, whatever) and DC the sliding scale and make the accuchecks 6:30 and 4:30. Then if that works they'll decrease them to three time a week, etc.

To answer your actual question though, LOL...if a person gets fast-acting sliding scale insulin the day shift has to get their accucheck and give their insulin. If they have no fast-acting insulin night shift will get their fasting blood sugar.

[MN-Nurse, ASN, RN]

The oncoming AM nurses cover insulin at my facility. If the patient needs to eat early for any reason the NOC nurse will cover the insulin.

[Pepper The Cat, BSN, RN]

Day shift gives insulin.

We usually wait until Breakfast has been delivered as kitchen has a history of late deliveries. Although breakfast is supposed to be delivered around 8:00 am they have been known to be late. The other day, it was almost 9:00 before the breakfast were delivered - totally threw us all off on our plans for the am - but I shudder to think of what would have happened if we had given insulin at 7:45 anticiapating an 8:00 meal tray delivery.

I personaly do not give insulin until the tray is in front of the pt. I would NOT expect night shift to give insulin before ensuring food was in front of pt.

Considering the current trend of insulin is long acting at bed time, and short acting before each meal, I think day shift should be giving it.

[AngelofLTC]

I have never heard of night shift giving insulin...I work LTC though and breakfast isnt until 9am.

[caliotter3]

I gave insulin on night shift when I worked in LTC. I always tried to give it as late as possible because I knew the trays didn't get out until late. When I asked, I was told something equivalent to "shut up and do what you're told".

[classicdame, MSN, EdD]

ADA does not recommend REGULAR insulin sliding scale in an acute care setting, so we give Lantus/Levimir hs and Humalog/Novolog AC and prn

[RainMom]

Thanks everybody, this is kind of what I thought! I've only been here a few months, but when I first had a pt needing insulin ac I was told that I should give it, the day nurses are too busy! They are busy, but it doesn't mean it's right. Like I said above, I try give crackers with it, sometimes juice, if I'm giving it more than 20 minutes before breakfast is due. This week when I had the chance, I delegated it to students who were coming on - they were excited to get to give it & I was excited not to have to! Thanks again for the replies!