Would you have given the meds??

[**LaurelRN]

okay- here's the situation

69 yo female in because of weakness, fell at home after being at rehab for 3 weeks. normal aging issues- cad, htn, but completely aao x3-also iddm. offgoing nurse gives me report, says pt's fsbs @ 0600 was 39- she gave oj and graham crackers- rechecked the fsbs- it was 50- gave another oj. rechecked 105. pt states she was a little shaky and a bit diaphortic- but otherwise ok- that she knows it was because she took her hs insulin and didn't eat.

so she has metformin and actos ordered for 0800. i recheck her fsbs-it was 127- she's eating- so i give it but not her 70/30.

pt was fine all morning. in the mean time, i am floated to icu and get a call about 3 hrs later stating the md wants to talk to me.

i get there, he says did i plan on trying to kill his pt..because that is what would have happened. i explained what had happened- then reiterated that fact the the pt stated she had not eaten dinner. he freaked!! said he was going to my nm and i would not be taking care of any of his pts again.

so, it is not so much i think i was wrong...the problem came down to the fact that the offgoing rn did not notify him that the pts fsbs was 39 @ 0600- he said if he had know he would have given the order to hold all hypoglycemics and insulin...

what do you all think???

[Otessa, BSN, RN]

Would have made sure the MD had been notified about the 39 BS-most MDs would want to be notified.

[ChristyRN2009]

I would've given all the meds if her blood sugar was normal, meaning 80+. If I knew she wasn't eating, I might hold something, but you say she is aaox3 and able to follow simple commands, I'd have given her all her meds including any scheduled insulin and left her with plenty of access to snacks and instruction to eat.

I fail to see how another nurse not calling (IF that was protocol) is cause for this MD to act like that towards you. Perhaps she should've called, personally I probably wouldn't have unless I was calling regarding another issue. You just can't win with some MDs. Either they get mad at you calling for every little thing or they get mad when you don't call about every little thing.

[makes needs known]

This almost exactly happened to me. No harm to patient at all. Sometimes the decisions we make are not the correct ones.

[chelynn]

I would have talked to the doc first. I never hold a med without speaking to the dr first, or at least the charge