Quote from laurelethrn sulfate
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???
i think that the md in question is being a bit irrational by wanting to hold all
hyperglycemics and insulin. hypoglycemia is easily fixed, but severe hyperglycemia is a catch-up game and with the added stress of hospitalization he'd be setting the patient up for the inevitable icu transfer for an insulin drip all the while increasing her risk of infection.
a more reasonable and stable-minded md would have merely put the patient on a sliding scale regular insulin protocol and then tweaked from there. especially with the knowledge the patient is eating now.
either that or ordered more frequent fsbgs. which nursing should consider doing anyways regardless of how it was ordered.
regardless of how to best medically manage it, the physician clearly has anger management issues based on how you describe his reaction.