double-checking insulin with cokworker - page 3

Does anyone here work at a hospital where there is not a policy r/t double-checking insulin? I know that there are some places where it's not policy, but the nurses do it anyway because of safety. I graduated last June and was... Read More

  1. 0
    Hi All,
    Even if the hospital did not have a policy I WOULD STILL ask a nurse to double check with me. Tell that @$^%*@! nurse yeah 1 or 2 units off if you are lucky on that one mistake but what happens when even if you do all of the checks for some reason( horrible shift, migraine headache, etc) the order calls for 2 units and you give 20?!!!! Ask him what then?.....and this does happen!, even to really good, careful nurses. So ask him how he would feel if he ever brought harm to a pt all by simply not doing a 2 nurse check.

    juz my 2cents!


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  2. 0
    If I worked in a hospital I would want to have another nurse check my insulin, but in the setting I work in now, it's impossible to have another nurse check.
    I work in MR/DDS, we go to 8 separate homes to give meds. So I am in one part of the campus, and my co-worker is in another.
    There are a few safeguards tho. In this setting we only have U-100 insulin syringes TB syringes to get mixed up with them, and the insulin is exactly what is ordered for the resident. No other kinds there to get mixed up with his/hers.
    But I STILL read my cards and labels 3 times during the setup, just to be extra careful.
    Dosages can change at any time.
    But where I work we're on our second nurse to check.
  3. 0
    Quote from Mulan
    That's fine if they make the conversion, unfortunately those nurses didn't and gave overdoses.
    One more reason to double check with another nurse.

    I agree with LPN1974---in situations such as LTC, or MR/DDS, where there ISN'T another nurse to double check with, it's probably much more prudent to have ONLY insulin syringes on hand, to cut down on the inevitable errors that can occur when one is rushed, overworked, fatigued, or the victim of nurse understaffing.
    Last edit by stevierae on Mar 24, '05
  4. 0
    Have been a nurse since 1982. I was taught to always have 2 nurses check insulin (and heparin) doses, and I have done that ever since.
  5. 0
    Some places do and some don't.

    In Florida and GA, most facilities that I have worked do double check insulin.

    In Philadelphia and NYC, staff looked at me like I was insane when I requested someone check my insulin draw.
  6. 0
    Quote from bth44
    Does anyone here work at a hospital where there is not a policy r/t double-checking insulin? I know that there are some places where it's not policy, but the nurses do it anyway because of safety. I graduated last June and was hired with some other people from my class at the local hospital. Policy at our hospital is that insulin is to be double-checked by two RN's. Sometimes, doing the double-check feels like like a pain but I feel it's always better to be safe than sorry.

    Well, I was hired to a med/surg unit with fellow new grad who I went to nursing school with. He's always been a cocky, confident, know-it-all individual, and it continues here at work on the floor. Whenever I ask him to check my insulin with me, he won't even look at the syringe that I've just drawn up, but he'll say, "Looks good" then walks off. If he's in the medication room getting his insulin ready while I'm in there, I'll offer to check it with him. He'll say, "I guess, if you want to", and that tells me he was planning to give the insulin without a double check. I've confronted him about it and he told me that double-checking insulin is "lame". He said that insulin is just like the meds we draw up for IV pushes, and we don't double-check those, so he feels that double checking insulin is a waste of time and he said he's skeptical about an extra unit or two of insulin causing real harm to the patient. I'm one of those "go-by-the-book" type of people, especially when I'm in "nurse-mode". I'm not a timid or nervous nurse, but I feel that if I follow the policy of the hospital and try my best, then the chances of something bad happening diminish greatly. I expect myself to do a good, safe job at work, and I expect the same from the team I work on. I feel that he's cutting corners and he's being a lazy. He just applied for a charge position on our unit, and he got it. I find that really scary, and I'm seriously considering applying for a postion on a different shift, because I don't think I could work under a charge nurse that I don't trust or respect as a safe practictioner.

    So, all you more-experience nurses out there: Can getting an extra units of insulin be critical? Personally, I definitely think so. I also feel that giving the wrong type of insulin by accident because you didn't double check can also be big trouble. Or do I just sound like a fussy nurse?

    How do you feel about my coworker's attitude? I'm afraid that this attitude of his is going to get him in a lot of trouble later. If you were in position, would you address any of this to the unit manager? How would you go about doing it? Remember, he just was granted a charge nurse postion, so I'm pretty sure the unit manager thinks highly of him.
    I think his attitude will get him in trouble some day. Myself, I am one of the only RN's on our floor that actually checks it with another and it IS policy where I work. It is actually easier to make a med error with a small dose of insulin than with 2mg of Dilaudid. There are so many types of insulin and it is more difficult to read the lines on the syringes. Also, I frequently have student nurses with me and I teach them to tape the vial that they drew the med out of to the syringe. If it is a multidose vial, I have them write it on tape and attach that to the syringe. Anything to prevent that med error. I think you should keep on doing your checks and what you know to be right. Also, do your checks with another nurse. One who will look at your syringe.

    Keep the faith and the good nursing skills.

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