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.
Mar 13, '05
I work in the ER now, but I know on our med-surg units it is not a policy to double check SQ insulin before giving it...however our ICU's policy as well as ours is to double check an IV insulin bolus prior to giving it. But to reflect on the person that is having co-workers non-compliance issues...if it is a policy and he is not following it...I wouldn't worry about getting him in trouble, that's his problem...he decided not to follow...he has to live with the consequences...and unfortunately sometimes in order for "cocky" new nurses or even cocky seasoned nurses to realize they don't know everything, they need to get knocked down a few pegs...Pt safety should come first every time...besides who's to say if he's that complacent about not following the rules what happens if he ends up giving to much he tries to take someone down with him saying that he checked it with so and so...So since obviously your approach with him didn't work, and now that he's moving into a charge role...I would at the very least mention the behavior to the manager...you don't have to mention names necessarily, and maybe the manager can make a blanket statement regarding people not following the policy...good luck!
Last edit by mommatrauma on Mar 13, '05
Mar 13, '05
Well, let me relate a couple of things to you.
Years ago, a nurse came to me to double check her insulin, well guess what, she had a three cc syringe instead of an insulin syringe. This was an experienced RN.
Years ago, an LPN gave insulin to a pregnant patient who came in the day before for a routine c-section the next day, she was on a postpartum floor. Well the LPN gave insulin using a tb syringe, I think they said it was about 100 times more than she should have gotten. Patient was on frequent blood glucose checks all night long. The only way it was discovered was that another nurse was looking for an insulin syringe and the LPN said, there are syringes there, well, they were tb syringes.
Things happen. Even experienced nurses can have a brain farct.
Last edit by Mulan on Mar 13, '05