Insulin question

Nurses Medications

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I had a patient (who had Congestive Heart Failure, pleural effusion, diabetes, and a history of hypertension, and emphysema)... my instructor claims that those medical conditions will make insulin (subcutaneously) take a much, much quicker effect (so if the book says that the onset is 15 min, in his case it will be 3-5 min)... Can someone please explain how this would happen and why? What do you think about this??

Specializes in Med/Surg.

In all of this, I just wonder where the pt's primary nurse (and your preceptor) was to stand up for you?

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The nurse (preceptor) I was working with is on very friendly terms with my teacher and she just doesn't care enough to stand up for me.

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Specializes in Emergency.
I found a really cool chart that has onset, peak, duration, administration in

relation to meals, and other information. I don't have anything directly related to this thread (my first instinct was that that guy would have his insulin processes slowed down...), but wanted to share this chart. I have it tacked inside my MAR at work.

http://www.musc.edu/pharmacyservices/DI/InsulinComparisonChart1.pdf

Nice chart! I'm taking it to work, too.

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Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

BJLynn, thanks for the great chart....very helpful!

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OP, it might be time to speak with an attorney, if you're telling us everything and getting nowhere with the school. I agree, this alone should not be enough to fail you, or even place you on probation. Either there's something you're not telling us or there's something they're not telling you, but this alone is not enough.

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Specializes in Float.

Does the teacher not have to approve giving the insulin BEFORE you give it? At the hospital where I did clinicals two nurses have to approve all insulin. When I gave insulin I had another student watch me draw it up to make sure I had the right type and then the teacher checked the dosage before I gave it and she would check the SS and compare it with the blood sugar reading. Which semester are you? To me it seems the teacher has a responsibility to approve all meds given (ie..we gave PO meds ourselves, BUT the teacher ck the MAR and we would have to have lab values ready on the spot to tell her BEFORE we could give the med)

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I spoke to several attorneys, but my only problem is that one thinks it will be a difficult case to fight (since they are not a private school, but government), and the others want an hourly rate and I can't afford it. I am in a process of trying to find probonal lawyers...

And yes, she has to approve the insulin... my dosage and everything was correct, her problem was that the food was right in the hallway instead of right in front of him (preferably him eating) cause she thinks that otherwise he would go into a coma in 5 minutes... (she seems to be very confused about the onset, peak and duration of insulins).

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I'm woundering if there's more to the story than you may know . I agree with many other people here. Ask her to explain . There may be something to this pt / dx than we see here. Although , is doesn't sound correct. In general it sounds like the pt may also have pvd or poor circ in general, there are many (too many to list here) factors that cause increased, decreased absorbtion of any med. I would also read as much as you can about it, so you go to your instructor with some background on the subject. Some times instructors have one thought in mind but , the communication line between student and teacher gets messed up.

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Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.

That instructor has some 'splaining to do, as far as I'm concerned. And I'd want the explaination in writing so that stories don't change. What would it cost you to have a lawyer write a letter to the Dean or college prez (on their official letterhead) asking for that explaination from that instructor? The school, no doubt, does not want a lawsuit. That said...I'm certain that you do not want to resume the pursuit of your degree at that institution!

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Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.
Insulin doesn't work instantaneously, even if it's given IV.

This is news to me. :uhoh21: I guess I was under the impression that IV insulin could be carefully titrated for the best control of severe hyperglycemia. Could you get just as adequate coverage SQ? Could one of you great diabetic educators expand on this a bit?

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I had another meeting today with the committee... And I requested proof of her statements over a week ago, and she was unable to provide any. If the committee thinks I am right, then they will make a recommendation to the president of the college, and then he can make a recommendation to the Board of Trustees...

I am not sure how much it would cost to have a lawyer write the letter, but I will find out. It's a good idea.

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Specializes in Emergency.

It shouldn't cost you more than $100 - $200 for a lawyer to write a letter.

Why has the instructer singled you out with her bizarre behavior? Do you have a protected minority status that she has a bias against?

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