advise on long lasting insulin

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I'm a RMA/CNA and the new NP we have at our facility stop the blood sugar checks at bedtime on several residents but we still have to administer large amount of long-lasting insulin not knowing what the residents blood sugar is these large amounts are giving at night and a lot of the times they don't eat a snack or anything. i understand how long lasting insulin works but me and several other staff don't feel comfortable to continue give with out knowing what sugar is. We have address this with the NP and she stated we needed to get educated and she wasn't changing it back. Any suggestions what we should do unlike our NP we have hearts and care for our residents, and don't want nothing to happen to them.

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Specializes in ICU.

So when do you check blood sugars? And do the patients get short acting insulin also, or just long acting? Are these patients who have relatively stable blood sugars? That will help us shed more insight on the situation.

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Specializes in Med/Surg, Ortho, ASC.

It's my understanding that long-acting insulins do not have the highs and lows associated with short-acting insulins. They traditionally are given regardless...

But this is an education issue that should have been addressed prior to the NP issuing new (and unusual to you) orders.

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example on one get sugar check before meals and they get 15 units of novolog before and long lasting 85 units of levimir at 7am and 7pm. sugar go from 80 to almost 300. i understand how levimir and lantus works and all that.

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i understand how long acting insulins works dont get me wrong its just a peace of mind for example there sugar could be in the 60s and we give 85 units and they go right to bed with out a snack there sugar could drop in the middle of the night. if we know what there sugar is might give us the peace of mind

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Specializes in Med/Surg, Ortho, ASC.
i understand how long acting insulins works dont get me wrong its just a peace of mind for example there sugar could be in the 60s and we give 85 units and they go right to bed with out a snack there sugar could drop in the middle of the night. if we know what there sugar is might give us the peace of mind

And again, you might feel better about carrying out orders if you had been educated on this topic. Thank you for being such a patient advocate.

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Perhaps if the NP doesn't have time to educate you, you can call the pharmacist; they're usually a great source of information when you have a question like this.

And don't think that because the NP was brusque with you (probably trying, however imperfectly, to motivate you to educate yourselves) that she is heartless and doesn't care. That's not fair.

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