Dangerous nurses

Nurses Relations

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Have any of you ever worked with a nurse you would classify as dangerous ---- dangerous as a nurse and as a person?

No it's not better to have hyperglycemia. There's more risk for infection and less wound healing if blood sugars are not properly controlled. Blood glucose should be maintained within the appropriate limits. It all depends on the patient and their insulin resistance. If you have a problem with giving a patient 100 units of Lantus and 20 units of regular insulin with a meal, by all means call their physcian or endocrinologist to verify the order.

hat

That is not true...I discussed this with several pharmacist and I trust them because they are the drug experts,even the docs ask them for advice regarding some drugs..the pharmacist always tell me it is safer for the patient to develop hyperlycemia than hypoglycemia because it is easier to reverse the effects of the first one.

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Specializes in Telemetry & Obs.

Let's break this down into very simple terms: think of glucose like sugar crystals in the bloodstream. Rough scratchy crystals. Imagine them tearing thru the brain, the kidneys, other vital organs. Ok, now imagine that there's a LOT of those crystals...think of the damage they're doing to the whole body.

Too little sugar in the blood?? Simple to remedy...give some sugar. Too much?? Well, in the average person that's pretty easy to fix: give some insulin. Now imagine that insulin resistant patient. A LOT harder to fix because their body doesn't recognize insulin.

Too much: decreased healing, DKA, HHS, COMA, DEATH!!!!

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Anyway I did call pharmacists several times arleady regarding this isssue and most of the time they did actually told me to hold at least one of the insulins....I guess it is a potent drug and it is better to be safe than sorry,I make sure I take my precaution with all the "high risk" medications even if it means to make a @ss out of myself...

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Specializes in Telemetry & Obs.
Anyway I did call pharmacists several times arleady regarding this isssue and most of the time that did actually told me to hold at least one of the insulins....I guess it is a potent drug and it is better to be safe than sorry,I make sure I take my precaution with all the "high risk" medications even if it means to make a @ss out of myself...

I'm sorry, but a pharmacist could not tell you to hold a medication...not and keep his license. That's a MD judgment call.

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Ever heard of DKA? Ever seen it?

Yes I heard about it and learned about it,never had a patient with it,however I had an opportunity to see a patient to go into the early stages of hypoglycemia and it wasnt fun at all...

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Specializes in ICU.
Once had a student nurse unplug a vent to plug in an IV pump and not realize it. Pt died. Massive lawsuit ensued.

To this day I still wonder how someone would even consider unplugging anything in an ICU! I'm glad I don't work in that particular hospital anymore.

The vent did not have a battery backup?????? Must have been a log time ago. I haven't seen a vent in my career that doesn't have a battery backup.

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I'm sorry, but a pharmacist could not tell you to hold a medication...not and keep his license. That's a MD judgment call.

Well let me rephrase it...he made a suggestion...

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Specializes in Neuro ICU and Med Surg.
hat

That is not true...I discussed this with several pharmacist and I trust them because they are the drug experts,even the docs ask them for advice regarding some drugs..the pharmacist always tell me it is safer for the patient to develop hyperlycemia than hypoglycemia because it is easier to reverse the effects of the first one.

Trauma is right. Lower blood sugar is better and leads to better healing, there have been studies done on this. That is why in the ICU even if the pt isn't diabetic and the sugar is 150 or higher and they are NPO we start a insulin drip.

Seriously I don't know what pharmacist you are consulting with but I suggest it should be a different one.

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Specializes in Telemetry & Obs.
Well let me rephrase it...he made a suggestion...

And if you held a medication at his "suggestion" YOU MADE A MED ERROR because only the MD can give the order to hold a medication unless there are parameters ordered.

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The vent did not have a battery backup?????? Must have been a log time ago. I haven't seen a vent in my career that doesn't have a battery backup.

Wow makes me really wonder where was the instructor at the time when the students was suppose to hook up the IV,we are not allow to even touch the IV pump without the instructor being present at our site and I would not dare even if the teacher would told me to do it on my own,than again how come the alarm didnt go off,how come no one checked on the patient (high risk patient),it sounds like there is more to this story...and I dont believe this is entirely the student nurse fault,I think the whole team is to blame here...

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Specializes in Neuro ICU and Med Surg.
Well let me rephrase it...he made a suggestion...

Did you ever contact the pt MD about this after you spoke with the phamacist? I too have held off on meds until speaking with the MD, but never hold insulin without an order or the blood sugar is hypoglycemic.

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And if you held a medication at his "suggestion" YOU MADE A MED ERROR because only the MD can give the order to hold a medication unless there are parameters ordered.

No I dont think so if the nurse believes that this order is unsafe,she has a right to refuse to give it...

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