Dangerous nurses

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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?

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.

No the nurse did this,we are not allow to call the MDs

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Specializes in ICU/Critical Care.
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.

I don't know what pharmacist you are talking to but it's obviously one who doesn't know anything but a hole in a wall. There have been numerous studies in regards to wound healing, infection and their relation to blood glucose control.

Let me tell you a story, we had a patient s/p CABG. Patient was NPO, intubated and blood glucose checks were between 200-250. Patient was not properly covered with insulin. Per our protocol, he should have been placed on an insulin drip. Patient developed an abscess in his leg where he had a central line placed, one week later, patient's leg was amputated. This ALL could have been prevented had his blood sugar been controlled. Now when you are pulled into a court of law and questioned by the attorney for the patient, are you gonna say "Well, so and so pharmacist says its better to have a higher blood sugar than a low blood sugar." That patient would win tons of cash based on that idiotic response...PLEASE REMEMBER THAT THAT PHARMACIST IS NOT THE ONE TREATING THE PATIENT.

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

And you though an insulin order was "unsafe"? Really.......seems like I remember the patient's nurse didn't have the same concerns.

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Specializes in ICU/Critical Care.
Well let me rephrase it...he made a suggestion...

A suggestion is a suggestion but you run things like dosage changes by the MD not by a pharmacist.

If I ever have surgery and have you as a nurse and you believe that it's better to be hyperglycemic than have a normal blood glucose, I would have to request another nurse. I wouldn't feel safe.

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

Within reason. The doctor needs to be aware of what you are holding and why. If the patient develops adverse effects of you not giving the medication even though a doctor states that he/she wants it given, guess whose butt is in trouble, your's.

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You yourself have stated that you are just learning and don't know everything. These experienced nurses are attempting to share knowledge with you, and yet you continue to argue. Ironic, considering the topic of the thread, I think.

My thought exactly. I think a huge part of not being a "bad" nurse (or nursing student) is being able to receive information about a subject that you might not have known previously, and add it to what you do know and then use ALL of that info to form a good plan of care...You know, to LEARN..:stone And in order to learn, you can't feel personally attacked by someone correcting misinformation that you hold. It's about safe care, and if you take each correction personally, then you will never learn (since you have decided you are right and therefore know everything) and you WILL be an unsafe nurse...because in general that is the least safe nurse--the one who thinks he/she is always right.

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Specializes in LTC/Rehab, Med Surg, Home Care.
What???It is better to have hyperglycemia than hypoglycemia....

It's best to have good control.

It is an emergency to have hypoglycemia. In other words, this is an immediate life threatening situation that requires fast action. Hyperglycemia is also dangerous, but you have more time to deal with the situation than you do with hypoglycemia. This is where the idea that hyperglycemia is "better" comes from. It's really not better, it just does not require the fast attention that low blood sugar does.

With low blood sugar, we're talking about minutes in some cases before the pt. may lose consciousness and need a glucogen injection. With hyperglycemia, you can page the MD and get new orders to increase sliding scale and/or Lantus, 70/30, etc. and then monitor blood sugars over the next several hours.

BUT, good control, 80-120, is best, without the extremes of either direction, and without the need to be constantly adjusting insulin. "Chasing" high blood sugar is never a good thing.

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Specializes in Gerontological, cardiac, med-surg, peds.

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It's best to have good control.

It is an emergency to have hypoglycemia. In other words, this is an immediate life threatening situation that requires fast action. Hyperglycemia is also dangerous, but you have more time to deal with the situation than you do with hypoglycemia. This is where the idea that hyperglycemia is "better" comes from. It's really not better, it just does not require the fast attention that low blood sugar does.

With low blood sugar, we're talking about minutes in some cases before the pt. may lose consciousness and need a glucogen injection. With hyperglycemia, you can page the MD and get new orders to increase sliding scale and/or Lantus, 70/30, etc. and then monitor blood sugars over the next several hours.

BUT, good control, 80-120, is best, without the extremes of either direction, and without the need to be constantly adjusting insulin. "Chasing" high blood sugar is never a good thing.

I agree.

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I worked with another RN who was making up glucometer results and writing them onto the MARs. The way I learned this was when I went in to take a glucometer reading on a patient. The patient asked me why I was doing this. After I explained it to her she told me that Nurse xxx never did this. That sent me checking the MAR and the memory of the glucometer. I was sickened. I couldn't believe that a nurse would do something like this. We watched and also found that this same nurse was also charting but not giving medications to the confused people in the Alzheimer's unit (this was in a nursing home). It was so widespread that the DON called in the pharmacy which did a physical count of her medicine cart before and after the last shift that she ever worked for this facility. From what I heard the DON and pharmacy were shocked at what they found she didn't do include falsify yet again the blood sugar readings. Apparently, she wasn't giving any medications at all to the Alzheimer patients! They allowed her to quit rather than fire her. Because of confidentiality reasons I do not know if she was ever reported to the board of nursing. I watched the BON reports for awhile, but never saw her name listed.

That is absolutely DISGUSTING! I really, really hope she gets what's hers.

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Specializes in Management, Emergency, Psych, Med Surg.

Being a nurse for 30 years I still go back to my nursing school training. If the order sounds funny, it might be. Always best to double check. I NEVER EVER give a medication drawn up by another person. I never give a pill unless I know exactly what it is. I use the pharmacist if needed and I look a lot of stuff up on the internet. And do the patients real favor and document these incidents and forward that information to your manager. It is your job to protect patients from harm and you have a duty to report unsafe care under your license. Some of the nurses that I work with are wonderful and we are able to figure out things together, but there are some nurses that I would never ask a question of. It is a lot to keep up with and you have to be really careful.

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Specializes in Family Nurse Practitioner.
We have one on our unit. Her patient care is terrible. Instead of trying to improve things, she lies to cover her butt. The worst part is that she doesn't seem like she cares one bit. She's been spoken to, written up, etc. She just doesn't care. That's part of the reason I think she's dangerous.

and why then has she not been fired or terminated or promoted to an administrative position ? Would you care to elaborate for me on that situation ?

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