Having another nurse check insulin doses & other med Qs

Nurses General Nursing

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Virgo_RN, BSN, RN

3,543 Posts

Specializes in Cardiac Telemetry, ED.
Do most people here still Draw up insulin in an actual syringe?

I'm quite certain that would be a yes. Diabetes, oral agents, and insulin were covered very thoroughly in the nursing program that I graduated from, and rightly so. Diabetics make up a significant portion of the patient population in both acute care and LTC.

*ac*

514 Posts

"Do most people here still Draw up insulin in an actual syringe?"

I assume this post refers to insulin pens.. Personally, if someone comes in with their own insulin pen I still draw the dose out with a syringe. Have seen too many high sugars after administration with a pen that my person conclusion is too many times the needle on the pen is not getting under the skin well enough. Just my opinion.

Maybe the needles weren't primed first.

I really hope you aren't giving the patients their pens back to be used as intended, because once you draw out of a pen cartridge with a needle, then it IS inaccurate because the plunger of the pen hasn't moved - there's most likely air left in the cartridge.

zebsmom2002

91 Posts

This seems somehow strange to me. I've been a nurse for over 30 years, and have always had to have a co-signature for insulin (sq) and heparin. now most facilities require it for quite a few other meds, strangely enough including po's-warfarin & tamoxifen (anti-coag + chemo, respectively).Yes, it's a pain. Then again, I was on shift when a nurse gave 20 units of reg insulin instead of 2.

kate45

4 Posts

I am an LPN and I worked in a long term care here in Edmonton, Alberta .I have 36 residents to give medications to and I have 5 residents with insulin and yes we have an RN who is covering 4 other units who will have to check with me everytime I withdraw the insulins. It's quite frustrating though to wait for a long time for the RN to come. While in my other facility, I also have 32 residents to give medications to and I have 4 residents with insulin but we're using the pen instead of the regular insulin syringe, so we don't have to ask the RN to check with us when giving the insulins.

zebsmom2002

91 Posts

Interesting, we have to check with the pens too. Lucky you! I'm so jealous!

AmericanChai

1 Article; 268 Posts

I'm a block 1 student and we were taught that insulin and heparin are high alert drugs, meaning you do indeed have to ask another RN to double-check math, the MAR, and watch you draw it up. I also know that when administering opiods, if there's any left over you have to ask another RN to watch you waste it.

Specializes in ER.

We have to do this at our hospital, and it is a TOTAL waste of time. Not only do you have to find a cosigner for insulin, but for Heparin, coumadin, ivp narcotics.....it's getting a bit silly. It takes forever to track someone down, as we have "electronic med administration".....a computer on wheels that we have to drag up and down the hall with us to beg a coworker to sign in. Another one of those "super-duper great ideas" thought up by people who haven't passed meds in 20 years...if ever. They never stop to take into consideration how much extra time gets eaten up by their bright ideas..and just last week I got to write up 3 nurses, a PA, and a pharmacist for sending me a patient on a heparin gtt at 2.1 ml an hour-yep, the pt got 1/100 of the dose she should have...BUT, hey , it was all cosigned!!!!!:mad:

zebsmom2002

91 Posts

We have to do this at our hospital, and it is a TOTAL waste of time. Not only do you have to find a cosigner for insulin, but for Heparin, coumadin, ivp narcotics.....it's getting a bit silly. It takes forever to track someone down, as we have "electronic med administration".....a computer on wheels that we have to drag up and down the hall with us to beg a coworker to sign in. Another one of those "super-duper great ideas" thought up by people who haven't passed meds in 20 years...if ever. They never stop to take into consideration how much extra time gets eaten up by their bright ideas..and just last week I got to write up 3 nurses, a PA, and a pharmacist for sending me a patient on a heparin gtt at 2.1 ml an hour-yep, the pt got 1/100 of the dose she should have...BUT, hey , it was all cosigned!!!!!:mad:

don't you just LOVE having to push the cart into a pt room, scan the pt, then scan the med, then wander the halls trying to find someone to co-sign, then the computer times you out....so you have to go back & scan the pt & start all over again. Particularly frustrating with tamoxifen & coumadin po.

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