Nurse considering Insulin Pump???

[coffeeluvr]

Hi, I'm an new RN in the ER and absolutely love my job!! :heartbeat It was my dream to get right into ER after school and am still in disbelief that it happened! Now that it's real, I wanna be the best nurse I can be...I luv to be that energetic nurse that greet patients in the ER with a big smile and goes above and beyond for them just to make their stay a little bit less begrudging. I don't even mind when patients in the waiting room coming yelling at me that they've been waiting 9 hours...that's my cue to figure out a way to cool them down and ease their frustration.

That being said, I've had type 1 diabetes for 8 years now and have definitely had my share of ups and downs. Getting through 4 years of nursing school was hard, but now being a nurse working 12 hour shifts both days or nights is a whole new ballpark. Anyone working in the ER knows that it's not uncommon to miss breaks or practically run for 12 hours straight...don't get me wrong I'm not complaining, this is the kind of nursing I wanted and the environment I thrive in! However, it often becomes a struggle for me when I don't feel up to par myself and know my blood sugar levels are bouncing all over the map. I'm not going to get into the reasons why...anyone familiar with diabetes know how sensitive this condition is and even the most conscientious person simply cannot maintain perfect control.

Soooo...I've been thinking long and hard about going on an insulin pump. Most of what I'm discovering about these things are that they are full of pros and only a few cons...I really like the idea of continuous glucose monitoring and setting your own personal ranges. I think that this feature alone would eliminate a huge heep of my problems!! I don't like the fact that it is attached to you all the time, but my purse (with supplies) always has to be within range of me now anyways so really I'm sure I could get used to it.

Just wondering if anyone else is in the same boat and wears an insulin pump. Are they better for shift work? Do you have better glucose control despite your hectic schedule? Do you feel refreshed in the morning after a night's sleep or does that all too familiar groggy feeling from irregular blood sugar levels still haunt you? Is it a hassle if I wanna go for a spontaneous work-out at the gym or do I have to cross my t's and dots my i's still before I go?

Any advice would be great!!

[RNMeg]

I'm a nursing student, and I'm not diabetic, but my fiance has been a type I diabetic for about 8 years also. He uses an insulin pump, and it's fantastic. His blood glucose levels are more stable than they ever were when he was on injections, and dosing is a lot easier..we all know how hard it is to draw up 1.6 units of insulin (for example), but if that's what his blood glucose level requires, that's what it'll push in.

One part of your post confused me, though..are there pumps now that do continuous glucose monitoring? I've never heard of an insulin pump that does that (at least, none that are covered by medical insurance..most are experimental at this point, from what I understand).

Overall, I think insulin pumps are a godsend for type I diabetics. Perhaps some nurses who are type I diabetics can weigh in about the shift work thing, though. I don't think it'd be a problem, but I don't know for sure :)

[Spritenurse1210, BSN, RN]

We're not supposed to offer medical advice on here. MHO, if you don't keep yourself healthy then you won't be any good to your patients. If you think getting an insulin pump is the best option for you then by all means, go to your DR and have a chat with him/her and see if this is the best option for you.

[DDRN4me]

i am currently training for a pump with one of the kids i care for.

from what her CDE tells me. they are a great options. One of our clin specs has one and he says it was the best thing that he did. I think you should call your endocrinologist to discuss!

[Hoozdo, ADN]

I wasn't aware that there were pumps that also did continuous monitoring either. I would be very interested in hearing more. I thought they were still in the "experimental" phase.

I must say it is very challenging to run for 12+ hours, not knowing when or IF you will be able to eat and keep glucose levels in check. It can be very precarious if you run low and need to take time out to glug down some soda pop to get your glucose up to a functional level when you have an extremely busy assignment.

I tend to under dose on insulin on nights when I am working and keep tight control on my 4 days off. It's not ideal, but the best I can come up with.

[RedCell]

I wasn't aware that there were pumps that also did continuous monitoring either. I would be very interested in hearing more. I thought they were still in the "experimental" phase.

I must say it is very challenging to run for 12+ hours, not knowing when or IF you will be able to eat and keep glucose levels in check. It can be very precarious if you run low and need to take time out to glug down some soda pop to get your glucose up to a functional level when you have an extremely busy assignment.

I tend to under dose on insulin on nights when I am working and keep tight control on my 4 days off. It's not ideal, but the best I can come up with.

The Minimed Paradigm offers continuous glucose monitoring. Right now this is the only insulin pump to provide both. Also, another option is to obtain a Dexcom. This is another device that provides continuous glucose measurements (q 5 minutes) but is not integrated with a pump. The nice thing with these devices is that you can program them to provide an audible alarm at a set high and low glucose. This can be especially helpful at night when sleeping. I have found both to be fairly accurate when compared with the patient's CBG. The only downside is that the sensors usually have to be changed within 7 days or so depending on which company you choose.

[coffeeluvr]

I think that pretty much makes up my mind about it, and I'm definitely willing to give the pump a go.

...and yes, just like RedCell explained the Minimed Paradigm pump has the continuous glucose monitoring which seems to be a fanastic little feature for conscientious diabetics. It also lets you know how fast your blood glucose levels are either spiking or dropping, giving you the heads-up on a plan of action should you need one.

Thanks everyone for your thoughts...I'm almost a bit excited to start on the pump!

[blondy2061h, MSN, RN]

I've been on a pump for three years. It's fabulous, and I can't imagine doing nursing (or college) without it. I love my pump (as much as one can like something like that).

My blood sugars are much more stable than they were before. Being able to adjust basal rates to when I need the insulin is a life saver. Being able to suspend my pump if need be is a life saver.

That being said, I still can't go 12.5 hours without eating without major consequence. I pack food in "snack sized" zip lock bags and eat one in

I can honestly go on and on about the joys of a pump. It's HUGE. It is expensive if you don't have insurance. It can be a drag to wear it all the time. I had holes sewed in my scrub top pockets and leave my pump in the pocket and thread the tubing through the hole.

I used the continuous monitoring system for about 6 months. I DON'T RECOMMEND IT. What a nightmare. It's extremely expensive and rarely covered by insurance at all. I got lucky and did get mine covered. It was extremely inaccurate and useful for nothing. I was testing >25x some days just to verify the constant alarms it was throwing randomly. It said I was low or high all the time and I rarely was. It woke me up constantly with these alarms. Minimed was no help at all in getting it to work better. It truly made me hate my pump and I was ready to throw the damned thing out the window. Gah. It was also extremely irritating on my skin. The white dongle bit has no tape of it's own so you get to play with IV3000 constantly trying to get this $1000 device to stay taped to your abdomen. I know it sounds very appealing. I wish it worked well. It doesn't. From what I've heard, Freestyle's new Navigator seems to have much better accuracy.

I recommend you check out John Walsh's book "Pumping Insulin."

Feel free to PM me or ask any questions here.

In short, pump = good, cgms = hellish.

[coffeeluvr]

Wow, that was pretty informative. Good to hear it from someone on a pump firsthand rather than each company trying to market there pump as the best. I'm definitely going to research them all well before I make a choice! Thanks again!