To do, or not to do.....

  1. Hi everybody....
    i come bearing a problem from yesterday at work....(with a happy ending....yay)

    They're sending home one of my patients next week with insulin for the first time... He's s/p L sided CVA with minimal residual...
    for 2 days, I've been teaching the patient how to self administer the insulin... I've also included teaching the wife exactly the same things as the husband....

    One of the other nurses (mind you, I know this nurse, albiet an RN... the same one who didnt want me to go to ER after a high risk needlestick b/c he didnt wanna cover my patients... I know he's an idiot.) insisted that when i brought in 3 sterile insulin syringes, one for me, one for the pt, and one for the wife, and 3 bottles of sterile water for injection that would expire the end of the month to practice how to draw up into the syringe and measure the amounts that it was unsafe, and dangerous for me to do that... and that it was homecares job to teach it...
    I blew him off, saying 'Well, I"ve got 20 minutes, I can do this...'(what a lie... what a lie)
    45 minutes later, he and his wife were doing an excellent job... I fielded all their questions... and then junked all the used sharps and bottles...
    That night, The patient self administered his insulin for the first time, start to finish... no problems...

    I personally think that it would be less safe to send this dude home without the practice and education I gave...
    but.. now in addidtion to the first problem.... NOBODY is following up... i ask the pt 'did the morning nurse let you give your own insulin' and he said that the nurse didnt let him, as it was faster... I know 5 mins is time... but damn... c'mon...

    My question, is, what should I do about the first nurse?? I nearly slugged him once for Pure stupidity(after the hiv+, hbv/hcv stick...)
    and now, I just wanna avoid him like the plague.

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    About CashewLPN

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  3. by   P_RN
    You were not wrong. You did great.

    The other nurse is a ***. Don't slug him, it won't knock any sense into him and you might cut your knuckles.

    You DO GO to the ER and you DO attach a note to the NMs copy of the occurrence report that Mr. X stated you couldn't go. Oh and don't you DARE clock out to go to the ER.

    Next time attach a sticky to the MAR and an entry on the Kardex that says....
    "Patient WILL administer own insulin. Document in nurses notes."
    I'm proud of you teching this patient. It took a little time, but you did what needed to be done. Keep it up!
  4. by   frustratedRN
    you did a GREAT job and should be damn proud of yourself. thats half the problem these days...nobody has the time to teach and that includes the docs!
  5. by   cmggriff
    You did the right thing as I am sure you already know. Except, I would have hit him. Not with my knuckles, since that can lead to a nasty cut. Instead I suggest you smack him with and open hand. This is very humiliating for any male and will not usually leave a bruise to be photographed by his attorney. But then I am a violent person Gary
  6. by   aimeee
    Originally posted by cmggriff
    ...Instead I suggest you smack him with and open hand. This is very humiliating for any male and will not usually leave a bruise to be photographed by his attorney. But then I am a violent person Gary
    Gee Gary, if she does that she might just knock what little sense he does have clean out of his head!

    Barbara-its great that you took the time to teach! I agree 100% that the earlier you begin the teaching and the more practice they get before they go home, the better. Maybe if you see the Dr. you can get him to write the "observe self-administration" as an order and that will improve the follow through with the other shifts.
    As for the idiot, well, no suggestions there. He sounds like a really lazy selfish SOB. CYA and avoid him sounds like the course to me. You surely aren't going to change him.
  7. by   kewlnurse
    You go Barb, CM is right except use the back of the hand, we call that a "b$%#H slap, very humiliating. Personally when i want the other nurse to follow up and stuff i write a telephone order from the md such as :Pt to administer own insuline, document progress" than write it in the mar. I do the same thing wiht dsg changes if i notice they aren't being done.
  8. by   CashewLPN
    thanks guys... its just been a bad week...

    talked to the manager, she inserviced nurse x....

    feel better now...

  9. by   Walter R. Hobbs
    That guy (the other RN) is a waste of skin.

    Know that you made a difference in that couples life and they will probably never forget it.

    Frequently RNs MUST take that x-tra time to serve the needs of a pt. or family.

    This is what the public does not see but what the individual will always remember.
  10. by   radnurse2001

    You exemplified what it means to be a nurse. If that patient had gone home not knowing how to administer insulin, and home health could not get there until the next day, the patient could have been in a lot of trouble. Teaching is the one thing I loved to do when I was a staff nurse. It was one of the things that made a measurable difference. you could see the positive outcome.

    My hat is off to you.
  11. by   kamand4kids
    I think you did a good job with the situation. as nurses it is our job to make sure our patients get the adequate knowledge they need to know to do these things for themselves. I know him and his wife appreiciated your thoughts and concerns. but for that first nurse he has some major problems. somewhere along the line he has forgotten why we all became nurses. everything is for the patient . to make them feel welcomed and safe .so when they are discharged they have the knowledge to keep themselves well.
  12. by   frustratedRN
    i found that a lot of nurses arent concerned about patients caring for themselves after discharge. they just try to get through the day as quickly as they can. no time to teach. they arent thinking that if we teach patients to care for themselves they wont be back as often as they will have less anxiety and complications.
    knowledge increases complience.
    a perfect example of this is feeding. countless times ive seen nurses and assistants feed patients that should be ASSISTED. its just faster to feed them than to let them try to do it themselves. and its far less frustrating.
    with all the focus on teaching while i was in school i was dismayed to find so little available on the unit from hell in regards to teaching materials. it just doesnt seem important to keep these materials stocked. this is why i end up on the phone and running around the hospital rounding up materials for the patient who just "doesnt understand"
    the other nurses seem to think im "wasting time"

    knowledge is power. i am empowering the patient to care for themselves. in the long run it will be less work for me.
  13. by   TracyB,RN
    Yeaaaaa Barb Now, if we all just close our eyes & imagined that we had time to teach all of our pts . . . . . .

    Ooops, WHAT AM I THINKING?!?!?! Reality can really suck sometimes