Implications for the administration of insulin

[Blackheartednurse]

I have a couple of questions regarding insulin administration.. I was hoping that some of the nurses out there can share their experience...

Ok so I know that diabetic patients have orders for the short acting insulins before their meal time...I wonder if most of the nurses actually administer t insulin after the meal has arrived and they saw it served with their own eyes? Or you are you too busy to check on the arrival of the meal and administer insulin,leave orange juice on a bed-side table and instruct the patient to drink it if the meal arrives late and the patients starts feeling shaky and weak...I was just wondering what are the techniques of handling of the working nurses out there? Also is it a safe practice to leave orange juice on on the bed-side table next to the diabetic patient..

[Pepper The Cat, BSN, RN]

I don't give the insulin until the meal has arrived.

Of course, as we practice Total Pt care, I usually have to help the pt open things up, put the tray within reach, etc so this is easy. I never give short acting insulin until the meal is delivered - our dietary had messed things up in the past so I don't trust them!

As for leaving OJ at the bedside to take "just in case" this makes me nervous. The pt may not drink it in time, it may not be enough to raise the sugar, etc.

[BerryHappy]

Personally I wait until the meal trays are on the floor and starting to be delivered. I work at a LTC and have dozens of diabetic pts. I would rather be a little bit late with the insulin, than too early. I have NEVER left OJ at bedside, if I don't see them swallow it, I assume they didn't take it. That goes for meds, food, drinks, EVERYTHING...

[Virgo_RN, BSN, RN]

Our P&P states to wait until the meal trays arrive on the floor. I would either run and give the insulin along with any other dinner time pills, or deliver the meal tray to the patient myself and give the insulin then. The only time I ever waited until after the meal was consumed was if the person was a very brittle diabetic with a significant dose of SS insulin, or if the person had a poor appetite and often did not eat their meal.

[Blackheartednurse]

Personally I wait until the meal trays are on the floor and starting to be delivered. I work at a LTC and have dozens of diabetic pts. I would rather be a little bit late with the insulin, than too early. I have NEVER left OJ at bedside, if I don't see them swallow it, I assume they didn't take it. That goes for meds, food, drinks, EVERYTHING...

I run into a situations in which the dietary forgot to send someone's meal!!

[classicdame, MSN, EdD]

We never leave food or beverage, other than water, at bedside of diabetic patients (at least, not intentionally). We give rapid acting during or immediately after meal (within 30 minutes is recommended by manufacturer). We also instruct patients regarding our routine. We are acute care

I would think there would be some issues with leaving orange juice at bedside then instructing patient to take care of themself till I get back. Why not just leave the insulin at bedside and tell them what to do? Same issue to me.

[Not_A_Hat_Person, RN]

I work in an ALF, and residents eat their meals in the dining room. We can't give injections in the dining room. I always told residents to meet me in the med room on their way to the dining room. If they didn't, I would go to the dining room, find the resident, and have them come to the med room.