Lame mistake, stupider question

theatredork · Feb 16, 2008

I think you're worrying too much. As long as you wore gloves, and the lancet was new, I think the patient will be fine. Just think of it as a paper cut.

In fact, instead of using alcohol, I usually tell diabetic patients to just wash their hands with soap and warm water, so they don't dry out their fingertips from constantly using alcohol pads.

nightmare, RN · Feb 16, 2008

I'm a diabetic and never use alcohol wipes! Don't worry about it.If you want to, check with your wards policy on testing to make sure then you won't make the same mistake again,it's all about learning!

lushka3661 · Feb 16, 2008

Much appreciated.

Pediatric Critical Care Columnist · Feb 16, 2008

Alcohol can skew your results, if it isn't completely dry before you collect your sample. The risk of infection is pretty small, unless the patient was one of those that "picks" at himself.

A single elevated level does not = diabetes. You say you never noticed anything on the chart to suggest diabetes; is the patient receiving corticosteroids, or being physiologically stressed by the illness or treament for which they were hospitalized? Look at everything in context and you'll have fewer of thsoe panicky episodes.

jjjoy, LPN · Feb 16, 2008

Great question! Too often we feel discouraged from asking "simple" questions but how else will we know? I wish more people could refrain from scoffing, eye rolling, etc in regard to what they consider "dumb questions" ... oh well, I guess I just need to continue working on thickening my skin!

Daytonite, BSN, RN · Feb 16, 2008

Hi, lushka3661, and welcome to allnurses!

Just wanted to let you know that there are forums for nursing students on allnurses. You find them by clicking on the "Students" tab at the top of any page of allnurses. You will find all kinds of helpful weblinks in the sticky threads to help you with your nursing studies. You will also find a lot of support and understanding from other students just like you.

Pediatric Critical Care Columnist · Feb 16, 2008

Great question! Too often we feel discouraged from asking "simple" questions but how else will we know? I wish more people could refrain from scoffing, eye rolling, etc in regard to what they consider "dumb questions" ... oh well, I guess I just need to continue working on thickening my skin!

The only stupid question is the one you don't ask... my mantra when precepting new nurses and when dealing with family members who are overwhelmed with information.

Little D · Feb 16, 2008

Hi, I am a nursing students who is greener than green. I needed to get a patient's blood glucose before I went home. Simple procedure. Went home. Then I realized, I forgot to swab the area with alcohol before pricking the skin. I feel dumb because I do not know for certain if the patient is a diabetic. I mean, I got a 13.5 level so I would assume diabetes, but I don't recall ever seeing it when I briefly went over the patient's chart. I guess I am a little concerned with infection. I know it is just a small prick of the finger, but could it get worse or am I worrying too much? Lush

Like you, I am also new and green. I am a nursing student, and in my experience so far, I have been told that using alcohol pads, or even if the patient uses Purell before performing the blood glucose testing, that it can actually cause the reading to be inaccurate and too high. Apparently, it is better to just rub the site with a clean, dry tissue before lancing it. I don't think it is anything to be worried about.:)

loriangel14, RN · Feb 16, 2008

I was taught NOT to use alcohol, just make sure their hands are clean.

jjjoy, LPN · Feb 16, 2008

The fact that medical practice is ever-changing means that we need to be tolerant of different practices and evaluate them on their own merit and not immediately assume something is unsafe is it's a little bit different than the way you do it. And it should be okay to inquire about the difference without being felt to made stupid.

One problem I had with nursing school was that any deviation from what the instructor/text taught was usually considered *wrong* and was discouraged with the same degree of vigor as life-threatening mistakes. Thus, if you set up a foley cath kit in a different order (that didn't break clean technique) you'd fail the task. Yes, following directions precisely is important, but understanding clean technique & practicing it without needing step by step instructions is even more important.

There is "more than one way to skin a cat" and it's useful for nurses to accept that so they don't waste time quabbling over the *right* way to do something that's not that crucial.

In this case, the main issue is that the fingertip is clean so that the lancet doesn't introduce contaminents under the skin or throw off the results. Alcohol swabs have long been a way to clean the skin surface. Is it the *best* way? At one point, it may well have been considered the best way. The latest I've heard is that soap and water are better. But for all know, there may have been a study published somewhere that this or that certain soap should be avoided and that's what we use at my facility... so no reason to be overly nit-picky when there's neglible difference in th relative risks of the alternate methods.

Also, nurses should be using all of their assessment skills. So if the blood glucose measure is off due to an unknown problem (maybe alcohol hand rub contamination) other patient assessment should cue the nurse into the patient's condition and not just rely solely on the glucose reading.

lsyorke, RN · Feb 16, 2008

I'm a diabetic and never use alcohol wipes! Don't worry about it.If you want to, check with your wards policy on testing to make sure then you won't make the same mistake again,it's all about learning!

Hubby is the same way. The alcohol created more problems than the finger stick.