Never felt so helpless in my life!!!! LONG

[AngelfireRN, MSN, RN, APRN]

I held off on posting this for a couple weeks, since I was so rattled by the whole experience, and since you just never know who may be reading here and recognize someone. However, since this story is ALL OVER work now and anonymity is pretty much out the window, I wanted to get some feedback.

2 weeks ago, I worked the evening shift at my plant. I was the only nurse there. At shift change, a lady came in for ibuprofen, and signed her name. This was a blessing later, since that was the only way I knew who she even was.

I was sitting in my office at 1630 when I heard the outer door hit the wall -BAM!- and someone start yelling "Hello, hello!". I ran out to see Ibuprofen Gal, flanked by 2 coworkers, diaphoretic and sweaty, saying over and over, "I need a tablet, I need a tablet". One look, and I knew she was having an insulin reaction. We had no insulin tabs, we had gel, so as I am running around the counter with the meter, I sling a tube at her. She picks it up and goes, "Ew, I don't like this", to which I said "Deal with it".

Her sugar was 77, came up to 113, and the shaking stopped. She was out of tabs, and I gave her my last 2 tubes of gel, and made her turn off her pump. She refused to go home, said she did this all the time, she was just not used to B shift (1430-2230). Against my better judgement, I let her go, with instructions to come back if she felt funny again.

I could not find any more gel, all I could find was some fast-food jelly packs that I put in my pockets. I must have ESP, I just KNEW it would not end there. Ever have a gut feeling? Called the day nurse to ask where more gel might be, called my sup to tell her what happened, and was in the midst of ringing her when the lady's sup walked in.

"Can you come take a look at her?"

I walk out, and she's shaking like a leaf again. OK, now I'm worried, and I tell her she's going home.

"No, I'm not!!!!!! I just need to eat, I get like this, I need to eat."

Her sup tells her to go eat, and I get her bag and invite her to eat dinner with me, mainly so I can keep my eye on her. She stands up and WHUMP!

As we're running to Medical, (me and the 2 men that are carrying her) we pass Security, on her golf buggy for her rounds. I yell, "I need an ambulance!", and she whips a U-ey and speeds off.

Meanwhile, we get Low-Sugar Lucy on the trauma table and pour the gel and OJ to her. She's arguing and refuses to give us her # to call her hubby, and her cell is in her pocket. ( I know the arguing is the sugar, and allowed for that) The guys all looked at me to get the phone, but I was not going to get slapped with a sexual harassment charge for trying to dig a phone out of skin-tight jeans. As luck would have it, hubby called about then. She spoke to him, and handed me the phone.

"Here, he'll tell you I get like this and I am fine."

"Hello, hubby? This is Angelfire. Yes. Yes. Well, I am not releasing her to work nor am I to drive home. Can you come and get her? An ambulance is on the way, but she says she will not go. Yes. Well, she can't stay conscious. Yes. I believe she needs a dextrose infusion, and I cannot do that here. Well, I don't know who will pay for the ambulance, sir, but I can find out and let you know ."

The ambulance gets there, she refuses it, and 5 minutes after they leave, while we wait on hubby to pick her up, she has the first seizure. i have no IV supplies, no intubation supplies. All I can do is lay in the floor with her and the sup and hold her, protect her airway, and time the seizures. 14, count 'em, FOURTEEN seizures later, the EMS crew gets there, loads her up, and gets an amp of D50 in. She perked right up. Off to the ER she went. If she had tried to refuse at that point, I believe I'd have strangled her, lol!

About that time, Security said, MY sup called and said to tell me that she was on her way, that she was taking her time, since I was as good as an NP, and she knew I could handle it. All I could think was, "Thanks for the vote of confidence, now GET YOUR BUTT IN HERE!!!!!!!!" I just needed moral support at that point. Well, that, a 55-gallon drum of Mountain Dew, and an Ativan the size of a hockey puck.

Anyone else ever do anything like this? Anything else I should have done? By all accounts, everyone says I did well. I know she could have coded on me, she should not be working at all in her condition. I just can not stop thinking about it. Thanks in advance.

[FireStarterRN, BSN, RN]

Sounds like you did a good job.

[TopazLover, BSN, RN]

Wow. Sounds like you did a great job. Pat yourself on the back and know that most of us have never had to do that, you did and could. Certainly you may have felt helpless. Seizures always make us feel helpless, if we don't have a pocket full of IV meds,etc.

Good job.

[CHATSDALE]

i once worked with a cna who would show sx of hypoglycemia if her bs diped to the 150 range because she was usually 200+

i don't know what you could have done other than what you did. i hope that it will not repeat itself if she comes back to work

good luck

[ohmeowzer RN, RN]

holey moley.... what a day..... you did a very good job and give yourself a hug for me.... i've had many incidents that i couldn't get out of my mind.. eventually i think other things that i couldn't get out of my mind and took the place of .... well you know....lol.....

you did a excellent job with the crazy time you had... you are awesome...

[Dolce, RN]

That is really sad that she was having that kind of hypoglycemic reaction with a BG of 77. I wonder what her glucose normally is!

I think you did an awesome job! You did everything you could but she was not being very compliant. I hope she thanks you and apologizes for not listening. I'm glad nobody got hurt with all the antics going on!

[Spritenurse1210, BSN, RN]

Well done, well done! You did great!

[AngelfireRN, MSN, RN, APRN]

Her sugar was 77 after the gel, she started seizing at 140. No idea what it norally runs. And the only one hurt was me, I threw my back out picking her up and putting her in the floor when she had the 1st seizure in the chair. All my help was in the hall Monday-morning quarterbacking the situation when all that started, lol.

[Dolce, RN]

Sorry you threw out your back. I was kind of wondering how nobody could have gotten hurt in that whole fiasco. What a mess! I hope she is able to get better control of her BGs so that she doesn't put everyone else at risk!

[stefano]

good job angelfire!

[veronicajr]

I think you did great! You can only do so much, people have their right to refuse I guess. Maybe next time she'll listen to you.

[oldladyRN]

I have to chime in and put in my 2 cents.

Without knowing any more about this lady (and I don't want to get jumped on for sounding "judgmental"), it does sound as though she is extremely non-compliant. I think you did a fabulous job, and my hat's off to you. Just reading about what all you did made me so proud, and I don't even know you. It sounds like you kept a really cool head and handled everything perfectly.

With that being said, this lady's a disaster waiting to happen (again, but worse). You said she's got a pump, which I am assuming is an insulin pump. Either her dose needs to be changed, or she needs to eat WHAT she's supposed to eat/WHEN she's supposed to eat it. She's obviously been down this road before, guaging her reaction to having to swallow the gel. I don't know what kind of company this is, but think about this happening *if she's working with something very sharp OR *if she's working with heavy machinery. I don't feel as though this is a safe place of work for her or for her coworkers. Are pre-employment or annual physicals required? I do know that in my state of residence (Texas), many positions require a Department of Transportation physical (pre-employment). You can't even BE diabetic and hold certain certifications, even if a HA1-C shows a history of good control.

This lady is either gonna get hurt and sue the pants off of your employer or hurt someone else, who's gonna sue the pants off of your employer. Either way, she's an accident waiting to happen.

Good luck to you, and again, Great Job!!!