No more glucose checks by CNAs/PCTs

martymoose, BSN, RN · Apr 14, 2014

I was told it was because nurses are basing insulin dosing on this , so UP cant do the fsbgs. We've had to do our own bgs for a few years nowIt stinks, esp. when every one of your pt';s is diabetic.

But if one's using that same reasoning, I guess we shouldn't be basing b/p meds on vs obtained by UP also.

Obviously there was some big mistakes made re" insulin.hence the nurse only checking and dual sign offs.

Paws2people · Apr 14, 2014

That's what I was thinking. That some big (or many small) mistakes were made, hence this new rule. Thank you.

tokebi · Apr 14, 2014

But if one's using that same reasoning, I guess we shouldn't be basing b/p meds on vs obtained by UP also.

Actually, I do re-check BP myself, sometimes manually even, before holding routine BP meds or giving PRN BP meds. It's not that I don't trust UAPs, but I just want to make sure the original number wasn't a machine error or positional.

As for glucose checks, I never worked in facilities where UAPs were able to do them for us. So I envy you if you have enjoyed the convenience, even if short-lived.

applewhitern, BSN, RN · Apr 15, 2014

In every hospital I have worked, only a nurse could do finger-sticks. We have tried to get administration to let our techs do them, but no go.

jadelpn, LPN, EMT-B · Apr 15, 2014

In my neck of the woods, it has to do with then what does the UAP do with that information? If someone has a low FBS, they need immediate intervention. Based on variables. ie: Is patient NPO for surgery, for instance. So a UAP can know that a FBS of 60 is low, but to then go ahead and give the patient oj when perhaps they are NPO is an issue. Or that the FBS is 300. but the patient is eating breakfast before the RN can get to the patient and give them insulin.

If someone is a patient in acute care and they are on BP medications, and the BP that the CNA obtained is way out of the normal for the patient I would re-do it before giving meds. It becomes an issue when the UAP doesn't report vital signs that are low or high.

morte, LPN, LVN · Apr 15, 2014

follow the money, if the UAs are not "certified" to perform the function, it is not billable.

Paws2people · Apr 15, 2014

Thanks for various replies. Some of the nurses are upset with this. Particularly the day shifters, as they have two meals (equalling more glucose checks) on top of all their other daily madness.

I'm surprised to see doing your own finger sticks is the norm. Here I thought NY was so "sophisticated" lol. Meanwhile everywhere else is ahead of us on this one. Thanks again :nurse:

NOADLS · Apr 15, 2014

Been doing all of the checks myself and would be uncomfortable with CNA's doing this anyhow. Better practice since I am the one giving the insulin. If a CNA messes up taking a blood sugar and I give a dose of insulin based on an incorrectly taken blood sugar, I am responsible.

nynursey_ · Apr 15, 2014

I also practice in NY and our PCA's are still very much allowed to check FSBG. It could be your facility's policy.

KelRN215, BSN, RN · Apr 15, 2014

Our UAPs were not allowed to do them when I worked in the hospital, either. It was RNs only. Honestly, our UAPs were known to make up blood pressures and temps or to ignore severely out of range vitals (like a temp of 39.2 C in an Onc patient) and not chart them for hours. We wouldn't have been able to trust them to do fingersticks.

ThePrincessBride, MSN, RN, NP · Apr 15, 2014

I'm an aide, and I think that is just stupid. At my place of work, we scan the patient's wristband and when we dock the blood sugar, it automatically loads up into the patient's lab values. We immediately inform the nurse of blood sugars and if it is low, unless the patient is NPO, we are allowed to give them something.

By that same logic, aides shouldn't be allowed to do any vitals either. More work for the nurses!