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No More Fingersticks for Techs!!

Posted

Specializes in Community Health, Med-Surg, Home Health.

Is this happening where you all are? I live/work in New York City and work in a city hospital, and in the past few months, the BON sent a mandate stating that techs, CNAs, PCAs, etc...can no longer do fingersticks...this is designated only to licensed personnel; LPNs and RNs. Now, I am hearing from other RNs working in private industry that they are still allowing their techs to do this. Last year, they just upgraded many of our CNAs to Patient Care Associates, which was supposed to include this skill, but, now, they are not allowed to.

In addition, it causes more stress to the nurses, especially in our prenatal diabetic clinic, diabetes, endocrine and medical clinics because there are more PCAs than there are nurses. Now, I can be backed up with 8 charts, trying to push them out, and then, here comes the page: "Fingerstick in room 10" and this can go on for awhile! I emailed the BON and straight from the horse's mouth, it was told that we can no longer allow them to do so. I suspect that a mistake was made, or something was probably not reported to the nurses which had determental affects on the continuity of care. I was just curious to know if any of you are confronted with this as well.

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 49 years experience.

It has not been OK in my state for a decade.

I was one of thousands who worked for this law.

Once before rations I had eight patients on telemetry. Six were diabetic. The CNA gave me a list of room numbers and accucheck numbers.

One was listed as 47 so per parameters he told me.

I went into the room with D 50, a standard protocol on that unit unless the MD orders otherwise.

The room mate of the patient who supposedly had the low BS was seizing.

I called the resident, did another accucheck, and when it was 39 gave the dextrose to the patient with the actual low glucose.

Nursing is a process, not just a series of tasks. The licensed person who does the fingerstick (or any bedside lab testing) must be the person to respond to the result.

I think you need more nurses.

Good for the BON!

LHH1996

Specializes in Acute Care/ LTC. Has 13 years experience.

i don't know what the laws are in ohio..but i was suprised to see that the PCA was doing fingersticks to my roomate when i was in the hospital this past weekend. (i work in long term care and only nurses do it).

i am actually suprised it is allowed. i too, am interested in what other nurses think about this and what their experiences are.

Neveranurseagain, RN

Has 26 years experience.

"Nursing is a process, not just a series of tasks." per Herring....

Great statement!!! Thanks for working for this law...

chicookie, BSN, RN

Specializes in Peds Hem, Onc, Med/Surg. Has 8 years experience.

That sounds horrible to me! It does sound logical though. I guess I am spoiled. Usually while I am doing my assessments the CNA comes in and does it, then lets me read it right there and then. But my floor has really awesome CNAs' that are on top of everything. It makes it easier for me because its one less thing for me to be running around for.

Herring did make an excellent point though........

I am ambivalent........

shugrr22107NA

Specializes in HH, SNF, LTC, Hospital. Has 2 years experience.

I'm a CNA and we do the accuchecks for AC&HS pts. My usual Pt load is 8-11 pts and if there are alot who require it can be pretty daunting to get the numbers to the responsible RN. If I have alot to do, I begin a little earlier but then I can chart it in the system (HED) in case my RN is tied up passing meds, etc.

It's my responsibility to get that to the RN ASAP for a blood draw if there is a noteable High or low reading.

I am happy to have good relationships with my RNs. We work as a team and good communication is a key element.

Edit: I report ALL readings to the RN, then chart them per protocol

pink2blue1

Specializes in Med-Surg.

Techs have never done fingersticks where I work. Always been the LVN/RN responsibility.

I think blood sugars are an RN's responsibility

I think blood sugars are an RN's responsibility

I sure did them as an LPN.

catshowlady

Specializes in ICU.

Ohio here - I did them as a PCT for my nurses, and my techs do them for me now that I am an RN. I am OK with this. I can repeat the test or ask the tech to repeat it in my presence if I need to. I see little difference between an accucheck & VS as far as that goes - the tech does them and reports to the nurse.

ChristineN, BSN, RN

Specializes in Pediatric/Adolescent, Med-Surg.

The hospital I work at now (level one pediatric trauma center) allows PCT's to do fingersticks. All the other hospitals in the area that I did clinical at when I was in nursing school also allowed PCT's to do it. As a nurse working on an endocrinology floor, I am very comfortable with letting PCT's do blood sugars. They know the protocals, if it's high/low recheck immediately, if low let nurse know, and treat with 4oz of juice. We check blood sugars every 3 hours on my floor, so having PCT's to help is a Godsend.

We can't even let techs do our first set of vital signs, because our facility decided that we have to do a set before we delegate them according to a pump and pearl's interpretation of the practice act. It's getting to where the techs can't do anything. If the armband is scanned, then you can check who the blood sugar "really" belongs to. I can come up with a worst case scenario for anything that we delegate. That doesn't mean that we have to start acting like techs are incapable of doing things. And taking tasks away from the techs will NOT get us more nurses, it will just give more work to the nurses already there. Believe me, I watch it everyday at my hospital as we take away things the techs are allowed to do, but the ratios keep going up even as the workload goes up.

ETA: Agree with above, it's just like VS. If the number doesn't make sense for the patient, I can redo it myself. What's next, I can't trust the lab with my CBC? Do I need to go to the lab and run the bloodwork myself? Nurses CANNOT do it all! We have to trust other people to help out in caring for our patients.

boggle, ASN, RN

Specializes in Med-Surg.

Techs do fingerstick glucose checks here. Thank goodness! There are far too many to do at busy times in the shift for nurses to get them done without the tech's help. The computerized system helps avoid communication problems about who's blood sugar was what.

The glucometers are linked to the computer system. The glucometer scans the barcode on patient's writstband, so "Right Patient" is not a problem. Once the glucose checks are done, the glucometer is "docked" in it's holder. That's linked to the computer. The glucose reading, time, and patient is all immediately recorded in the patient record. Of course, the techs report their findings to the nurse, but the nurse verifies all glucose readings on the computer. The judgement of what to do about the Blood sugar reading is the nurse's responsibility.

Our techs do a great job. They use correct technique. (it's pretty hard to mess up a glucose finger stick!) Facilities need to work on making it easier to communicate the findings accurately, not add more tasks to the nurses shift.

crb613, BSN, RN

Specializes in Med Surg/Tele/ER. Has 7 years experience.

Nurses only at my hospital.

WalkieTalkie, RN

Specializes in CVICU.

75% of our patients in the ICU have Q1-2 hr glucoses, and if they are not Q1-2, nearly all patients have at least Q4-6 hr ones. Thankfully our techs do them. I couldn't even imagine trying to keep track of everything else I do and be doing hourly finger sticks. I certainly don't mind doing them if the techs are busy, but there are simply too many, especially when my patient is on an insulin gtt.

The techs take competencies/training on this, and know when to alert the nurse, and most of them are very good about this. The glucometer is also uploaded wirelessly and its results will show up under our patient's lab values in the computer. The techs also write them on a strip of paper taped to the inside of the patient's door. I rarely have problems with techs taking glucoses, and they are able to do them in a much more timely manner than I would be able to do... especially if one of my patients is occupying a lot of my time.

katgirl46806

Specializes in LPN. Has 11 years experience.

I use to think that this was okay until last Friday.I was working with another nurse and a QMA which for those that dont know is a cna who has undergone training on passing medications and has passed examination by the BON to be able to do so. I usually pass meds from 2 med carts and it is known to be the heavier med pass with numerous blood sugars, blood pressures, breathing treatments and a couple of gtubes,and temps that have to be done.I was responsible for her and they are suppose to notify the nurse of the blood sugars.Well I work in LTC and is reponsible for about 25 and about 8 blood sugars that get coverage,and are done before meals.She did 2 blood sugar checks. She told me of one but she left to help in the dining room I stayed on the floor to finish passing meds. I work evenings and dinner is served at about 545.She comes back at almost 630 and says oh by the way sos and so blood sugar was over 400 about 439 to be exact. My mouth about hit the floor.I know i should have been on top of that but i got extremely busy and i know thats no excuse but anyone who works LTC can attest.So I had to call the doctor and explain and she was thinking that the lady was having a hyperglycemic reaction which thank god she wasn't because of when i had called. So Ive learned my lesson and its fine to let them do that but it all depends on how competent that tech or QMA and if they understand the parameters involved.

DeepFriedRN

Has 8 years experience.

They stopped allowing techs to do them in our hospital a few years ago. (I'm in CA) It can get kind of crazy when in stepdown and all 3 pts have q 2 hr checks.

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