2 Nurses needed???

nightingale, RN · Mar 19, 2003

It is done at some of the hospitals I work Agency in. I am all for a second set of eyes and an extra signature. A lot of nursing is documenting and CYA.

MandyInMS · Mar 19, 2003

I'm not sure if it's a policy at our hospital or not.Years ago a lot of people did this..now hardly anyone does.I always double-check with another nurse if it's a med that's not given often/has to be calculated/or seems out of the norm....2nd opinion never hurts..better safe than sorry.

littlemack · Mar 19, 2003

It may be "old school" to verify insulin and heparin, but it only takes one mistake to ruin your future and also the life of the patient you are providing care to.

Most definitely heparin and insulin should be verified with another nurse and the orders should be as well.

bellehill, RN · Mar 19, 2003

As a traveler I rarely know what each hospital's policy is; however, it is a good personal policy to verify anything you aren't comfortable with. I always double check heparin gtt doses and lab results, insulin gtt doses and PCA pumps. As far as routine insulin I only verify if it is more than 8-10 units. There is nothing wrong with getting a second opinion!

JohnnyGage · Mar 19, 2003

It didn't used to be a policy at out hospital -- "old school" was the line of thought. However, after a couple of sentinel events, it is once again strict policy for both heparin and insulin.

I do find it amusing that we don't have to double check more lethal drugs, however. Maybe it's because heparin and insulin are so "routine" that more mistakes are made. The more unusual and dangerous drugs are more carefully checked by nurses. I dunno.

KC CHICK · Mar 19, 2003

We don't have a policy to double check at my facility.

Us nurses DO double check our calculations for our weight based Heparin protocol though. Have never seen or heard of any nurses that I work with double checking insulin w/other nurses.

...and always, if someone is uncomfortable with something they always know they can, and are very comfortable with, asking for a second set of eyes to look something over.

Anne

jemb · Mar 19, 2003

The last few places I've worked do not require doublechecking heparin or insulin doses. One of the educators said, "The nurse that gives the drug is responsible legally, so why do it?" (True, but what does that have to do with protecting the patient?)

Personally, I think it is just common sense to double check anything that is easily miscalculated, or that you are unsure of.

We always doublecheck our chemos, first with the pharmacist when we get them from the pharmacy, and then again with another RN before we give the dose.

JENZEL75 · Mar 19, 2003

Aymy facility we only jave to co -sign wasted narcs, epidural & pca set ups and blood products... An nurses we give alot of meds. that can be harmful if not deadly if given in the wrong dose.. If we check insulin and heprin that means w should have to double check every medication we give... b/c almost every med is harmful if given in the wrong amounts... where would we stop?

jenn

frannybee · Mar 19, 2003

After having to special a patient who had been given 10x too much insulin (40u instead of 4u) I always check with another nurse. The nurse who made the error was off for a month on stress leave even though the pt was fine. She hadn't had it checked because she was in a hurry to get home to her children. It doesn't have to be signed that it's been checked, but our policy is to have someone cast their eyes over the script and the syringe. Yes, all meds have the potential to cause damage, but these meds are particularly easy to get wrong if you're tired or rushed or just not thinking straight.

Sourdough · Mar 19, 2003

In the late 1980's there was a major incident at a hospital in Toronto involving Heparin and Insulin...Back in those days we had heparin locks, they had not yet figured out that NS was good enough. Well, 7 patients died because their locks were flushed with insulin instead of heparin. The containers looked similar and the colouring on the bottles was the same...needless to say, if they had been checked with another nurse, 7 people would still be alive (hopefully!)...the drug companies went into overdrive to change the packaging...but the fact remains that we are very busy and usually over worked, and mistakes could easily happen. LPN's at our hospital are now giving meds (everything except IV drugs), but as the RN, you are ultimately responsible...they never forget to double check their meds...med errors can have catastrophic repercussions...I don't know if any of the nurse in th US heard about it, but in 1981 a nurse was arrested and charged with the murders (by digoxin overdose) of something like 20 babies at the Hospital for Sick Children in Toronto...she was condemmed before the facts could be investigated, but ultimately she was not guilty but her family and life were destroyed...we had digoxin locked up in the narcotics drawer for a long time after that....it was a frightening time to be a nurse(I was a student nurse then doing a rotation on that unit, and I also lived in the Nurses residence at sick kids)...so, it is foolish to think that just because you"ve got your "RN" means you don't ever have to double check anything anymore...that kind of attitude makes you a very dangerous nurse... :nono:

CCL"Babe", BSN, RN · Mar 19, 2003

I've never heard of this policy. I have worked in several hospitals besides doing agency in several more. The only thing I've ever had to check with someone else is blood. I'm not saying it's wrong to do it, I was just kinda surprised. Safety is always key.

CougRN · Mar 20, 2003

Give me a break. If you don't have the sense to know that 40 units of insulin isn't a regular dose and you should check the order then you aren't paying attention. I do agree that having certain gtt rates checked with peers is a good idea. But come on now, do you really need someone to check your insulin dosage before you give it? If it is out of the ordinary then yes, check the order. But a normal dose of insulin you should be able to handle yourself. If you are in such a hurry to get home and don't stop to think about your patient then I hope I don't have to work with you. We all need to focus on our jobs and really think about what we are giving our patients. You shouldn't have to have someone else always checking your dosage. We are smart enough to know what is normal and what should be rechecked.