2 Nurses needed??? - page 5

We are having a "dispute" of sorts at our small hospital. For the longest time, we have not had a policy that 2 nurses had to verify amount/type of drawn up Insulin and Heparin. Many people think... Read More

  1. by   Hellllllo Nurse
    I have worked in LTC where the policy is two nurses check insulin, two sign off wasted narcs...But.. I was assigned as the only nurse in the entire facility.
    Guess the people writing the policies need to take a look at staffing.
  2. by   NotReady4PrimeTime
    In our unit ( a PICU), we are required to double-check and double-sign virtually ALL meds given, even PO meds. The current exceptions are ASA, acetaminophen, ibuprofen and vitamins. Every dose, every time. This is a huge problem at certain times of the day when there are few people on the floor, and when you're in isolation all by your lonesome. We've wondered what would happen if we had to tell our intensivist we couldn't sedate the patient who just self-extubated because there wasn't a nurse available to double check our chloral.
  3. by   bjfitzger
    I've drawn up one wrong insulin dose. When it was double checked it was found. We can all make mistakes and a little caution protects the patient, you and your employer.
  4. by   gwenith
    Double checking some drugs ain't just policy over here IT'S THE LAW! Especially "schedule 8 "drugs. Routine all hospitals have a policy that ALL IV drugs (including IV FLuids MUST be checked by a second person. Some hospitals it is policy not only for two nurses to check ALL drugs but to countersign that they have been checked (oral included) they double check the lot!
    Last edit by gwenith on Apr 3, '03
  5. by   Chaya
    Had the same problem as HelllllloNurse and Janfrn..Unwritten policy is for two nurses to check insulin syringes before subcu dose BUT the night nurses do the greatest numbers of fingersticks (about 12-14 at 7 AM) and there are only two nurses on the floor (and occasionally only one!). They are trying to give insulin as close as possible to breakfast, which is about 8, so they are usually doing it about 6:45, with the new shift coming on and redistributing the MAR's and patients all waking up SO this is when insulin syringes might not be double-checked, depending on how crazy it is...makes ya think.
  6. by   JillRene
    Hi! I'm new here! Love this site!!
    As for the insulin, I'm a Travel and per diem nurse, I've worked at different hospitals and it varys. Out of habit I get it double checked along with Heparin gtt calculations.
    Sad Story: My boyfriends mom broke her hip, went to Nursing home for 2 weeks after hospital stay for rehab. She was on sliding scale. LPN gave her 64 units Regular insulin!!! Do you believe this?? She stated she thought the u was a 4. I was so angry, never in my career have I given 64 units of Reg., and I've taken care of PT. on insulin gtts. My boyfriend had power of attorney so I told him to request a copy of chart. Here is the kicker, the Mar was typed, how could you possibly confuse a typed u with a 4. Needless to say with much sadness she was never the same after that, didn't recognize own family.
    Attorney was contacted, still pending.

    If it was up to me I'd have the LPN's job and license.
  7. by   jeanrnurse
    The last 3 hospitals I have worked at, as an Educator, had no policy on this, or have specifically eliminated it. We do regard it as "old school", & there are so many other drugs more dangerous. If you continue to do this for insulin, why not EVERY drug? It may be a good rule of thumb to double check those infrequently given or with unusual dosages, but putting it in a written policy sets the hospital up for litigation, if it is not followed in every case.
  8. by   KnitRN
    It may be old school, but my inpatient oncology unit required two RN's to verify insulin, heparin, IV narcotics, and chemotherapy.
  9. by   sbic56
    Originally posted by KnitRN
    It may be old school, but my inpatient oncology unit required two RN's to verify insulin, heparin, IV narcotics, and chemotherapy.
    I can see the logic if an institution wants to adopt the policy to include all potentially harmful meds (isn't that everyting?) but to have one in place just to check heparin and insulin? Definitely old school. Checking doses that require a calculation is a great idea though. It's well known that most nurses a mathematicallly challenged.
  10. by   Good_Queen_Bess
    In the NHS Trust I work in, ALL IV's as well as IM medication are double checked. Even "just" to give IV fluids. This is policy and there are trust guidelines written specifically for it. Two signatures are required.
  11. by   southernbelle36
    Originally posted by CougRN
    Do you all mean like in nursing school when your instructor looked at your syringe to insure you were giving the right drug and right amount? If so, wow, no this is not done where i work. Hopefully by the time you are a RN you can learn to give drugs without help.
    I don't know if you are trying to say that LPN's are incompentent to give medication without verification, but she was just saying that was their hospital policy. I don't care what your title is you still have to follow policy. In my 12 years of nursing I have seen ALOT of incompentent RN's and LPN's. I am an LPN and I am not ashamed of it. I would go up against your nursing skills anyday. People get their degrees according to life style, finances and many more things that can inhibit spending more time in college. Most of you RN's would not be able to function without us LPN's because then you would have to get up and do a little work.
  12. by   JillRene
    Hey Southernbelle, hold on now I don't think you want to go there. I'm not defending what Coug said, but for you to clump all RN's into one stereotype is just plain wrong. 90% of the hospitals I work at don't even hire LPN's because hospital policy limits what they are allowed to do. Unfortunately incompetence is everywhere, in every field. I and many other RN's have no one to depend on for help, and I myself work my ass off and I have saved many lives, and I'm proud of that. That's my job and I love it. But how dare you state that RN's would be lost without LPN's you are showing your ignorance and are being extremely disrespectful. If you have a problem with a post then you address that person. Show your knowledge and your professionalism, not your discriminating statements and stupidity.
  13. by   bella548
    Where the heck do you find an available nurse that has time to come and check your heprin and insulin?I sure dont know where i d find the time to check other nurses?????With 7-8 very ill pts per shift.It would be nice if we could do it !!!!!!!!!!!!!