2 Nurses needed??? - page 8

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   debmsn01
    Yes it seems that JCAHO does make our lives hectic-for the 3 days they are present, plus the weeks prior to their arrival. Isn't it funny that the organizations are not concerned with those important points until they "need to be".
    In response to whitecaps: I do make a point of double checking critical meds with another nurse, I have for 24 years, it covers me & makes sure the patient is receiving the correct dose. Taking a few seconds to do this seems like alot-until something happens. We become so concerned with delegating our tasks, doing the paperwork, & other things that we forget the important things that need critical thinking application. I know staffing is bad in places, I have taken care of 5-6-7 patients in one shift, WITHOUT a CNA, PCT or LPN to assist. I didn't like it, so I quit after 23 years in the same organization. Speak out, get yourself involved in your State's nursing organizations, look at UNIONS!!! I do not advocate unions wholely, but if it can help- GO FOR IT!!! Nursing must become responsible for ourselves, no one else seems to worry about us, & *****ing about it in the lounge or at home gets you no where.
  2. by   boopchick
    Originally posted by Julielpn
    Heck! I can't even get the nurse going off duty to count narcs with me!!!!
    Wow! Are you serious???

  3. by   Joycean
    I ran a poll on this subject a few months back and 65% of the responding nurses do double checks on insulin. Our hospital policy states double check orders and dosing when drawing up any type of insulin when dose is 20 units or greater. This is evidenced based by research done by our pharmacy dept.
  4. by   River
    When I worked in a hospital setting both insulin and heparin were double checked. But, interestingly enough in home health setting we give lots of insulin all by our little ol' selves.
    Last edit by River on Sep 20, '03
  5. by   Geeg
    It is an outdated policy in regard to the insulin. Originally, the double check was because insulin syringes were not standardized. It was necessary to match the units that the syringe was marked off in was the same as that of the insulin vial. i.e. you'll notice that the all the vials say U-100 and so do the syringes. If the hospital does not trust us to draw it up correctly, then it stands to reason that everything we do needs to be double checked!!!!! Ridiculous.
  6. by   sjoe
    This has been the, largely ignored, policy at most places where I have worked. The function of the written policy is to cover the butts of management personnel, but in practical terms there is not usually a second person nearby to verify the dose of heparin or insulin.
  7. by   debmsn01

    Yes it is an outdated policy, but it is making a come back due to many medication errors!! Having someone double check your meds, your calculations & such for meds, is an avenue of protecting yourself. When we stop taking it as a personel affront to our competence & look at it as a way to ensure safety to our patients, then we can see how benefitial it is to our practice. Just because we haven't been doing it, doesn't mean it is RIGHT. We falsely assume that because it is not required, we will be covered in case of an error-that has cost many nurses their right to practice or the lingering doubt of "if only, I would have checked it", & that is difficult to live with.
  8. by   AstudentLPN
    It is old school but a good idea I think . fTO ERR IS HUMAN!!
  9. by   sbic56
    But, first...there must be adequate staffing to even utilize this old practice! Where the hec ya going to find that nurse to double check you everytime you give a dose of heparin or insulin?? Oh, but then, if facilities were adequately staffed we would not be so harried as to make the mistake in the first place and the old policy could be put to bed. This is an old idealist rule that in theory is beautiful; in reality is laughable. Bottom line defense in preventing medication errors of any type is to have adequate staffing. We are competent singularly or as a group only when there are enough of us to perform the job competently.
  10. by   VivaLasViejas
    My hospital reinstated this policy last month, and it's a pain in the patoot to have to go find another nurse to check insulin with, but it's no different than having to find someone to witness a narc waste. When I first started working there, I'd been in LTC for a long time where we ALWAYS checked insulins, and thought it was bizarre that we didn't do it in the hospital where it's so easy to make mistakes due to being rushed, distracted etc.

    Now we have to sign off as well, which means dragging the insulin bottle & syringe, the pt's chart AND the diabetic flow sheet all over so the other nurse can check both the order and the dose. Lots of fun when you've got 3 or 4 diabetic patients on your team......but ya know, I've always made a habit of checking ANY med I'm not sure of with another RN, so it doesn't really bother me all that much even though I've always taken extra care with insulin, heparin, IV antihypertensives etc. I think it's just good policy, even if it IS inconvenient for us nurses....I mean, how "convenient" is it to deal with the aftermath of a med error?
  11. by   debmsn01
    There in lies the answer, nurses must bring to light that the effectiveness of these changes & quality patient care are only feasible with adequate staffing. So speak up for staffing issues with your state nurses assoc., legislators & whomever else can help.
  12. by   nurse62
    WOW...I work at in LTC and when I first received my license I would have another nurse check it. They would give me the funnies look, like I was crazy. I know this is how we are taught however it is never done at my facility. I think I will look it up in the policy book...thanks.
  13. by   melbnurse
    It is Policy at our facility, to double check all insulin, anti coags , and IV meds