Nursing and practices that are not safe

[Springdaisy04]

I am a registered nurse and I work in a LTC facility. I have some practices to me that are not safe. For example, there is one instance I member that involved levemir, long acting insulin. I was always taught that you never hold long acting insulin even if the blood sugar is low. As long as the patient is eating and has their snack, it is ok to give it. This one in particular kept holding the levemir and writing that she held it because the sugar was very low at 90. According to this nurse if the blood sugar falls below 100 it should be held. She was holding it consistently causing the resident's sugar to be high on the morning. Some mornings it would be 200, 300 and one morning it went up to 700. The patient ended up having to go to the hospital in the ICU. I spoke to nurse about this before but she refused to listen. She taught she knew better than everybody else. She try argue with everybody because she had to be right all the time. This time she endangered a patient's life. I did not report her because I wanted to give her the benefit of the doubt. How else could I have handled that differently? Any input would be much appreciated.

[iluvivt, BSN, RN]

Your first obligation is to the patient! I try to handle situations like this directly by providing the nurse with evidence indicating their shortcomings. I actually will print out policies and articles and standard of care statements.If I do not see that they are open to learning and then a change in how they practice then I will go straight to management.I can't seem to live with myself if I do not take action for those that entrust us with their well being.This is not a situation to give someone the benefit of the doubt since there is no other way to interpret her actions other than lack of knowledge and critical thinking!

[BuckyBadgerRN, ASN, RN]

Wouldn't someone be looking into what necessitated a trip to OR for a resident? Is no one auditing MARS and charts and seeing that she is holding insulin when it's not warranted?

I am a registered nurse and I work in a LTC facility. I have some practices to me that are not safe. For example, there is one instance I member that involved levemir, long acting insulin. I was always taught that you never hold long acting insulin even if the blood sugar is low. As long as the patient is eating and has their snack, it is ok to give it. This one in particular kept holding the levemir and writing that she held it because the sugar was very low at 90. According to this nurse if the blood sugar falls below 100 it should be held. She was holding it consistently causing the resident's sugar to be high on the morning. Some mornings it would be 200, 300 and one morning it went up to 700. The patient ended up having to go to the hospital in the ICU. I spoke to nurse about this before but she refused to listen. She taught she knew better than everybody else. She try argue with everybody because she had to be right all the time. This time she endangered a patient's life. I did not report her because I wanted to give her the benefit of the doubt. How else could I have handled that differently? Any input would be much appreciated.