Purple_RN

One more thing - if a person is in the hospital it is hard to really form any opinion on whether or not Lantus is working well. Usually in the hospital a person is sick or just had surgery - so naturally our bodies are releasing stress hormones, which can counteract the insulin and make a patient's need for insulin greater. So it is really hard to keep blood sugars stable at the time. Thus making it hard to really see how Lantus or any other insulin for that matter is working - and more than likely when the patient gets back home and is no longer under a stressor like infection or surgery their insulin dose will most likely need to be lowered. Also the patient in the hospital would benefit from having a fast acting insulin to cover meals such as Humalog or Novolog in addition to a long acting insulin like Lantus or NPH. Purple_RN

Lantus can be given at anytime of the day. But a patient needs to take it about the same time everyday of course. It use to be that Lantus was only taken at bedtime. But Aventis the Company that manufactures Lantus now say it is OK at anytime (I think this came about 6 months ago or so). Some people do not get 24 hours coverage. Lantus usually lasts between 18-24 hours. That is why some doctors may prescribe Lantus BID. I still prefer Lantus over NPH. Lantus usually peaks between 1-4 hours after injection and then it plateus. So the patient is less likely to get hypoglycemia. Whereas NPH you need to make sure it is mixed well and say you take it in the am and then at lunch you did not eat much you are going to crash. So usually I find that adults and children who take NPH tend to have to feed there insulin to avoid lows. However, Lantus is a more unstable insulin so you really do not want to recommend that a patient store Lantus in their refrigerator door, rather on a refrigerator shelf to avoid it bouncing back in forth as the door opens because it will cause the insulin to break down. Purple_RN

First off the volunteer is an intern, but not for a medical postion at our facility. Secondly, I always ask a client without the observer present if the so called future RN, or new healthcare professional can sit in on the visit - I have no problem with that. There is usually never a problem once you present to the client that it is a healthcare professional - they usually like the idea of 2 healthcare professionals for the price of 1. But I think it would be harder to convince a client that Mr. Smith the intern in the computer dept. would like to sit in on a visit for example. The reason I do not want a volunteer there who has no background in healthcare and wishes to keep it that way is because it changes the visit dynamics. Clients express a lot of personal things in their visit with me and I want them to be comfortable and get the most for their money. Is that too much to ask for? Fortunately, unlike you my boss actually understood my request and I have overcome this obstacle. Purple_RN

I believe it isn't fair to a patient because when they arrive for the 1st visit at the clinic they are put on the spot - with out any time to really think about if they really want a volunteer to sit in on a visit with them. Having the volunteer sit in has no benefits to the client. Also most clients will say yes because they trust nurses. It just leaves a bad taste in my mouth Purple_RN

My boss today requested that a new volunteer with zero background in the medical field sit in on an individual patient visit with me to get a better understanding of what our agency provides. I disapprove completely with this request and believe that having a volunteer sit in on a visit even if the patient agrees to it - is wrong and has no benefits for the patient. I would like to get others opinions on this matter. I looked up Hippa regulations and can't seem to pin point anything specific in regards to non medical personal observing medical visits esp. volunteers. In my opinion it makes no sense to have a person observe a visit unless they are a new employee who is in training for a similar position. I am going to discuss my unhappiness with my boss, but I was hoping to find some concrete rulings favoring my believes prior. Thanks for listening to me vent :) Purple_RN

Just bumping this message up in hopes of getting more replies.

Hi, For anyone who lives in the San Jose, California area could you please tell me what hospitals are good hospitals for a new grad to work at. Basically I want to know about the hospitals where the staff wants to see you succeed, supports new grads, and has good benefits:) Thanks Purple_RN

Hi Everyone, I interviewed for a MDS position and just wanted to get the opinion of others as to what it is really like. What are the pros/cons. What kind of experience should I have, etc? That why I can make an educated decision as to whether or not to pursue this type of job. Is this a good job for say a nurse with less than 1 year of nursing experience? Sincerely, Purple_RN