Debrajo MSN

Also check with your state board of nursing about licensure and other issuesl. For example, in the state of PA there are very few places you could work because the state require criminal background checks if you are working with the elderly (as in a nursing home) or with kids. Most hospitals do background checks also. You would find it very difficult to find a job in this state, even if the state board granted you a license.

OK, heres the diabetes CNS in me speaking. First, If the sugar was high, coverage is appropriate even if the patient is NPO. Hyperglycemia in hospitalized patients is a serious problems that increases their risk of complications such as infections. Depending on whether it was regular insulin or humalog, the insulin would have peaked by 6.5 hours. Pts need more frequent blood glucose monitoring if they are NPO however, every 2 to 4 hours routinely is appropriate. However, something you said makes me suspicious of hypoglycemia long before you checked his sugar..... the fact that you state he yelled at one of your co workers. Unexpected or inappropriate anger is a symptom of hypoglycemia. Having said all that, I think you acted appropriately when you realized the pt was hypoglycemic, if just would have been better if you had discovered it earlier. I don't know the type of institution you work for but I can't imagine they would have suspended you for this incident. Sounds like you are inexperienced and need a little more education but certainly I would not consider this a reckless act, just the type of error that occurs when a nurse is not well experienced.

Hey, don't be discouraged. If you have explained the content etc. maybe just maybe, this bunch is not cut out to be nurses. Even though we have a nursing shortage one thing I don't want to see is programs "dumbed down" to the point that just anyone could be a nurse. The true mark of your success is not how many students pass the test.

I am a CNS in Diabetes management. I work in a hospital outpt setting directed by an endocrinologist. I have a masters in nursing with an adult health in illness focus. I graduated from Bloomsburg University of PA. My program allowed each student to study a particular area of concentation and mine was diabetes self management. I am a CDE but also hold the crediatial of BC APRN from nurses credentially center. I am board certified in advanced diabetes self managment at the masters level.

I am trying to create a JCAHO quiz or game to make learning all this stuff fun ( or at least less painful). Does any body have anything they could share? pm me. We're being surveyed in November and have lots to do. Thanks Debbie

There are definite time constraints, due to short lengths of stay, to teaching inpatients about diabetes not to mention they are sometimes not ready to learn. Most patients need "survival skills" prior to discharge. They need to know about their meds and depending on those meds they may need education about the signs, symptoms, treatment. and prevention of hypoglycemia. They may also need to learn the basics of self blood glucose monitoring. We usually have the outpatient diabetes eduator and dietician make a visit to help assess the patients needs and begin planning their educational plan of care. It is not true however that their is not usually payment for out patient education. Medicare pays for up to 10 hours the first year and then 1-2 hours each year there after and may pay for more if the patients medical plan of care changes or if they develop complication. Many private insurance companies cover outpatient education also, but it usually requires a physican referral. Out patient education is the very best setting for diabetes eduaton in my opinion because you can eliminate most distractions and provide "real life teaching". Debra Moyer RN MSN CDE BC-ADM

At my hospital full time can be a .8 to 1.0 (32 to 40 hours per week) depending on the position. Employees recieve full time benefits at 32 hours and some positions are only 32 hours per week but some are 40. We pay bonus to any .8 employee who works over their fte however.