privatelabelRN

I'm currently in the Peace Corps doing nursing education for my hospital in Mongolia. I'm writing up on how to care for diabetic patients and since they tend not to check blood glucose that often (but they have the means), I'm including a section on how to correctly do an accucheck. I brought along a couple nursing books that I had when I was in school (I graduated in 2008) to help me with lesson planning, and they say to wipe away the first drop of blood when you do a stick, and test the next drop. I've never actually done this in practice, but I've heard of it and I've seen some people do it in my hospital in America. There's the reasoning- the first drop could be full of serum (? is this true?), but if you squeeze the finger to get the second drop, the second could be as well. One of the reasons I didn't wipe the first drop was because I tended to have really old diabetic patients who seemed to not have enough blood for one drop, let alone two. What do you guys think? Is there a best practice for this?

I know, right?? I think my nose is broken, actually. I worked in a fish lab in college, and I got used to some really, really funky smells (rotting walleye insides!). I now have the ultimate poker face haha :) It's helped me a lot with patients, especially the colostomy patients... they look at me expecting a reaction, and usually they're comforted that I don't cringe!

Vomiting. I can handle the aftermath, but I seriously have to turn away when the patient is puking. I have a terrible gag reflex. Other than that, I can pretty much handle anything. I love me some stage 4 pressure ulcers and colostomies.

I think my hospital used to stop TPN, flush other line, draw back and then take the sample (then flush and hep lock, of course). At least, that's what I was taught. Now if the patient has TPN, they just do a stick in a different vein. I know it's one more stick for the patient, but the lab was having such trouble with the skewed lab results that I guess they decided it was worth it. (I'm not working at that hospital currently, so I don't know if it's changed)

Allegiance Health in Jackson stopped hiring LPNs, and they were mostly phased out in 2009. I really loved working with them too.