AllynaBerry

My approach to the use of Novolog and Humalog was to give the dose after the tray was already in front of the patient - if they are eating well. If they might not finish their entire meal, wait until after they finished eating whatever they were going to eat, then, give according to carb counting ratio set by the CDE/RD. I was a CDE for 10 years and soon discovered that insulin was (ans still is) the most mis-understood medication out there. There are more med errors related to insulins than any other medication -- that include errors by health care professionals as well as patients and families. As for sliding scale, a better way to think of it is as a "correction dose"...meaning, to bring a high BG back down to a range that would be closer to "normal". It is not intended to cover food intake. When I served as Clinical Educator, this was a topic that had to be repeated often. The "older" nurses tended to still think of Regular Insulin and were confusing the "newer" nurses who were too unsure of themselves to argue or do something opposite of the rest of the nurses on their shift. I would find them holding Lantus/Levemir for low BG's, waiting to give sliding scale until trays arrived, and not wanting to treat lows too close to meal time...or holding mealtime insulin after treating a low an hour or two earlier. AB

At this point, I would be very certain to have a valid explanation of the delay ready for any interview that you do get. It is an obvious question for any interviewer to ask. I would make sure that you practice a very sincere and honest answer. You do not have to make it super personal and by law, they cannot delve too deeply into your personal life with their questions. But they will want to know why the delay. So be ready to deal with the question.

A few suggestions to consider: You might want to look into Quality Management nursing positions. The reviews are simply chart reviews. You do not have to deal with patients in beds, family members at the bedside, doctors on the phone (at least not much), and night/evening/weekend/holiday hours. You need to be a very detail-oriented person with excellent attention to detail for this type of job. Another place where nurses function very well are in offices of lawyers. It requires someone with organizing skills, task oriented daily activities, and ability to deal with a variety of personalities (clients as well as attorneys). School nursing is another option. Consider the long list of options for nurses: camp nursing, resorts/cruise ship nursing, home health nursing, etc. There is also medical sales...but that is very stressful unless you are "a born salesman". You can also write...article, short stories, novellas, children's books...and publish for free as ebooks. Hope this gives you some hope! AB

I am so encouraged by your post. After more than 37 years in the field of nursing, I still remember how terrified I was those first few months...how I prayed I wouldn't hurt anyone..then I prayed that I might help a few...then I prayed that I would help most of the patients most of the time all without hurting any one. I knew I had "arrived" when I quit praying that they were all still breathing at the end of my shift! LOL To you who are just starting out, remember, your instructors have taught you well. You actually know more than you believe you do. Trust that. You will reach the point where you will sometimes "get a feeling that something is not quite right" about your patient (or your co-worker). Trust that. Remember to take as good a care of your co-workers as you do your patients...you need them and they need you! Allyna allynaberry.com