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I have a question to ask you guys regarding giving half a dose of medication. Patient is on dialysis and is also diabetic. Patient blood sugar was 250. Patient has order for 20 units of levimir plus sliding scale insulin. Patient is alert and orientedx3. Patient husband was also at bedside. Came in to informed patient that her blood sugar was 250 and that she needs 20 units of levimir and sliding scale insulin (6 units). This is the first day I have this patient. Patient refused her sliding scale and only wanted half of her levimir. Patient husband agrees. They told me her blood sugar drops after dialysis. patient also told me she hasn't been eating very well including her diabetic snacks. I check her trends over a few days and what they are telling me is true. It even drop to 40 at one time. Patient is very much alert. I notify the supervisor and then gave half of the levimir per patient request. I then sent a message to the doctor in the morning as I did'nt want to wake him up at night. patient blood sugar in the morning was 185. Thats without the sliding scale coverage and only half of the levimir. So the patient knows more about her progress. A morning nurse told me its either you give it all or none. At my previous facility we were allow to do this as long as there is a trend of result. I'm a little worry now. I also look back on the patients chart and she has been refusing the levimir on certain occasions and the blood sugar goes up to the 350s and higher.

I'm new here guys. I recently been working as a rehab nurse for about 5 months. I'm really worried now. Today just when shift about to end I saw a new lab result pop up on my patient access list. It was a critical lab value of 6.1 for potassium. This was the first time that I have this patient. I was freaked out! I told my charge nurse and nurse manager as well. They were totally surprise and didn't even know the lab came. They told me lab always call for critical lab values or fax over the results. They didn't received those labs through the fax machine or saw them posted to the patients charts yesterday so they didn't know about it to call the doctor. The thing was that this lab value stated that it was posted on 6/28/15 at 0000. However, the results just came up around 0530 on 6/29/2015. I already gave the potassium 20 mEq as well as another nurse during the morning shift. I pretty sure to triple check the lab values before giving the medications and at that time around 2050 on 06/28/2015 there were no lab values for electrolytes such as sodium, and potassium. Now I find out after shift that they are ordering a stab lab to probably check out the patient potassium level. I just don't want any harm to my patient. I don't know why that lab result just pop up on the following day, but listed it for the previous day. They probably think I was careless of either not checking electrolytes labs before giving the medication or know the results but gave it anyway. I'm really freaking out.