"I need to eat, I'm a diabetic!"

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I get a little tired of patients and their visitors demanding food because "I'm a diabetic". Last time that line was used on me by your typical overweight type 2 diabetic, I took his blood sugar. It was over 200 of course. I told him that, you only HAVE to eat when your blood sugar is low, and no, I'm not getting you a sandwich, your blood sugar is actually high. This was an ER patient with a minor complaint. :banghead:

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
In an ideal world, perhaps. But that's not what I'm being taught in first quarter nursing school. My instructors are telling us that is is 100% about addressing the patients needs, not ours. This is pretty hard. I didn't realize that sainthood was a prerequisite for the RN credential but we appear to be held to a very high standard that includes not requiring or expecting any compassion or other meeting of our needs from patients. That's TOUGH but can anyone who's out there working as a nurse tell me it's different?

It is about addressing the pt's needs. But that won't mean you stop having needs yourself. Your needs won't be addressed while you are caring for patients. If you can race around like a fiend for 12 or 14 hrs, with an empty stomach and a full bladder and never lose your saintly composure, great. Maybe it's best you wait until after graduation to judge the rest of us.

I thought the OP was referring to people who use any pretext to garner "special" treatment. Diabetes is only one pretext. All pretexts do a disservice to people who are actually coping with various conditions. I also think nurses should be a little better at looking out for one another.

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Specializes in Oncology.

Agreeing with MunoRN. It's not always just blood sugar that matters with meal times. If someone is 200 but peaking out on their NPH designed to cover a 60gm carbohydrate lunch and doesn't eat, you'll be amazed at how quickly that drops to a bg of 50. If someone has 10 units of insulin on board and their CGM says 200 with double down arrows, you better bet they need to eat. Granted, neither of these scenarios seem like what you're talking about in the OP.

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Specializes in SICU.

I took a very intense Diabetes education class (20 hrs over 2 days) and gained an in depth understanding of the disease process....

However..... the person with BG in the 200's is not going to die if they do not get their snack RIGHT NOW. How many uncontrolled diabetics have we placed NPO (on NS 0.9%) and they did just fine! I think a lot of people latch on to the excuse that "i will get hypoglycemic really quick if i do not eat right now" when all that eating (of non compliant food) is what got them into the mess in the first place

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Are we talking about feeding people in the ED? If they are sick enough to be there, then unless and until they are assessed, they need to be kept NPO. If on the floor, I agree, they need to eat, and it should be a priority. BUT at some point they need to take some responsibility! It's not about being "mean" or anything. Diabetics, like anyone else, should take some ownership over their disease, e.g. bringing carb snacks/emergency kits to keep their blood sugars from dropping if they are coming to the hospital. In Med-surg, there are a lot of priorities---some which are higher than feeding a person with sugars of 200 plus.....and.... They should be scheduled snacks in between meals from the kitchen, and fed them, anyhow.

BUT..... At SOME point, the patient needs to take care of his own disease!

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There are reasons for hyperglycemia other than non-compliance. One can't assume non-compliance or not taking responsibility for the disease based on BG alone.

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Specializes in SICU, trauma, neuro.
In an ideal world, perhaps. But that's not what I'm being taught in first quarter nursing school. My instructors are telling us that is is 100% about addressing the patients needs, not ours. This is pretty hard. I didn't realize that sainthood was a prerequisite for the RN credential but we appear to be held to a very high standard that includes not requiring or expecting any compassion or other meeting of our needs from patients. That's TOUGH but can anyone who's out there working as a nurse tell me it's different?

I remember reading a post along these lines recently....something about nurses being held to a higher standard. I don't want to take this thread too far OT, but maintaining good self care doesn't require the patient to meet our need. I know that you weren't inferring that, but just wanted to agree with you....even the best of nurses can get hangry if they don't eat.

This is how I took it too...not that the PP was expecting a patient in the hospital to meet our needs, but it is more than fine for a nurse to meet his/her own needs. In fact, if you DON'T meet your own needs you are going to perform as a substandard nurse (think "I didn't even have time to pee!!" "In fact, I got a UTI because of holding my bladder and not drinking any water!!" "I work 12 hour shifts and NEVER get to eat lunch!!" "I got mastitis because I worked a double and had NO time to pump...AND no time to drink water.") Self-care is actually a very important concept to nursing.

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Specializes in HH, Peds, Rehab, Clinical.
In an ideal world, perhaps. But that's not what I'm being taught in first quarter nursing school. My instructors are telling us that is is 100% about addressing the patients needs, not ours. This is pretty hard. I didn't realize that sainthood was a prerequisite for the RN credential but we appear to be held to a very high standard that includes not requiring or expecting any compassion or other meeting of our needs from patients. That's TOUGH but can anyone who's out there working as a nurse tell me it's different?

I'd LOVE to be able to put every need of every patient ahead of my own. BUT, realistically, it's not happening.

Think back to the airline safety speech most of us spend flipping through the skymall magazine--put YOUR oxygen mask on first and then help others around you. You can bet that any sane firefighter is going to make sure his/her protective gear is in place so they protect their butts before they attempt to rescue mine. My police officer husband is not going to blindly race into a potentially dangerous situation without taking certain precautions. It is wholly unfair to expect nurses not to take care of their own needs as well.

Now granted, I don't work in a fast-paced ER or highly critical NICU, but by golly, if I have to pee, Mr. So and So in room 305 can wait for his refill of ice water. A mild example, there are several more that I'm sure others can offer up

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Sorry, When I read it, that is not the impression I got. It seemed to be making fun of Diabetics dealing with a sugar drop. If it was as you say, it would have mentioned more of the 'service' complaints, and less of "poor stupid diabetic you' type comments.

yes, I get the upset of having to do this menial activities. That is NOT the patients fault. That is the SYSTEM in place. Which makes the joke on us, the nurses for putting up with it.

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I took a very intense Diabetes education class (20 hrs over 2 days) and gained an in depth understanding of the disease process....

However..... the person with BG in the 200's is not going to die if they do not get their snack RIGHT NOW. How many uncontrolled diabetics have we placed NPO (on NS 0.9%) and they did just fine! I think a lot of people latch on to the excuse that "i will get hypoglycemic really quick if i do not eat right now" when all that eating (of non compliant food) is what got them into the mess in the first place

Actually, part of the problem is that you believe it's an excuse. If person with a gun shot said they needed pain pills, would it be considered an excuse? The issue is real, not an excuse. What a patient feels is real, not an excuse. The body might not be in any real danger, but IT does not know that. Notice I said "IT", not the person. It's an actual physical response the person can not control. It does not matter how the persons health got this way and it shouldn't be used as judgement when treating patients.

A nurse can not educate, if the nurse level of understand is it's all an 'excuse.'

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Maybe various reasons for hyperglycemia, but diabetics should always be in the habit of eating well and snacking in between meals. This is basic; it is Diabetes 101. And I am NOT "making fun" of diabetics, but the vast majority of my most non-compliant patients are serious diabetics who refuse to take responsiblity or ownership. I work daily with them, so I know them well.

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Specializes in SICU.
Actually, part of the problem is that you believe it's an excuse. If person with a gun shot said they needed pain pills, would it be considered an excuse? The issue is real, not an excuse. What a patient feels is real, not an excuse. The body might not be in any real danger, but IT does not know that. Notice I said "IT", not the person. It's an actual physical response the person can not control. It does not matter how the persons health got this way and it shouldn't be used as judgement when treating patients.

A nurse can not educate, if the nurse level of understand is it's all an 'excuse.'

I see this was directed at me.

You do not know me, therefore you have no idea as to my level of understanding on any topic. I am entitled to my opinion as you are to yours. And I am sure we can all have a healthy debate without taking potshots at each other.

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Specializes in ER.
Maybe various reasons for hyperglycemia, but diabetics should always be in the habit of eating well and snacking in between meals. This is basic; it is Diabetes 101. And I am NOT "making fun" of diabetics, but the vast majority of my most non-compliant patients are serious diabetics who refuse to take responsiblity or ownership. I work daily with them, so I know them well.

I agree. I think my frustration with many (not all) diabetics is the lack of personal responsibility. Such as the patient in question, in my original post. He reeked of cigarettes, came to the ER for the sniffles, was getting impatient because of the wait. Then he demanded food, saying he was a diabetic.

I asked him what his sugar was because, of course I was concerned that maybe he was dropping. He said he had no idea. So I took his blood sugar and it was over 200. He actually wasn't my patient at the time, but we do a lot of teamwork in the ER.

But you compliant, responsible diabetics out there, please don't take this thread personally! We love and care about you, and sympathize with your struggles!

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