Seriously I don't understand it. I work 12 hr. nights in LTC. so about 2am i went to check on my resident b/c it was reported from days that her bs was running in the low 50's. also she was asymptomatic of hypoglycemia. she was fine when i came on talking laughing just her usual self. i've been checking her bs and it was pretty much the same 53. i goes in and she was disoriented shaking etc. i took her bs and it was 23. i immediatly ran to call the md. there was no order for glucagon but we got it in the ekit and that's what i was going to give her. told the md what was going on and see if i can give the glucagon he said yes. i give her 1ml of glucagon IM. immediatly she started to come around. bs slowly was coming up and in about an hour she was 119.
of course i charted and reported to the next shift finished up my work and went home. i got a call later from the DON chewing my butt out for giving glucagon and she wasn't unconscious. i told her there was nothing else i could give her and i had the permission of her doctor to do so.
Coming from a LTC, I too would have given it. As the only nurse in the middle of the night and dealing with this type of issue the injection was the best option. First off, lets say you wanted to give them something oral...LOL, cause unless you brought juice in or hid some surgar packets...good luck fining it. How about the time issue on hunting these down and sititing there getting them to drink it.
I keep sugar packets hidden. Part of the things I stash to make my job a little easier. Even though we have them in the pantry and the dining room is very close to the unit, my stash always comes in handy.
Seriously I don't understand it. I work 12 hr. nights in LTC. so about 2am i went to check on my resident b/c it was reported from days that her bs was running in the low 50's. also she was asymptomatic of hypoglycemia. she was fine when i came on talking laughing just her usual self. i've been checking her bs and it was pretty much the same 53. i goes in and she was disoriented shaking etc. i took her bs and it was 23. i immediatly ran to call the md. there was no order for glucagon but we got it in the ekit and that's what i was going to give her. told the md what was going on and see if i can give the glucagon he said yes. i give her 1ml of glucagon IM. immediatly she started to come around. bs slowly was coming up and in about an hour she was 119.
of course i charted and reported to the next shift finished up my work and went home. i got a call later from the DON chewing my butt out for giving glucagon and she wasn't unconscious. i told her there was nothing else i could give her and i had the permission of her doctor to do so.
Was i wrong for doing this?
I agree that your post needs the grammar police, but I'm beginning to feel that young people from everwhere see nothing wrong with poor spelling, punctuation, and grammar. It's the way it is now. However, can someone PLEASE explain to me WHY glucagon is only given if the patient is unconscious?? Is there a rationale or something?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I am wondering why she would repremand you if you had an order. In the Acute care setting IV glucose is usually the first line but many patients have IV's. Is she from acute care? Maybe she was unaware you had an order........you reacted to an emergent situation, got an order, and acted......result the patient did well.......good job!
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I agree that your post needs the grammar police, but I'm beginning to feel that young people from everwhere see nothing wrong with poor spelling, punctuation, and grammar. It's the way it is now. However, can someone PLEASE explain to me WHY glucagon is only given if the patient is unconscious?? Is there a rationale or something?
I think they are typing on their phones........ The glucagon thing? I have no idea........
Specializes in Gerontology, Med surg, Home Health.
Your grammar is a bit crazy, too.
I would have given the glucagon without an order.
Nothing wrong with my grammar or spelling, but, perhaps, I could have improved on the syntax. My children laugh at me and tell me I am the only person they know who uses correct grammar and spelling in a text message.
I am the DON. I would NEVER tell someone not to give a med or a treatment because of the cost, especially in an emergency. I was always taught, and, yes, it was the dark ages, to give something PO if the patient could swallow before you stuck them with a needle.
I think the LPN vs. RN is absurd.
I got hollered at once by the DON and ADON because I didn't call them to assist in a code blue. For one thing I didn't have time and for another, they were both STUPID and would have only gotten in the way. We saved the patient and I told them that was more important to me then calling them so they could stand around.
Nothing wrong with my grammar or spelling, but, perhaps, I could have improved on the syntax. My children laugh at me and tell me I am the only person they know who uses correct grammar and spelling in a text message.
I am the DON. I would NEVER tell someone not to give a med or a treatment because of the cost, especially in an emergency. I was always taught, and, yes, it was the dark ages, to give something PO if the patient could swallow before you stuck them with a needle.
I think the LPN vs. RN is absurd.
I got hollered at once by the DON and ADON because I didn't call them to assist in a code blue. For one thing I didn't have time and for another, they were both STUPID and would have only gotten in the way. We saved the patient and I told them that was more important to me then calling them so they could stand around.
People overreact for all sorts of reasons.
Isn't syntax a component of grammar? Anyway....I was referring to the way your sentences jump from past tense to present tense. I thought you had to chose one point in time and stick with it, but I could be wrong. After all, I've been known to make my own rules- and even my own words. I'm not even sure why I put that dash in my last sentence- I just liked the way it looked.
"If the resident is able to swallow, we would have given oral glucose."
Should be?: If the resident had been able to swallow, we would have given oral glucose.
Or?: If the resident is able to swallow, we give oral glucose.
The two sentences that followed that one jumped around the same way. :chair: I only noticed because you were picking on the OP. :sofahider
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you so much from this "electronically challenged nurse." I appreciate it! Have a good day.
You're welcome :heartbeat.....us old girls need to stick together;). I just happen to be a late bloomer and have a 13 and 14 year old at home. My daughter will actually text me from her room ! (sigh) A sign of the times.......I was forced to learn to keep an eye on my teenagers...LOL
You had an order. Sometimes MDS dont call back as fast as we want them to. Its a terrible thing to watch someone crash. Did your DON state to you why this is a problem even though you had the order?
That is insane! Of course you did the right thing...I seriously want to know the reasoning behind that DON's thinking. She got upset because you gave ordered glucagon for a blood sugar of 23?? If you had waited until that resident was unconscious it would have been too late she would probably have been dead! Sleep well tonight you did exactly what any prudent nurse would have done...the right thing.
However, can someone PLEASE explain to me WHY glucagon is only given if the patient is unconscious?? Is there a rationale or something?
The glucagon thing? I have no idea........
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Forever Sunshine, ASN, RN
1,261 Posts
lol i giggled out loud when i read that. too true.