We had a resident die recently and he was a very brittle diabetic, on a continuous tube feeding and a full code. (thankfully he was not on my hall). This res. blood sugar would sky rocket so high the CBG machine could not even read it. When he would get his insulin he would drop down into the 30's. The Dr. had been called numerous times regarding his insulin dosage, so that was changing daily, I don't know how high a dose or what long acting he was getting, I just know he was very brittle.
For about 4 days this man would refuse his insulin, he was alert and oriented and therefore was able to refuse, he did not want his insulin for fear of bottoming out. the nurse on dayshift would chart that he refused his insulin at 8am and noon. But she never charted that she called the doc, the evening nurse only gave him insulin at 5pm, and res refused insulin at 9pm, the nurse never charted this nor called the doc. The night shift nurse comes in and the res requested his blood sugar be take, the ,machine would not read it, the nurse called the dr and told him about the blood sugar being to high to read, and that the res had also been refusing his insulin for the last few days. the doctor said that was his right if he didn't want the insulin then we can't give it to him. so he didn't give her any new orders or even tell her to give insulin.
Later that night during the CNA rounds they found him unresponsive without resp or pulse. so the nurse started CPR and called EMS. and did all the necessary steps that she was suppose to do. The nurse was off for the next 2 days after that, when she came back to work, she worked her shift and when her shift was over, she was called to the office and put on suspension pending the investigation into this guys death. The DON asked her why she didn't give the insulin, the nurse told her she didnt have an order for it, and the DON told her she should have given it anyway.
So now she is on suspension and will probably not be coming back. I think it's wrong for them to suspend her when she did everything she was suppose to do, she charted that she called the doc, told him that res had refused insulin on previous shift, and that his CBG was extremely high, doc gave no order to give insulin because res would refuse it. So the nurse gets in trouble for not giving insulin to the res. How is she to blame ??
