Very concerned

Nurses General Nursing

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I'm going to make this as clear as possible . I work nights at a hospital on a tele floor. I'm currently on orientation and am towards the end of it. So, one night I had a pt who was in ARF, dialysis, and a Type 2 DM. So the pt BG drops to 44mg/dL and when asked states "I don't feel so well". I run in there to give OJ to which pt states "I don't want anymore ". Protocol is 50u of D50 if unable to give PO. So I gave 50u D50W. Pt shot up to above 200. I offered milk and pt refused (was also ineffectively coughing/ had fluid in lungs). Offered graham crackers (refused). After the elevated BG I administered the Levemir that was scheduled. 10 units of levemir which has no peak. Anywho out of my 4 pts I rounded on this pt the most because they had fluids and labs that I did. Pt had no BG checks during night (we don't do them). Every time I rounded I asked how pt was feeling (pt is aaox3). My last round was during lab draw around 0545. Pt actually told me "thank you for your help" and when asked if she was in pain (pain assessment) or if she felt weak/off (BG) pt stated "no I'm good, just want to get some sleep."

Gave report to day nurse who sees pt asleep and goes and continues getting report from other nurses. I was now giving report to other nurse and to finish charting.

1.5 hours after handing report to day nurse, preceptor runs to me stating "pt has a BG of 14! I run in and pt is non-responsive. Day charge nurse was pushing 2 amps D50 when I wheeled computer. When I mentioned pt only had LEVEMIR given preceptor yelled "WHY WOULD YOU GIVE THAT WITH A 200mg/dL BG!?" I'm a T1DM so it wasn't that I have a med I knew nothing about. So I told preceptor "but why wouldn't I?" She gave me a look of hatred as Rapid Response was called. Pt taken to ICU.

I sat at the nurse's station in tears. I'm being looked at as the one who did this even though my pt was aaox3 BEFORE report and pt wasn't checked after I gave report. I'm freaking out. They're investigating and pt is ok. What would normally happen? Would I lose my license or job? I'm really freaking out to where I have chest pain.

Specializes in Telemetry, IMCU.
If you keep up with the attitude you have now, you're going to have a really hard time with your new floor too.

Highly doubt that. They investigated and it wasn't the Levemir decision. It was the lack of teaching and a large amount of verbal abuse that made me afraid to speak up. Everyone flipped their story but it was decided for me to start fresh. I have no attitude, however your comment is irrelevant. Me saying God is good is literally it. Whether you or others do or don't agree is your choice. I get to start fresh and have learned to speak up because it's not just my license, it's patients' lives. I'm not a new nurse so the fact that I fought HARD for my job is NOT indicative of my future position. Thanks.

Specializes in Mental Health, Gerontology, Palliative.

just to add to what others have said, you have been given some good advice

- Never ever be afraid to do your own obs. If it comes down to it saying "oh but someone else does the BGLS" wont cut the mustard. Also you have your own gut instinct, and dont be afraid to trust that. Sometimes that involves doing extra obs to confirm that 'feeling'

- Also important to always follow up quick acting carbs with something longer acting. Its ok to politely put your foot down and insist that the patient eat something, even if it is only a small amount

Highly doubt that. They investigated and it wasn't the Levemir decision. It was the lack of teaching and a large amount of verbal abuse that made me afraid to speak up. Everyone flipped their story but it was decided for me to start fresh. I have no attitude, however your comment is irrelevant. Me saying God is good is literally it. Whether you or others do or don't agree is your choice. I get to start fresh and have learned to speak up because it's not just my license, it's patients' lives. I'm not a new nurse so the fact that I fought HARD for my job is NOT indicative of my future position. Thanks.

I really felt for you and your plight butI'm saying your attitude in this forum is one of defensiveness and inability to accept feedback that is not 100% positive.

Use this second chance to ask for feedback during your orientation and learn from it. It's not always going to be positive, that's how we learn. At least you will have a chance to work on areas you may have weaknesses in-as opposed to being called into the managers office one day and being blind sided with issues you never heard from your preceptor. It's helped me grow as a newer nurse.

I hope you find a good preceptor and utilize her/him well.

Specializes in Telemetry, IMCU.
I really felt for you and your plight butI'm saying your attitude in this forum is one of defensiveness and inability to accept feedback that is not 100% positive.

Use this second chance to ask for feedback during your orientation and learn from it. It's not always going to be positive, that's how we learn. At least you will have a chance to work on areas you may have weaknesses in-as opposed to being called into the managers office one day and being blind sided with issues you never heard from your preceptor. It's helped me grow as a newer nurse.

I hope you find a good preceptor and utilize her/him well.

Your post did not make sense. I dealt with the heavy responsibility of what happened for weeks. Is that not enough? I took everyone's feedback and it's still not enough? I fought for my job AFTER the patient was safe at home and I was canned and it's still not enough? I fought and by God's grace they decided to make me eligible for rehire without having to go elsewhere (another hospital system) and it makes you think I didn't listen to anyone's feedback? Yes, now I'm defensive. This decision is a GOOD thing. I mean did you expect me to take the road Kim Hiatt took? It looks to me as though if others don't see you wailing and tearing your clothes in despair that you don't care. I was in a deep depression for weeks, over this. I followed the protocol and was within my right to ask for an appeal. It saddens me to see how some people in person or on a forum could take what's written at face value without seeing how difficult and sick I got over the patient, then how depressed I got after being fired, then how I woke up countless nights sweating from yet another nightmare of reliving that night, and so on and so forth. So please, if it's condescension you were attempting to deliver and expected me to accept it I won't. I take what I experience as my learning curve. I fought and it was approved. I won't apologize for fighting for my career. If this response upsets or rubs you the wrong way then I can't help there because your assumption rubbed me the wrong way as well.

Just chiming in, not sure if it's the OP's situation, but i worked for a hospital where literally the nurses were not trained/given access to the accucheck machines. Just the techs and the charge nurses were trained and had access....

Specializes in hospice, LTC, public health, occupational health.
Just chiming in, not sure if it's the OP's situation, but i worked for a hospital where literally the nurses were not trained/given access to the accucheck machines. Just the techs and the charge nurses were trained and had access....

That might be the dumbest thing I've ever heard of...

That might be the dumbest thing I've ever heard of

It is a really nice hospital and you could just get one of the techs to get a sugar for you, but it was irritating. I am hoping to go back to that hospital at some point though (it's a LONG story....) anyways, perhaps it has changed in the last year.... I know there was a contingent of nurses that were trying to change it. Probably shouldn't say anymore Incase details get too identifying

Specializes in IMC, school nursing.

Your preceptor was irritated because she realizes that she is partially culpable for this. Never give any insulin after a low blood sugar without running it by a physician, that will put the responsibility on a primary care. I am in an orientee relationship now, with nurses who technically have fewer years of experience than I do, but this is a new area for me. I ask that they treat me like I have a few years of experience and I need to humble myself, otherwise I may miss a valuable part of the education I need. Please take all criticism as constructive. There is pain with growth and that will ultimately place you in a better place.

Specializes in Telemetry, IMCU.
Your preceptor was irritated because she realizes that she is partially culpable for this. Never give any insulin after a low blood sugar without running it by a physician, that will put the responsibility on a primary care. I am in an orientee relationship now, with nurses who technically have fewer years of experience than I do, but this is a new area for me. I ask that they treat me like I have a few years of experience and I need to humble myself, otherwise I may miss a valuable part of the education I need. Please take all criticism as constructive. There is pain with growth and that will ultimately place you in a better place.

Please read above. Appeal was complete. Thank you.

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