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.
I'm confused why someone continued to feed a patient who wasn't protecting their own airway and didn't call RRT instead. Where was your preceptor during all this?
you stated the preceptor,: "where she slammed her locker, looked at me and then slammed the door without saying a word to me. She had been working her 7th shift with me so I thought "
Being there 1.5 hours past your shift is abuse.
Your preceptors behavior is unacceptable.
You will eventually learn how to manage and intervene on this kind of patient..that part of only the nurses aides or whatever they call them today , only the ones doing glucose.....those type of rules are based on ..as long as the patient is stable--which she no longer was--so I feel there should have been more monitoring....
you will not lose your job,get back on the horse,say sorry,do not argue ,do not offer counter excuses,stop discussing it.
Like others have said, you've had alot of good advice on many posts. This move to day shift may be a good one especially if you are placed with a preceptor that you work well with. Keep your head up!
Am I supposed to understand, why exactly, this patient's blood glucose was not checked again for an entire shift after a hypoglycemic episode, an amp of D50 and you giving a dose of levemir in a renal patient?
Regardless of whether or not you followed hypoglycemia protocol, that is just poor nursing judgement IMO.
OK I'm a cna so the nurse lingo is kind of lost on me
Reading the fir comment and judging by what I know you gave insulin to someone with low blood sugar. Huge no no as far as I know ( again just a cna)
all I have to say to this is you seem to at least care about your resident and thought it was best. If you don't get any severely negative repracautions it's best to learn from it and move on
I know this will not be the popular opinion but I want to address the need to work thru the trauma of your experience. Nursing is an abusive profession. You mentioned being reprimanded for holding another medication. I imagine that played a factor in you decision. Every nurse I know has some kind of past childhood trauma. We are professional codependents. Work triggers past events, especially the ones we haven't worked thru. This may seem silly to some but get a therapist. Do not go thru your work assistance program. Nothing with them is truly confidential. Establish a relationship with this therapist so you can go to her when you need to. The nursing profession can eat you alive. I have never any where else seen so many emotionally unhealthy, unstable individuals. Practice self care, first and foremost.
I know this will not be the popular opinion but I want to address the need to work thru the trauma of your experience. Nursing is an abusive profession. You mentioned being reprimanded for holding another medication. I imagine that played a factor in you decision. Every nurse I know has some kind of past childhood trauma. We are professional codependents. Work triggers past events, especially the ones we haven't worked thru. This may seem silly to some but get a therapist. Do not go thru your work assistance program. Nothing with them is truly confidential. Establish a relationship with this therapist so you can go to her when you need to. The nursing profession can eat you alive. I have never any where else seen so many emotionally unhealthy, unstable individuals. Practice self care, first and foremost.
Nursing is an abusive profession.
No it isn't. I am sorry you work in a bad place.
Every nurse I know has some kind of past childhood trauma.
Given the high level of functioning needed to be a nurse, this seems inaccurate. Probably less than the general public.
We are professional codependents.
I don't know what this means, but I am pretty sure I disagree.
I have never any where else seen so many emotionally unhealthy, unstable individuals
I work with some decent people. Sorry you don't.
Nursing is not inherently traumatic or abusive, and anybody who feels it is, should find a job that is not. You might, or might not, benefit from professional counseling. I have absolutely no idea. And neither does siddenmj.
I know this will not be the popular opinion but I want to address the need to work thru the trauma of your experience. Nursing is an abusive profession. You mentioned being reprimanded for holding another medication. I imagine that played a factor in you decision. Every nurse I know has some kind of past childhood trauma. We are professional codependents. Work triggers past events, especially the ones we haven't worked thru. This may seem silly to some but get a therapist. Do not go thru your work assistance program. Nothing with them is truly confidential. Establish a relationship with this therapist so you can go to her when you need to. The nursing profession can eat you alive. I have never any where else seen so many emotionally unhealthy, unstable individuals. Practice self care, first and foremost.
If all any one can do here is more of the same, it's all yours ladies. Eat your young.
I object.I am not a lady.
OP has gotten some good guidance, most of it given pretty gently.
There is actually a middle ground between eating ones young, and telling somebody that the error they made is a result of unresolved childhood trauma being relived in an inherently abusive environment.
OP treated hypoglycemia with a short acting, temporary fix, and did not meet the standard of care in monitoring. It also sounds like her preceptor is not up to the job.
Both of these have been pretty well responded to, with rationales, and acknowledgement that we all make mistakes, and suggestions of how to best move forward.
Update: it's been 3 weeks since the incident and they're still investigating. Patient is back home and has been for 2 weeks and I'm still waiting on the verdict. í ½í¸«
I did. It was 200mg/dL. ARF is acute RESPIRATORY failure. I'm seeing a lot of confusion where I wrote ARF. That's why she didn't want to eat or drink. She was coughing. She'd aspirate.
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