Ok I'm a newer nurse just off orientation, and last night was my 2nd night flying solo.
So here is my situation, what would you have done and did I do anything wrong? (I got conflicting responses from senior nurses on the floor).
My patient is NIDDM. She went down for surgery late afternoon and came back. Because she was NPO all day she didn't recieve her metformin. She came back from surgery and immediately called for food and forgot to let any of us know she was about to eat. Her blood sugar 2 hours later was 255 (10pm). Talked with patient she REALLY didn't want insulin to cover her. Talked with 2 senior nurses one said do insulin one said go ahead give her metformin.
For me giving her the metformin still made sense. She eventually came down to her normal ranges, but nurse who said to give insulin said technically it was a med error for me to give metformin that late because her normal time was in the AM. (BTW she ate more when i gave her the metformin).
I briefly talked with doc about it when I was calling him reguarding something else, he had no problem with me giving the glucophage. But still other nurses acted like what I did was wrong and I"m confused about why,(because I gave a med that was skipped didn't give it twice when I wasn't supposed to) in the end patients sugar went down, and she was happy about not having insulin....
Specializes in ub-Acute/LTC, Home Health, L&D, Peds.
Very true you will get different answers from different people. My rule of thumb that has served me well these past (yikes) 20 years I have been nursing is ALWAYS, ALWAYS, err on the side of caution. That is what always runs through my mind when I have a decision to make.
I learned that after I had a LOL fall and I was a brand new nurse. I had never seen a broken hip before so I assessed her and thought her hip was broken. So I went and got another nurse who had been a nurse for over 30 years. She looked at it and told me "No her hip isn't broken." So I didn't go with my own assessment but instead listened to the more experienced RN. I am an LPN so I assumed with her RN and more experience she would know. Well come to find out the next day they did an x-ray and yep indeed her hip was broken. I felt terrible that she laid there all night with a broken hip! So long story short err on the side of caution, listen to yourself and make sure you do thorough documentation! Good luck in your career :)
katfishLPN
133 Posts
Very true you will get different answers from different people. My rule of thumb that has served me well these past (yikes) 20 years I have been nursing is ALWAYS, ALWAYS, err on the side of caution. That is what always runs through my mind when I have a decision to make.
I learned that after I had a LOL fall and I was a brand new nurse. I had never seen a broken hip before so I assessed her and thought her hip was broken. So I went and got another nurse who had been a nurse for over 30 years. She looked at it and told me "No her hip isn't broken." So I didn't go with my own assessment but instead listened to the more experienced RN. I am an LPN so I assumed with her RN and more experience she would know. Well come to find out the next day they did an x-ray and yep indeed her hip was broken. I felt terrible that she laid there all night with a broken hip! So long story short err on the side of caution, listen to yourself and make sure you do thorough documentation! Good luck in your career :)