Would you take a patient's blood sugar without an "order"?

[Nola009]

Especially if the patient asked you to because they were on solu-medrol and a diabetic? I would.

[Twinmom06, ASN, APN]

yea - checking BG is fairly innocuous - its not like you're giving insulin coverage and it makes a good tool to GET the orders you need.

[cayenne06, MSN, CNM]

I would think the answer would be to get standing orders to test at your discretion, with whatever parameters the provider wanted to include.

I mean, I wouldn't hesitate to do whatever was needed to assess/stabilize a patient I was worried about, but *ideally,* you should have orders for such things. If not, I'd be sure to get one after the fact.

[dishes, BSN, RN]

The patient was asymptomatic, so I don't think a policy and procedure for blood sugar to be done at the nurses discretion would be applicable in this case. A patient being curious about the effect of solumedrol on their diabetes and a nurse having the time to check their blood sugar, are not very compelling reasons to do a unordered blood sugar level. I hope your workplace is the type of place that uses these situations as teaching moments and opportunities to clarify policies.

[dah doh, BSN, RN]

Yes I would. Patient is diabetic and asked you to. I would document that it's done per patient's request.

[MunoRN, RN]

When a diabetic asks to have their blood sugar checked I do it in typical circumstances, I can't really imagine not doing it.

[NicuGal, MSN, RN]

I Asked my adult counterparts this at work: Answer is our

hospital has a standing order for glucoses on diabetic

patients. So I would ask the patient if they feel symptomatic and if the answer is yes then do

it.

[SummitRN, BSN, RN]

Getting an order for FS glucose ... I forgot what it is like outside Critical Care. All protocol RN discretion. If you have to request an order I would in that case

[proud nurse, BSN, RN]

I work in a hospital. I have yet to have a patient on solumedrol and not have an MD order for accucheck. If I did, I would think the doctor forgot so I'd call for an order.

[KelRN215, BSN, RN]

When I worked in the hospital, all patients on solu-medrol had their urine tested for glucose with each void. Anything 2+ for glucose or higher got a fingerstick. Standard of care, we entered the orders ourselves. The patient is diabetic- if he was at home, he wouldn't call the doctor and say "should I check my blood sugar?" He checks his blood sugar per his own discretion at home. If a diabetic patient, or in the case of my patients, a diabetic patient's parent requests a blood sugar check, I'd do it.

[nurseprnRN, BSN, RN]

Getting a blood glucose can be part of a prescribed medical plan of care, so it's something the nurse does as part of implementing nursing components of the medical plan of care. However, it's also something a nurse can do on a prn basis as part of your nursing assessment of a diabetic patient, as part of a nursing plan of care. Write up a protocol for it and have it approved for your P&P book.

(We are not in the military and do not take "orders." We are legally required to implement parts of the prescribed medical plan of care, not all [lab, dietary, PT...], and we are legally obligated to assess, diagnose, and prescribe a nursing plan of care, too. The "O" word's time has passed. Try living without it and see how much you'll like it. Language matters.)

[psychnursie]

if the pt is symptomatic absolutely

[joanna73, BSN, RN]

We check blood sugars all the time without an order. If the resident seems lethargic or there are subtle changes detected, we check vitals and sugars.