Ready?
So today wasn't such fun at work.
We have a patient on rehab, elderly lady who is a known brittle diabetic, dementia.. the whole ball of wax.
NA took her to the bathroom around 4p, and she can't stand, talk or do anything.. the woman almost hit the floor.
This was in the midst of my first med pass and vital check down the hall (she's at the end of the hall).
I go racing down there and do a quick check on her blood sugar. 43.
Barking out orders for oj with packets of sugar, anything to keep her from crashing.
Nothing during report was mentioned about said lady not eating much breakfast OR lunch.
I had to find this out by pulling the dietary book from the kitchen.
1 hour later, and after finally getting her blood sugar to slowly rise into the 50 range after chest rubs, shaking her and forcing sugary drinks into her mouth I still wasn't happy.
Checked her orders. NO standing order for Glutose, much less the Glucagon IM we keep stocked in the med room.
Without consulting the doctor first, I forced as much Glutose into her mouth as possible, feeling pissed and panicked all the while.
Recheck on blood sugar.. still at 58 30 minutes later.
Called the doc because I felt I should send her out.
No. He asks me what the problem was, and told me to go ahead with the IM Glucagon.
After that, she started to rouse and become more her feisty self.
She ate 50% of her dinner around 6, but promptly threw it up shortly thereafter.
Still, her blood sugar was at a happy 110 by then.
I made damn sure she was given HS snacks, and then spent at least 20 minutes writing notes on this poor woman.
Today, I was not such a happy camper. Arrgh!