An uneventful shift is always the best kind of shift. But what really stinks is when the events wait until shift change to happen. Know what I mean? New patient. Admitted around midnight. Fell asleep just after admission and slept through shift report. The techs did their vitals while we were doing report, and my new patient had a blood sugar of 35. To make it even more fun, her IV line inserted by EMS before she arrived wouldn’t flush. D50 at the bedside, couldn’t push it. Called IV team, called the doc, and then basically poured orange juice down the poor woman’s throat. Thankfully she was alert and talking to us, and totally asymptomatic. But really, a blood sugar of 35 is the kind of surprise I don’t like. Her other vitals were fine, we put a foley in to get accurate I&Os, and then the doc took his frustration out on – who else? – the nurse. Specifically, the night shift nurse. Why hadn’t this blood sugar been done every 2 hours since arrival? (Um, because we don’t do that… like, ever.) Why didn’t we get a new line started on her immediately after admission? (Because we replace field lines within 24 hours, but usually not while the patient is sleeping.) Why wasn’t endocrinology consulted? (Oh, that’s because a doctor has to order a consult. And the doctor didn’t.)
Of course, after 10 minutes of this rousing game of Nagging the Nurse, he reassured me that he’s not angry with me. No, it didn’t sound like that at all. And that none of this is my fault. Again, it didn’t sound like that at all…
I could write a book on all the stupid things doctors say to nurses. We nurses would get a kick out of it, but I don’t think it would go far in helping improve interdisciplinary communication.
My takeaway from this? There’s no harm in checking a blood sugar on a new admit with your first set of vitals. Maybe we’d have caught it before it bottomed out.