My professor already kinda cooked me the first time I tried to interpret this strip. This is the help she gave me. It’s in the chapter on junctional rythm and I thought it was type 1 heart block but now I feel confused. The orange stickies are her notes to me
Has anyone ever ordered these as a woman? I’m really into this color but the caterina top is sold out in a size small, so I was thinking of getting a small men’s sized top instead. I also think these pants are super nice with all of the pockets but I wasn’t sure if anyone has ever tried !!
I can’t tell if I like this or not 😭 any other women who mix metals/ styled their brushes silver ring? Im considering returning for gold :(
Okay so to begin, I haven’t gotten in “trouble” or anything yet. I’m not even sure if anyone noticed or will notice but I feel so horribly guilty and I can’t stop thinking about it since Thursday.
In my hospital we don’t use EPIC. We use a smaller charting system called QCPR. It’s awful, but I’m learning a lot, and now in my second month of residency I feel much more comfortable navigating the system. Also, we don’t do sliding scales for insulin. We do carb counting or we adjust the dosages based on the target goal and insulin sensitivity factor. The math is fairly simple (blood glucose-target blood sugar= *blank*/ sensitivity factor) now the only thing I wasn’t aware of, some patients have higher or lower sensitivity factors.
I had a diabetic patient receiving insulin supplementation on Wednesday and everything went smoothly, his factor was 40, so I calculated the dosage and QCPR has a system in place where you enter your calculated dose and if it matched the computers calculations then you’re good to give it (no 2 nurse checks) but if it doesn’t match it’ll flag that medicine and you have to have a second nurse physically come in to help you administer.
Then Thursday comes around and my newly admitted patient has insulin coverage. I do the math, tell my preceptor the dose I calculated, she briefly glanced at my paper and gave me the okay to go and administer his morning dose on my own. I didn’t notice my mistake until the lunch time dose, when she allowed me to go completely on my own to give him his meds I noticed that my math was way off from the computer. I calculated 3 units and he was supposed to receive 7. So (before doing anything else) I found a friend on the unit and had them back me out of the administration so I wouldn’t be flagged, and they double checked the work with me, where we figured out that his insulin sensitivity was actually 20, not 40. Apparently this isn’t something really common but yeah, not 40. I have the correct dose but from that moment forward I knew I messed up his morning dosage.
Should I report this myself? He was fine but could this come back to bite me? I gave him one unit in the morning when he should’ve gotten 3. I’m so angry at myself for not making my preceptor watch me do the math and just showing her the work when I was done because maybe she would’ve caught it and taught me about the different insulin sensitivity factors but I truly didn’t know, the computer didn’t flag my administration so I didn’t even get that second “red light” saying hey this may be wrong. Though I’m sure it isn’t totally uncommon, I’ve never worked in a place with this type of math being used or anything close to it, I’ve always been taught with a sliding scale in school and clinical so I feel really silly for not knowing this before. What should I do?