In my previous posting, I used to get called about hypocounts (ie. blood glucose levels) of <4 or >20. Perhaps the occasional 18 or so.
However, in my current workplaces, my calls are punctuated by fruitless conversations such as these:
Caller: Hi, my 20/6 has a high hypocount.
Me: Oh, you mean HI? (that would be >33.3)
Caller: 13!
Me: one-three or three-zero?
Caller: ONE-THREE
Me: Er, that’s ok. Don’t need insulin.
Caller: Sure or not? So high.
Me: No, don’t need.
Caller: Ok.
This exchange might take twenty seconds perhaps, nothing much but a blink of the eye in our daily life, but put 5 of these calls and the irritation together and it just stops me from doing the more important changes on call.
What I’d like to know is who taught the caller that 13 was a HIGH hypocount?
And I’d like to know what sort of training the callers in this workplace has been undergoing that taught them to bother the on-call with such inane questions.
One thing about some of the staff in this place is, they sadly do not exercise the significant amount of grey/white matter that I’m sure they possess.
Hey, actually there is evidence that in sepsis, tight hypocount control improves outcome. Not sure which posting you are in, but there are patients out there who would benefit… so unfortunately this means sometimes that phone call may actually reflect an issue which needs to be addressed… :(
Comment by Visiting MO — October 14, 2007 @ 9:40 pm
i remember in my ortho posting in SGH, the nurses will give me a whole stack of hypocount to note (just before passing reports)! If patients are already on oral DM meds and not in sepsis, just look at the HbA1c. Forget about stat doses of insulin if the HbA1c within the last 3 months is less than 7%.(i used to give stat doses of actrapid when i was a HO. Yes, i’m Guilty). If they are in sepsis, they should be on IV insulin infusions already and should be in HD (in an ideal world) and not in the general wards!
Comment by dth — October 16, 2007 @ 1:48 pm