Reflective Account on Diabetic Patient

(GIBBS 1988) REFLECTIVE ACCOUNT                                  



During a day shift I was part of a staff team of six.   In the morning report we were all given a rundown of each patient from a night shift member. One of the patients is an elderly lady with dementia and diabetes. We were informed she had slept well and that her morning blood sugar level was reading high however she had received her insulin for this. No other information was given and the reporting nurse continued onto the next patient.

After report I came out onto the ward floor and done what I usually do which is make beds and carry out our usual routine. At approximately 9.00am it was discovered by another staff member that the female elderly diabetic patient was laying on her bedroom floor. Four staff members, including myself, went to attend to the patient where we found her responsive but drowsy. I took a blood sugar reading and found her levels to be low at 2.5. We moved her onto her bed and administered Hypo stop as the patient, although responsive, was too drowsy to administer sweet fluids as a potential to choke.

On call medical doctor was informed, patient was monitored throughout, continual blood sugar levels were done at intervals, physical recordings taken and routine checks of patient’s responsiveness /orientation was carried out. It became clear to us that the patient had not received breakfast following administrated insulin earlier that morning. No breakfast tray or signs of any meal was evident. The patient slowly improved with our interventions and by afternoon was back to her usual self.


Initially I was quick to lay the blame on the night staff. They had administered the insulin therefore it was their responsibility to ensure the patient had breakfast to prevent a hypoglycaemic attack.

The night staff was an easy target, I felt they had contributed to a breakdown in continuity of care through...