[Mazzi]

What are the guidelines for taking an 02 saturation? Is it no longer considered a nursing measure? The hospice I work for is now saying it must be a doctor's order in order to take it. They do not consider it a nursing measure. What is the concensus of the readers on this issue? Also if it needs to be an order, then it must be specific as: PRN for air hunger or dyspnea. If the family asks for it would you take it without an order? Then, would you chart it? Is it really that big of a deal? Please let me know how you feel on this issue. Thanks.

[doodlemom]

I've never heard of needing an order to take an O2 sat but the only time we do is when we are recertifying a patient for COPD.

[AtlantaRN]

I use one for routine use. It is necessary for anyone with lung cancer or any primary pulmonary diagnosis. I'm the only one at my office that has one (hubby had a pe 6 yrs ago).

I let the other nurses use my pulseox when they have recerts or lung ca patients.

linda

[morte]

i am betting it is a BILLABLE activity with an order.....

[earle58]

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.

think about it.
what are you going to do with the results?

hospice nurses assess their pts by their presentation, and not of assistive devices.

i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.
but because my oxi reads 96% on ra, i'm not going to administer o2?

truly, we treat by what we see in the person:
and not through electronic, inanimate devices that don't communicate otherwise.
i'm sure for many nurses, this seems implausible.
but when you think about it, it really is the most natural way of nsg.

best of everything.

leslie

[CANRN]

Originally Posted by earle58

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.

think about it.
what are you going to do with the results?

hospice nurses assess their pts by their presentation, and not of assistive devices.

i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.
but because my oxi reads 96% on ra, i'm not going to administer o2?

truly, we treat by what we see in the person:
and not through electronic, inanimate devices that don't communicate otherwise.
i'm sure for many nurses, this seems implausible.
but when you think about it, it really is the most natural way of nsg.

best of everything.

leslie

Exactly, it is not required at all. There are other presenting symptoms and behaviors to support a DX. It is true, you can have a pulse ox reading over 90 and the patient can still display behaviors of air hunger. And if they have cold hands and poor circulation they aren't accuate anyway. Our hospice director does not even recommend them. I guess it goes back to the time when I was working ICU and learned monitor reading, ACLS and the old saying "Treat the patient NOT the monitor" In hospice we "Treat the patient, not the numbers!"

[caliotter3]

Originally Posted by earle58

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.

think about it.
what are you going to do with the results?

hospice nurses assess their pts by their presentation, and not of assistive devices.

i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.
but because my oxi reads 96% on ra, i'm not going to administer o2?

truly, we treat by what we see in the person:
and not through electronic, inanimate devices that don't communicate otherwise.
i'm sure for many nurses, this seems implausible.
but when you think about it, it really is the most natural way of nsg.

best of everything.

leslie

Leslie

You have clearly and thoroughly explained to me the comments and intentions voiced to me by a pediatrician that I've wondered about for years. I accompanied my client and her Mom to the doctor for a visit after the doctor had ordered oxygen and I asked her why she had not also ordered use of an oximeter as I thought that went automatically with use of oxygen. She told me she wanted caregivers to assess the patient and not the machine readings. I only halfway understood what she meant and could not elaborate in front of the mom (the doctor's body language somewhat told me that I shouldn't ask for clarification at that time). I never did get a chance to have it explained to me. Thanks for such an informative post. I'm always learning something here.

[doodlemom]

Originally Posted by morte

i am betting it is a BILLABLE activity with an order.....

No - it is not - not under hospice but maybe in home health it is.

[ssmith2307]

It is mandatory with the copany I work for to take all Vitals, including SPO2 and weights or MAC with every visit unless it will cause the pt discomfort to do so. It can show a decline if a pt is having a drop in their sats.. My pulse ox is one of my favorite tools to use.

[RNandlovingit]

The hospice I work for requires us to use them!! They order them for us, but we pay for them over time out of our checks! For us its a requirement on the assesment! Mainly more important with the patients that have respiratory issues!!!!