Do you count resps every time you do vitals? - page 3

This question is to find out how many nurses actually count resps every single time they take vitals.... Read More

  1. by   bethin
    When I first started med surg (we were not allowed to do vitals in LTC) I was getting vitals on a pt. I was pretending to get the patient's pulse radially and looking at my watch. She told me "you can just guess, I do it all the time and I'm right most of the time."

    How do you know if you're right if you don't count?
  2. by   jill48
    Quote from bethin
    When I first started med surg (we were not allowed to do vitals in LTC) I was getting vitals on a pt. I was pretending to get the patient's pulse radially and looking at my watch. She told me "you can just guess, I do it all the time and I'm right most of the time."

    How do you know if you're right if you don't count?
    That is just ridiculous.
  3. by   crissrn27
    Quote from Angie O'Plasty, RN
    Vamedic, is that a typo??????
    I realize this question was asked a while ago, but I thought I'd answer it anyway. I believe this nurse works with kids/babies and I have seen some babies with RR over 120 with RDS, etc. Normal for term newborn is 30-60.

    BTW, I've seen your screen name dozens of times and it just dawned on me what it says............love it
  4. by   jamminworld
    I have pts on vents that are on set rates not breathing on their own and we get all kinds of RR recorded on them. I like checking things for myself.
  5. by   Suninmyheart
    [quote=
    When I was on med-surg, I ALWAYS counted. I remember an experienced nurse once telling me that I couldn't have 19 as a resp rate because RR are always even numbers LOL. I told her, that is what I counted!

    Dawned on me later that she must have been thinking of a manual BP where the dial is only calibrated in 2pt increments.
    [/quote]

    I usually count for 15 secs and multiply by four - of course is why I always get an even number. I know most of the nurses on our unit fudge the rr. I don't. I pretend I am taking a pulse and use that time to also check for skin color, posture, etc.
  6. by   CritterLover
    when i worked icu, i would verify with my first assessement the the monitor was accuratly reflecting their resp count. after that, i wouldn't cout myself, just look at the monitor, unless something changed. if they were on the vent, sometimes i would use the count the vent had. just depended on the situation.

    when working er, i don't always do a resp count with dc vs. if they came in for a non-cardiac, non-resp complaint (such as ankle pain) and don't get any narcs, then i just leave that spot on the vs form blank. probably not "by the book," but not falsifing records, either. part of the reason is that most of our rooms don't have functional clocks. i don't wear a watch (allergic to the metal), so i frequently have to use the timer button on the thermometer. thermometers (at least ones that work) can be difficult to find. (but it can be useful to count resps while the thermometer is in their mouth. esp for those who won't get off the phone)

    when i do count, i usually count for 15 sec and multiply by 4, unless the results are high/low or they appear to be breathing irregularly or in distress.
  7. by   Suninmyheart
    [quote=
    When I was on med-surg, I ALWAYS counted. I remember an experienced nurse once telling me that I couldn't have 19 as a resp rate because RR are always even numbers LOL. I told her, that is what I counted!

    Dawned on me later that she must have been thinking of a manual BP where the dial is only calibrated in 2pt increments.
    [/quote]

    I usually count for 15 secs and multiply by four - of course is why I always get an even number. I know most of the nurses on our unit fudge the rr. I don't. I pretend I am taking a pulse and use that time to also check for skin color, posture, etc.
  8. by   SteveNNP
    All our babies are on vents or at least monitors. I look once to see if the monitor waveform is correlating with the baby's actual respirations.....then it's monitor vitals from then on...
  9. by   LCAlpn
    it is one of the vital signs after all
  10. by   papillonailes
    I am a CNA and I count them for 15 sec, then multiply by four; unless their RR is irregular, then I'll count for 30 - 60 sec (and multiply by two, of course, if counting for 30 sec.) I haven't figured out how to do it yet without feeling like I am making them uncomfortable by staring at their chest, lol! Sometimes the TV is on and I pretend I am watching the pt's. TV while "Molly Dolly" (as one pt. calls the Dynamap vitals machine) is reading the pt's. BP. :wink2:
  11. by   SheriLynnRN
    When I work in the cicu, I set my monitor to show the resp parameter. When I am working in the surgical unit, the CNA's routinely take vitals. If I do a set I do usually count resps. I wouldn't ever make up a number though. If I don't count, I just don't chart a RR for that set of vitals. If the pt is in resp distress, or I have any reason to be suspicious, i count resps.
  12. by   Sterren
    Quote from critterlover
    when i worked icu, i would verify with my first assessement the the monitor was accuratly reflecting their resp count. after that, i wouldn't cout myself, just look at the monitor, unless something changed. if they were on the vent, sometimes i would use the count the vent had. just depended on the situation.
    this is what i do too. i count for myself every 4 hours but in between i will trust the vent if it appears to correlate with my count. on non-vented patients i count for 15 seconds and multiply by 4, every time. if a patient's rr is really high or really low on a vent i will also count for myself to verify.
  13. by   Indy
    Our respiratory rate on our datascope monitors is the one thing most likely to be wrong. It uses the red lead, I think, to get a rate but if the planets aren't aligned just right and the sticker isn't really fresh, and if I don't hold my mouth just right it will read anywhere from five to fifty and be nowhere near reality.

    So I do a lot more counting in ICU than I ever did in tele. On the floor it was 15 sec x4 and done, now I gotta really pay attention to it so I can chart that I know it's X when the monitor records Y. I won't chart that the equipment is inaccurate unless I know for a fact that it is. Besides, most of the low readings are on people breathing really shallow and those are overdoses not on the vent- yet. Gotta watch em! Can't automatically assume the one with 40's readings is faulty either, it may be someone in trouble, even if they weren't earlier.

    Don't assume no one pays attention to what you chart either. We have some very thorough docs who read the graphics, read my admission assessments, look at my flowsheets for trends, and double check my math on the fluid balance in their heads. So if the datascope printout shows trends of stuff that's dangerous and it wasnt accurate, I better have a readily accessed explanation for 'em. Look at it like this: when it goes in the chart you're swearing on your license that it's the truth. Do you want anything less?

    Edit: I forgot that with the vented patients there is another whole machine that counts resps and does quite a bit more accurate job than the datascope.
    Last edit by Indy on Jul 28, '08 : Reason: left something out

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