Do you count resps every time you do vitals?

  1. This question is to find out how many nurses actually count resps every single time they take vitals.
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  2. Poll: When do you count resps with vitals?

    • Every single time

      35.81% 140
    • Based on the diagnosis or medications given

      14.83% 58
    • I usually estimate, unless they are respiratory

      18.93% 74
    • I'll check them once, then estimate thereafter

      5.63% 22
    • I alternate between 16, 18, and 20, unless they look too slow or fast

      15.60% 61
    • truthfully, seldom

      4.86% 19
    • I always check them, and don't trust the CNAs to have really done them

      4.35% 17
    391 Votes
  3. 42 Comments

  4. by   Tweety
    Yes.

    I worked with a tech once that I noticed everyone had a respiration of 20 - all 19 patients we had on the unit. He didn't even own a watch. He eventually was fired.
  5. by   GardenDove
    Quote from Tweety
    Yes.

    I worked with a tech once that I noticed everyone had a respiration of 20 - all 19 patients we had on the unit. He didn't even own a watch. He eventually was fired.
    I've seen nurses do that, I've noticed that following certain people my resp counts are invariably different.
  6. by   GardenDove
    My poll answers are inferior, I'm not sure if I can vote.
  7. by   truern
    I don't routinely take vitals...I do, however, manually check "off" BPs. When I have taken full sets of vitals, though, I counted respirations.

    There used to be a tech at work that always fudged the RR until the day I observed him use the Dynamap, then record the vitals including RR. Knowing full well that he never once looked at the clock on the wall or his watch I asked him how he timed the respirations. After some cock-and-bull explanation, I told him I depended on him being accurate and that if he couldn't be then I'd take my own vitals, thank you very much. After that he made a point of counting respirations because he knew I'd check after him.

    I didn't answer your poll, though....none of the answers fit
  8. by   Marie_LPN, RN
    Estimating respirations isn't any better than writing down any old numbers for a BP.
  9. by   MIA-RN1
    I count them each time. Too important not too!
    My husband was getting his vitals done at his oncology appointment and the lady (assistant? Not a nurse, I Think a tech?) said "I just have to check your respirations" and looked at the dynamap!! Then wrote a number down! LOL I was dying trying not to laugh at her. I let her slide but told the doc when we saw her what she did, and asked did they have a new super-dynamap that measures respirs? LOL. Doc talked to her and now she counts.
  10. by   TheCommuter
    I am employed at a nursing home and care for stable geriatric patients with relatively predictable outcomes. We only take full sets of vitals by exception only, such as when a change in condition occurs.

    I check the pulse and BP every single time I give an antihypertensive drug or cardioactive med. I obtain temperatures on patients who are taking antibiotics and during the post-ABT period. However, I obtain a respiratory rate only when there are s/s of distress. I voted for the option that read 'based on the diagnosis or medications given'.
  11. by   arpeggiated
    As a CNA, I always check resps when I do vitals... I may not always count them for a full minute, but I do get a count.
  12. by   EmerNurse
    Most of the time I count. Rarely, as with a small lac or sprained ankel in a young adult, who is talking on their cell phone and annoyed with me for interrupting them to assess, I'll go with wnl. That said, I've learned that you can NOT estimate well someone who looks to be breathing "normally" but has a very fast rate. You have to count. From across the room, 20 and 34 RR may look very similar. Personally, I love the monitors that will monitor RR as well as everything else!

    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.

    Speaking of counting, had a new grad nurse tell me once that she didn't get a HR on a patient yet as they weren't hooked up to the monitor yet! Whatever happened to palping and counting a pulse (and RR while your'e at it)? I must do that 100 times a night - never wait for a machine when you can do it yourself!
  13. by   Justhere
    Had one nurse when I was an LPN and she the RN, that stated a patient had a RR of 40 during her assessment, I had just taken the patients vitals and the RR was 20. So both of us went down to the room to count. Come to find out patient was a RR of 20, she was counting the inhale as 1 and the exhale as 2, so 20 turned into 40. She wouldn't believe me that she was counting wrong.
  14. by   new_grad06
    Honestly,there just isn't enough time in one shift to do everything strictly "by the book", especially in a nursing home setting where you have 30-40 patients at a time-not to mention that most are stable anyway. I voted for,
    "based on medication or diagnosis".
  15. by   Tweety
    Quote from new_grad06
    Honestly,there just isn't enough time in one shift to do everything strictly "by the book", especially in a nursing home setting where you have 30-40 patients at a time-not to mention that most are stable anyway. I voted for,
    "based on medication or diagnosis".


    Count for 15 seconds and multiply times four. That's all the time it takes.

    I agree that there isn't time to do anything by the book. But when you document respirations, unless it says "estimated count" you're falsifying medical records by guessing what you think it is. The time it takes you to look at them and guess, you could actually get a true count.

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