buying a pulse ox of my own? - page 3
I am completing my school preceptorship on the same floor where I currently work as an aide and will be working as a nurse. We are a telemetry step-down unit. The floor has the same problem as... Read More
Jan 21, '07Quote from JolieThis pretty much sums it up.It doesn't matter what type of machine you are using. It is a JCAHO requirement that patient care equipment, especially that which runs on battery or electrical power, be safety tested, calibrated, and maintained, and that records detailing this are maintained.
I am quite certain that a lawyer would have a field day with a nurse who used an untested, uncalibrated piece of machinery on a patient who later suffered an adverse event.
I am also quite certain that you do not have documentation of competency on your own personal equipment, or could prove that it has been properly cleaned between patients.
Jan 21, '07Quote from asoldierswife05:yeahthat: :yeahthat: :yeahthat:this seems so very similar in concept to teachers in the public educational system spending money from their own pockets to be able to supply their students with needed materials for class.
while it is a quick fix to an immediate problem, the teacher is out of a considerable amount of money from a less than adequate salary. and because of continued practice of this sort, it has now become so acceptable for teachers to do so that the government (who pays their salary btw) now offers tax write offs for this! instead of addressing the real problem and putting money towards supplies and teacher salary.
now, take that concept and apply it to health care. you have a facility that is making billions of dollars a year, yet they can't supply enough $350 pulse ox machines to stock on their floors. the shortage of machines is so short, in fact, that nurses who are making a very small wage in comparison to the hospital are taking money out of their own pockets to purchase their own machines as a quick fix to an immediate problem. what do you foresee happening in the future? if most nurses are providing the equipment themselves, why should the hospital buy any at all. then it becomes a common practice.
you may want to buy a pulse ox for your patients, but i do not. it is the facilities responsibility and it is up to us to enforce that instead of carrying the burden. why are nurses so self-sacrificial? use the appropriate chain of command to require your corporation to meet the standards necessary to provide safe pt care to its clients! it's not the easy way, nor is it the fastest way. but in the long run, you will be doing us all a favor. we don't want the new trend in pt care to become purchasing your own pt care equipment.
i can't even imagine spending hundreds of dollars on a pulse ox because the hospital refuses to provide one??? i worked at a county medical center, translation: poor hospital. we still had the supplies we needed. maybe not the most state of the art supplies, but certainly adequate. i bought my own stethoscope but thats it.
on a floor with no pulse ox, if all staff were to report to nm, tthat they were unable to chart o2 sats, her answer is "you guys lost it, its up to you to find it". then as stated above, go up the chain of command! fill out incident reports, make a statement. but to actually spend your money. well i guess to each his own... i just hope this does not become the norm.. how many others would be willing to do this?
shell out hundreds for pt. equipment?
Jan 21, '07I'm not sure I like the idea of someone using my tax dollars (which is how Pell grants are funded) to buy a pulse ox. That just doesn't seem right to me.
Jan 21, '07Start filling out an incident report every shift after 10 mins of searching for a pulse ox. Your legal department will soon give your nurse manager a lot of heartburn until something changes.
Thankfully last time I worked with adults pulse ox readings were not part of routine assessment and were done exclusively by the RT's (they were the only ones with a pulse ox). Now that I work NICU there is a pulse ox at practically every bedside. So it's not an issue.
Jan 21, '07Quote from RNsRWeI disagree with you. I think #1 it is a battle worth fighting, and #2 it is MUCH easier to solve than staffing ratios...are you kidding me? These facilities have a budget for buying new, maintaining, and replacing equipment. Your NM has alot on her plate, but I guarantee you that there is someone in this corporation whose sole job is purchasing equipment and making sure the nurses are getting what they need. It takes alot of fuss to have your voice heard at the top, but it will solve the problem for good.Nope, it won't. And my demanding a new pulse ox be purchased for the unit won't result in this happening, either, I can assure you. I have fought a whole LOTTA battles in my lifetime, and have never shied from a good one. I can be quite the rebel, trust me. But one must know when the battle is futile, too, and there's a better way to "win" (for you and your patients, anyway).
Hey, what's with the fighting analogies, "asoldierswife"?
I continue to fight for better staffing, and better situations for new grads. Some of it might even have an effect; actually, some of it already has. Perhaps equipment purchases will one day be a priority to someone. But that day may just not come soon enough to keep me from screaming in frustration each time I come on shift and can't get what I need, is all I'm saying.
On to more battles
Incident reports are a great way to start. Written complaints to the nurse manager, supervisor, and director or CNO will help you as well. If your hospital has an ethics committee or hotline, you can address this through them too. How about risk management? Infection control? Does your unit have a Unit Based Counsel (group of nurses that address important issues on th unit and strive to make changes to improve pt care)? If not, you should form one. There are LOTs of ways to get this matter resolved, besides complaining a few times and doing nothing about it besides buying one of your own. But this is so much trouble right? It will be worth it in the long run...for all of us!
Buy your pulse ox if you wish, RN, but I will refuse and stand up for my own rights. The hospital puts out mission statements about their service and safety and promotes customer service to attract and please patients, therefore, if they are falling short of providing very basic supplies you have every right ethically and legally to hold them to their own self-imposed standards. Afterall, you are being held to a standard...
Jan 21, '07Quote from Jolieagreed on the blood pressure cuff. i've got a good electric one, but i wouldn't use it at work because of liability.I think there could be potential liability issues if your machine is not calibrated and maintained by your hospital biomedical department, if you don't have documentation of having been trained in its use, or if it could be shown to have contributed to nosocomial infections in patients.
On the surface, it sounds like a nice convenience, but in the medical-legal environment of healthcare today, I would not do it.
on the pulseox, i've got my own. my hospital cerified it for me, and it's a godsend in terms of saving time. i've got a nellcor i bought on ebay.
Jan 21, '07I bought my own and love it. I cant tell you how many times it has made a difference in the outcome of my patients. I got tired of searching the floor for the pulseox, sometimes unable to find it. Mine cost 250.00 new on ebay, but it has more than paid for itself. It was also tax deductible. I have the same brand that respiratory therapy uses..Nonin. Its a Nonin Onyx which is the most easily cleansed and maintained. There are cheaper ones out there, but they are made so you cant keep them clean. I couldnt function without it.
Jan 21, '07My mother is an LPN at a LTC that is routinely short of: Clean linen, A&D ointment, gloves in more than one size, clothing for the residents, deordorant etc. Some of the nurses have bought residents underwear and tolietries out of their own pockets but she will not do it.
I know it makes your job easier but it makes me uncomfortable because when people start jumping onto the bandwagon it becomes a common and then expected practice. I was a NYC school teacher and it pissed me off to no end that I was expected to purchase a rug for my classroom after the board of ed decided to implement their new reading curriculum (this was 2003.)
The idea was that everyday the children would be called to the common area of the room to sit on the rug and be read to by the teacher (which I had a problem with but that is another thread.) After having my arm twisted by my AP I was forced to buy a rug, in addition to the money I spent on: chalk, paper for the copy machine, decorations for the room(it's mandatory to decorate your classroom), pens, notebooks, folders (do you know that some parents will NOT buy even the most basic school supplies for their children), staples+stapler, pencil sharpner and the list goes on and on.
Yes it was a tax write off and I did receive a whopping $150 check sometime around X-mas as reimbursement but it dug into my measly salary and hurt me financially. I had to spend hundreds of dollars to set up my classroom over the summer and did not see a penny back for months. Honestly, you never get it all back as a teacher.
Buy a pulse ox today, tomorrow it's a cannister of 02 or gloves or thermometers or one of the endless list of things that are a part of what you need to get your job done.
Jan 21, '07oh and also... my main priority is patient care, not "fighting a battle worth fighting or not fighting". If it makes my life easier and patients care more timely and efficient, then why not. Ive had incidents of walking into a pt's room, upon a quick visual assessment it was obvious that pt was in resp failure. Within 10 seconds I knew the sat and was able to respond accordingly, whereas if I had to go look for a pulseox or call respiratory therapy to come check sat, the outcome may have been different. And yes, every second counts. But thats my opinion, like everyone else who has their own opinion also. If you dont want to buy one, then dont. If you do, then do it and no one should speak ill for your doing so. To each their own. But I do think that it should be checked and results compared to RT's equipment to ensure reliability.
Jan 21, '07You shouldn't need a pulse ox to know what to do when your pt is in resp distress. Numbers alone don't dictate treatment.
If the OP wanted to pay for a pulse ox on her own dime, that's one thing, but this is grant money...our tax dollars funded that grant. I don't know about anyone else, but all this excess she says she has could be going to someone else to help that person through school, not buying someone a personal pulse ox.
And as Jolie said, heaven help you if your oximeter isn't routinely checked by BioMed. You will up up the creek without an oar if something happens.
Jan 21, '07Quote from chenoaspiritDon't assume that a nurse who believes she should not be responsible for buying a pulse ox, does not make pt care her priority. This is the self-sacrificial attitude that is holding our profession back and allowing these facilities to continue this practice.oh and also... my main priority is patient care, not "fighting a battle worth fighting or not fighting". If it makes my life easier and patients care more timely and efficient, then why not. Ive had incidents of walking into a pt's room, upon a quick visual assessment it was obvious that pt was in resp failure. Within 10 seconds I knew the sat and was able to respond accordingly, whereas if I had to go look for a pulseox or call respiratory therapy to come check sat, the outcome may have been different. And yes, every second counts. But thats my opinion, like everyone else who has their own opinion also. If you dont want to buy one, then dont. If you do, then do it and no one should speak ill for your doing so. To each their own. But I do think that it should be checked and results compared to RT's equipment to ensure reliability.
If you walked into a pt's room and it was 'obvious that a pt was in respiratory failure' (your words, not mine) and you had to have a pulse ox reading before you reacted...pt care is not your priority and you are relying too heavily on fallable equipment anyway....but that's an entirely different thread.
No one is disputing that nurses who DO want to buy a pulse ox are doing them for noble reasons. However, their view of the situation is very short sighted. They want an immediate solution, and are less concerned with the long term problems that it may cause, not only at their facility but possibly others. They are not addressing the bigger problem at hand, nurses being taken advantage of by the larger corporations who are essentially responsible for providing this equipment. IMO, that is definitely a battle worth fighting.
Jan 21, '07Quote from chenoaspiritgreat priorities but what about the days/times you are not working? who's responsibility is it to make sure that pt. in distress has a pulse ox. available? it is the hospital. fighting the battle now will help assure there is is equipment there all the time for all staff to use. the nm needs to be accountable and do her job. she is getting off easy and people are letting her. i wouldn't. that would be my choice. i have never yet in 10 years had a detrimental pt. outcome due to lack of equipment. the hospital/facility has to provide.oh and also... my main priority is patient care, not "fighting a battle worth fighting or not fighting". if it makes my life easier and patients care more timely and efficient, then why not. ive had incidents of walking into a pt's room, upon a quick visual assessment it was obvious that pt was in resp failure. within 10 seconds i knew the sat and was able to respond accordingly, whereas if i had to go look for a pulseox or call respiratory therapy to come check sat, the outcome may have been different. and yes, every second counts. but thats my opinion, like everyone else who has their own opinion also. if you dont want to buy one, then dont. if you do, then do it and no one should speak ill for your doing so. to each their own. but i do think that it should be checked and results compared to rt's equipment to ensure reliability.Last edit by Cattitude on Jan 21, '07 : Reason: typo
Jan 21, '07Quote from casbeezgirlrnexcellent point!!!!great priorities but what about the days/times you are not working? who's responsibility is it to make sure that pt. in distress has a pulse ox. available?