Counting respirations...student freaking out!~

madcamRN · Jun 9, 2006

One of my clinical instructors helped me with this once. Now, I usually check radial pulse at the same time. I hold the pt's wrist resting on their abdomen. Then I count pulse for 30 sec and without moving my hand continue to count respirations for 30 sec.

The pt doesn't pick up on the fact that I'm counting their breathing and having my hand on the abdomen helps me feel and see their respirations. I'll do the same thing even if I am not actually counting radial pulse.

Also, I'll wear my watch on the same hand I use to check pulse/resp. so I don't have to look far away and lose count.

It always makes me laugh at myself if I have to stand there for too long because I lose count. Sometimes I wonder if pt's are thinking to themselves.."What the heck is taking you so long!"

Hope it makes sense..and helps!

Montessori Mommy · Jun 9, 2006

I'm a nursing student too, and I also pretend to be taking their pulse while I count respirations.

I've actually had nurses tell me they are going to count my respirations!! There is no way to breathe normally when someone tells you....

Recently I had a doctor listen to my lungs and he left the stethoscope on each spot for maybe half a second. I wanted to yell - Hey! I know you aren't really listenting! Where'd you go to medical school?

Beth

nambour51 · Jun 9, 2006

Not a silly question! Practise on a friend - get them to demonstrate different breathing patterns deep/shallow/holding breath/ rapid slow/ chest movemvent/ abdominal breathing etc. It is not just a matter of counting but also noting the type of resps and the reason for observing the resps.

ZASHAGALKA, RN · Jun 9, 2006

Also make sure that you are counting their 'baseline' respirations and not immediately after some exertion, especially true w/ dyspnea on exertion pts. Somebody just back from the bathroom might be breathing 40 times/min instead of their 'relatively' normal 24-28.

You call a doc w/ 40 resp/min instead of waiting for a few minutes and getting a better baseline of 26/min, you are going to trigger interventions that might not have been necessary.

~faith,

Timothy.

bahamabread · Jun 10, 2006

we were taught to place the hand against the top of the chest near the collar bone and then count resps for 30 sec and pulse for 30 sec. The pt is usually unaware that you are counting resps when you keep your hand in place at the pulse. Sometimes you forget what you count and have to start over.................even the experienced nurses do this...........so dont fret. Yes it takes time to be comfortable with this. It will come though.

But I find that counting resps can be done in 30 secs very well ( never with babies though) But the pulse..............when I can...........I ALWAYS count for a minute to really feel the pattern..........I have picked up many irregular beats like this that I would have missed in 3o secs.

LauraF, RN, ASN, CNA, LPN, RN · Jun 10, 2006

I find using a watch with a second hand works the best, you know the old, analog watches. Wear it on the hand that you have on their body, be it on their chest, abdomen or whichever you find works for you. If you have your watch in the same place you are looking it is easy to eyeball your start and stop place.