Alarm Fatigue ???

[C_AlexanderRN, BSN, RN]

Alarm Fatigue 

We have all experienced a stretch of shifts where alarms are constantly blaring off. You go home and sometimes even wake up from a nightmare with those alarms beeping in your head. Ugh!

 

Here are some tips nurses can use to overcome alarm fatigue: 

 

#1 Identify the underlying cause of the alarm.

Use your good ol’ fashioned critical thinking skills to uncover why your patient is beeping off. 

 

Are they paced? Maybe you need to change your tele settings to a paced mode.

 

Are they having frequent PVCs, bigeminy, trigeminey? Maybe you need to ask the provider to buff up their lytes. K should be>4, Mag>2 if you are worried about arrhythmias.

 

Anticipate hypoxia? Bump up the O2 before repositioning your patient whose sats drop when you lower the head of the bed.

 

#2 Feel empowered to speak up to providers. 

 

Does your patient who is experiencing skin breakdown really need telemetry leads and O2 sat monitors?

Does your patient who has a history of OSA and is compliant with their CPAP need continuous pulse oximetry?

Your patient with chronic A fib is transitioning towards comfort care and refuses electrolyte repletion. Is monitoring their ectopy necessary?

 

Often times providers are not aware that the alarms are even beeping or troublesome to patients and nursing staff. They are writing orders according to checklists and algorithms. If you have a conversation with the team and explain your rationale, you will probably be (happily) surprised to hear that continuous monitoring is not necessary for your patient.

 

#3 Get creative!

Are you having trouble getting a good O2 sat waveform? Are your patient’s fingers cold? Try using a heating pad to warm them up. Is your patient delirious and pulling off the probe? Try putting a sticky probe on their toe. Maybe you have an ear probe available on your unit…or maybe you can borrow one from another unit. Nursing takes a village. Reach out to your colleagues and resources whenever possible. Don’t worry about asking “dumb” questions. No questions are dumb if you learn something by asking them. And remember that every senior nurse started out as a new grad at one point. The only way to learn is by asking questions and through trial and error.

 

Good luck out there! Hope your unit gets a little quieter after reading this ?