buying a pulse ox of my own?

[LanaBanana]

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 apparantly every other floor in the hospital - there is never a pulse ox around when you need it. I did clinicals on one floor where they said they hadn't had a pulse ox for over a week because it had just gone MIA so when they needed it they called respiratory to come check it. My floor has never been that bad, you just spend forever trying to track down who has it or what patient room it was left in. Everybody tries to be the first one to get it in the morning so they can get assessments done. My Patient Care Coordinator has her own finger one and I love it! She lets people borrow it occassionally and everybody knows that it MUST end up back in her pocket. I am considering buying my own with the PELL grant check I will get at the end of the month. I am through with school and have this check and 1 more that don't need to go to tuition but I would like to put them towards my nursing career. I found some good prices on eBay for new ones.

I'm just wondering if anybody else has their own pulse ox and what experiences have been like. I don't want to have everyone borrowing it all the time so I would probably just get it and not tell anyone (of course someone would eventually see me using it!)

[tridil2000, MSN, RN]

problem:

not enough equipment.

dr solution: rants and raves.... makes a scene. demands equipment. gets equipment.

problem solved.

nurse solution: goes to ebay to buy equipment out of pocket.

problem remains.

'CMON nurses!!!!!! why do you do this to yourselves??????

[NRSKarenRN, BSN, RN]

hmmm. i've been following this thread and i didn't see it as a bashing.

actually, there have been some very, very valid points brought up. liabililty being one: lack of calibration and documentation and treatment based on that equipment. also, the other staff not having access to the pulse ox, because instead of going through proper channels to get the necessary equipment, some staff are bringing in their own.

:yeahthat:

placing my manager and safety committee hat on:

liability issues are enourmous here!

jcaho requires yearly calibration of low risk medical equpiment like pulse oximetry. all hospitals have p+p that only bioengineering tested battery operated and electrical equipment be utilized in patient care

if a patient is harmed as result rn's personal pulse ox equipment used resulting in inaccurate reading/treament, a facility will turn around and sue you, fire you and report to sbon for failure to follow procedure leading to patient harm-----license most likely sanctioned with possible revocation.

make sure you carry personal malpractice insurance as you need lawyer to aid in your defense. even your manager can be sued for failing to properly supervise you!

five minutes spent tracking down equipment versus hours in court ----please weigh these factors.

for those facilities lacking in essential equipment, that 5 minutes taken to fill out occurnace form notifying managemnt that needed equipment broken/ missing , insufficent quatity will be your defense too (alsways keep personal copy). put the onus back onto management/facility for having adequate equipment.

canadian nurses protective society infolaw bulletins aboriginal ...the court found that the nurse's employer, the hospital, was liable for the nurse's negligence because the hospital had control over the equipment used and ...

www.findarticles.com/p/articles/mi_qa3911/is_199905/ai_n8827721

patient safety and production pressure: icu nursing perspective

levels of liability: its not just the physician anymore

hhn: the top ten malpractice claims [and how to minimize them]

indmedica - journal of the academy of hospital administration

american college of surgeons professional liability program

[sirI, MSN, APRN, NP]

The employee, as well as the facility, have a duty to to provide a safe environment. Including, for example:

1. Proper employee orientation to equipment used for patient care

2. Facility provisions for said orientation with documentation of attendance

3. Ability to recognize failure of equipment

4. Provisions for safety maintenance

5. Properly overseeing that maintenance is carried out and documented

Federal and state guidelines as apply to health facilities require maintenance contracts for calibration of medical equipement. In fact, anything utilized for the patient. This includes the pulse ox, wheel chairs, blood pressure cuffs, etc.

Anyone wishing to utilize their own equipment must have this okayed by their facility. There needs to be in black and white, a policy regarding privately owned equipment for patient care that addresses the guidelines outlined by OSHA, JACHO, EPA, just to name a few.

Since I am in the rural clinic setting, I oversee all contracts for said maintenance thus satisfying rules/regs/P/P from the federal/state.

Here is a link regarding safety maintenance:

http://www.systoc.com/Tracker/Spring00/clinic.htm

Here is a link for rural health clinics:

1. All Clinic equipment will be inspected at least yearly, or as the type, use, and condition of equipment dictates. Each time an inspection or repair occurs, an entry will be made in the Inspection and Maintenance Log and signed by the service person to verify the event.
   
2. The medical/clinical assistant prior to each use must inspect all equipment.
   
3. An electrician or bio-medical engineer will inspect each piece of bio-medical equipment. The inspection will ensure that the equipment is in proper operating condition, is safe to use, and is calibrated properly.

http://www.ruralhealth.hrsa.gov/rhc/RHCManual/RHCmanualFive.htm

An excerpt from a p/p I wrote:

If medical/patient equipment is involved in patient injury/death:

1. Immediately notify the Medical Director/administrator/legal department
   
2. Complete incident/variance report
   
3. Document the model number, serial number, control number, and manufacturer of the equipment on the incident report
   
4. Notify Medical Engineering that you have a piece of equipment that has been involved in an alleged incident and requires evaluation.
   
5. Provide documentation of maintenance contract
   
6. Provide documentation of equipment QA

When viewed from a legal stand point of view, remember:

"Failure to maintain a safe environment".....

[cardiacRN2006, ADN, RN]

"Failure to maintain a safe environment".....

Ugh. That statement give me chills up the spine. Let's hope none of us have to hear that.

[RRTM2]

wow, did this turn into something! it's only a crummy little pulse ox. j

ultimately i do think that it's the hospital's responsibility to supply the equipment we need to care for the pts. but here in the real world... i got tired of borrowing a unit or rushing to get to work early so i could get one before they were all gone. another rt and i used to just trade as we gave each other report. it's a pita so, yes, i now have my own fingertip pulse ox. it's a nonin onyx ll model 9550 and i treasure it. onyx ll model 9500 works just as well. i looked at ebay but ended up getting it from a medical supply company for the same price.

i've adapted a thin pet leash to attach it to my waistband. it's been cut to the length i need to reach a pt, but short enough to not touch the floor when it's out of my pocket. i have it this way because i never put it back in my pocket until i've cleaned it. there are very nice pet leashes out there now... flowers, patterns, etc., and they are washable too.

i change the batteries every other shift, but i use it 50 times a shift.

biomed has approved it; checked once a year. our er has used a fingertip model for years.

it's fast, it's easy to use, only one part touches the pt, it's light... it was an all-around good investment for me.

as far as calibration, liability, cleanliness & competency issues...

my fingertip model, our rt department's hand held units with a sensor on the end of a wire, and the table top models, are not calibrated. calibration means set value ranges that are measured and verified. biomed makes sure there are no power issues, the alarms work and that it actually reads something that looks right, and that's it.

as to the liability of trusting a machine - it's general practice to verify anything that seems at odds with our observation of the pt, plus no pulse ox unit is ever to be trusted with a sat reading below 80. what could happen? an erroneously acceptable sat reading on a pt with no other indications of distress, and the pt crashes? it's not likely that a sat would be the only indication. an unacceptable reading would be verified.

if a nosocomial infection can be traced to a dirty pulse ox, as opposed to a dirty stethoscope, or bp cuff, or no alcohol swab use, or pillow fell on the floor, or, or... dirty shoes! j individual ethics and practices don't change with the equipment.

as far as i know, no one is checked out and signed off on the hand held units or on continuous/table top model pulse ox units. pulse oxs are pretty simple. it's not an iv pump, a swan-ganz monitor, or a balloon pump... items that could actually malfunction to the detriment of a pt. a hand held pulse ox is a battery powered light sensor with an led display. it isn't high tech. it works or it doesn't, no troubleshooting required. a laser pointer is more dangerous. i think the pts are competent with it after the first time.

yes, we ask repeatedly for the hospital to supply units for us. our department is 45 rts. we need 10 units per shift. we have 6. meanwhile, as it goes through the budget committees and funding to get a few more at a time, my 50 checks a shift x the 3-6 months it takes to go through to purchase the units, remain a p i t a for me. that's why i have my own.

there are always trade offs with budget negotiations. i will accept only 3 new pulse oxs a year instead of 10 (which really only replaces the broken/missing ones) to have an adequate supply of the best microprocessor ventilators available (at >$10k ea). a sat reading is a useful indication of condition but it never saved a life, but nitric oxide and bilevel ventilation sure has. i think our manager is fighting the good fight for both the rts and the pts. so, yes, in a perfect world we'd have everything we need, but in a perfect world we wouldn't need hospitals and somebody would be bringing me margaritas on the beach.

[Cattitude]

thank you nrskaren for that information, very interesting. i knew i didn't want nurses's t purchase equipment and now that puts the stamp on it as far as i'm concerned.

[Cattitude]

wow, did this turn into something! it's only a crummy little pulse ox. j

ultimately i do think that it's the hospital's responsibility to supply the equipment we need to care for the pts. but here in the real world... i got tired of borrowing a unit or rushing to get to work early so i could get one before they were all gone. another rt and i used to just trade as we gave each other report. it's a pita so, yes, i now have my own fingertip pulse ox. it's a nonin onyx ll model 9550 and i treasure it. onyx ll model 9500 works just as well. i looked at ebay but ended up getting it from a medical supply company for the same price.

i do appreciate the many points you made in your post and understand, i think your situation is a bit different.

some of us, i think were more opposed to the rn's buying equipment for more reasons than one. it's just indicative of so many other issues in nursing as a whole. a lot of it is principle, and apparently legalities, p &p's.

rt's have their own woe's, i'm sure.

[roshell1963]

My niece is a CCU RN in FL she bought her own when she started nursing school. Not only could she never find one but the calibration can be way off because they are frequently mishandled by the staff. Promedsupplies.com has a battery one for $695.00 a lot of money but think of all the time you waste waiting to have your turn with the floor's machine. I have little patience for time wasting when I have to be accountable to a Head Nurse for vitals. I start nursing school next spring and I am going to by my own after her advice.

[meownsmile, BSN, RN]

Ive contemplated buying one too. Found them a bit pricey, but havent done it yet,, i figured id probly lose it if i did so havent yet.

[bargainhound, RN]

I have a friend who found one on Ebay for $125. It is a good one.

[Dorito, ASN, RN]

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.

I agree. It could be a major liability. I'd invest in a stethescope instead. Years ago when I started in nursing we didn't even have pulse ox's. Is this a standard assessment along with vs now?

[caliotter3]

I checked back when I saw this thread again as I usually do when I am on this site instead of doing something more strenuous (like eating), and I noticed that at the top of the page were 3 ads for pulse oxims! I know that it takes money to maintain the site and I am not in favor of the increased number of ads, they annoy me, but I was kind of surprised. Don't really have a strong rxn pro or con; just surprised to see these ads.