when can nurses touch ventilators

Diary/Dairy, RN · Mar 28, 2008

That's about the same as when I have worked in the ICU - FIO2 only....

CarVsTree · Mar 28, 2008

I'm still pretty new to ICU (XFR'd there in November) but that is solely the responsibility of the RRT. There is so much that goes into understanding and changing vent settings, I'm not sure why you would want that responsibility. Do you mean in an ICU setting, in sort of an RRT role? In what capacity do you want to work with vents?

I can't imagine managing my patient's medical needs and having to be responsible for vent settings. Of course, I need to know what they are and to contact the RRT and/or resident when they are or are not working. However, I enjoy working with the RRT and problem solving together. I very much appreciate their expertise since they ONLY work with lungs.

The only settings I use are O2 enrichment and standby if I have to disconnect the circuit (for example, when changing a cervical collar). If I need to travel the RRT disconnects from the vent, bags along the way, and reconnects in CT scan or the dreaded MRI.

Hope my limited experience helps.

BlueRidgeHomeRN · Mar 28, 2008

in home care (where there is 24 hour coverage, not interrmittent visits) nurses (rn's only) can adjust with an md order, since these are chronic cases.

lorilou22RN · Mar 28, 2008

As with most of the post's we can only touch Fi02 settings for vents. Now with Nippv, I do adjust other settings if needed and then will notify RT.

OC_An Khe · Mar 28, 2008

Nurses in the US gave up all the respiratory responsibilities to the Respiratory Therapists, who really didn't exist 40 years ago ( at least not in great numbers)

danissa, LPN, LVN · Mar 28, 2008

In the case of vented babies, nurses change the FiO2 when and if required. The pressures, rate I Time are set by the Doctors, but it can be an over the phone order at times with certain experienced nurses. And, at other times, we nurses kinda steer the inexperienced Doc round to the right changes for the vent settings. If you have been doing this for a while, you have to have an input when the med staff are less experienced.

I'm totally comfortable with a ventilator...just dont ask me to put screenwash in the car or to put oil in it...DUH! :lol2: :lol2:

CraigB-RN, MSN, RN · Mar 28, 2008

Hi
I'm an Ozzie nurse working in Louisiana.Here ican can only touch the Fi02 on a vent.
Can someone tell me in which states are they a little more proactive with nurses and vents????
Thanks

In the laces I've worked, it's not a state thing, it's a hospital thing. When flying and transporting patients I manage the whole package. It has nothing to do with the state.

It is partially a reimbursement thing, if an RRT does it, they can charge for it. Everything you do as an RN is included in the base room rate. Hence it makes more sense to have RRT do it.

BlueRidgeHomeRN · Mar 28, 2008

in the laces i've worked, it's not a state thing, it's a hospital thing. when flying and transporting patients i manage the whole package. it has nothing to do with the state.
it is partially a reimbursement thing, if an rrt does it, they can charge for it. everything you do as an rn is included in the base room rate. hence it makes more sense to have rrt do it.

and there is the problem we nurses have--ranking with the linen and light bulbs!!

:banghead:

allnurses Guide · Mar 28, 2008

i cannot find restrictions on registered nurses adjusting a ventilator. of course no nurse may do anything they are not competent to do. perhaps i am missing it. maybe it is a hospital policy rather than a state scope of practice law or regulation. i would call or e-mail the board of nursing.

louisiana board of nursing: http://www.lsbn.state.la.us/documents/contacts.asp

louisiana nurse practice act: http://www.lsbn.state.la.us/documents/npa.asp

rules and regulations: http://www.lsbn.state.la.us/documents/rules/fullrules.pdf

louisiana board of nursing statement on procedural sedation: http://www.lsbn.state.la.us/documents/decstate/declerat18.pdf

regarding nursing accountability (floating included): http://www.lsbn.state.la.us/documents/decstate/declarat11.pdf

TX_ICU_RN · Mar 28, 2008

You could not pay me enough as a RN to TOUCH the vent other than the FiO2 settings. When I go on to get my ACNP or CRNA....then I won't mind because I have taken on the legal liability in exchange for increased pay and autonomy.

RN1989 · Mar 28, 2008

It really depends on the hospital policy and has nothing to do with particular states. I've worked hospitals where the nurses weren't allowed to do anything except give 100% before/after suctioning. Other places we took care of the vents because there weren't enough RTs (hospital didn't want to pay for them) so we did all the vents stuff with orders from docs and protocols set in place. The best place I worked was a collaborative effort with an RT in each crit.care unit. We worked as a team to care for the vents which made it much easier to wean off because the RT could help if we needed to be with our other patients.

I think it very much has to do with both reimbursement issues as well as whether or not the hospital has good protocols, highly trained staff, and docs willing to work with the nurses.