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I don't routinely take vitals...I do, however, manually check "off" BPs. When I have taken full sets of vitals, though, I counted respirations.
There used to be a tech at work that always fudged the RR until the day I observed him use the Dynamap, then record the vitals including RR. Knowing full well that he never once looked at the clock on the wall or his watch I asked him how he timed the respirations. After some cock-and-bull explanation, I told him I depended on him being accurate and that if he couldn't be then I'd take my own vitals, thank you very much. After that he made a point of counting respirations because he knew I'd check after him.
I didn't answer your poll, though....none of the answers fit :)
I count them each time. Too important not too!
My husband was getting his vitals done at his oncology appointment and the lady (assistant? Not a nurse, I Think a tech?) said "I just have to check your respirations" and looked at the dynamap!! Then wrote a number down! LOL I was dying trying not to laugh at her. I let her slide but told the doc when we saw her what she did, and asked did they have a new super-dynamap that measures respirs? LOL. Doc talked to her and now she counts.
I am employed at a nursing home and care for stable geriatric patients with relatively predictable outcomes. We only take full sets of vitals by exception only, such as when a change in condition occurs.
I check the pulse and BP every single time I give an antihypertensive drug or cardioactive med. I obtain temperatures on patients who are taking antibiotics and during the post-ABT period. However, I obtain a respiratory rate only when there are s/s of distress. I voted for the option that read 'based on the diagnosis or medications given'.
Most of the time I count. Rarely, as with a small lac or sprained ankel in a young adult, who is talking on their cell phone and annoyed with me for interrupting them to assess, I'll go with wnl. That said, I've learned that you can NOT estimate well someone who looks to be breathing "normally" but has a very fast rate. You have to count. From across the room, 20 and 34 RR may look very similar. Personally, I love the monitors that will monitor RR as well as everything else!
When I was on med-surg, I ALWAYS counted. I remember an experienced nurse once telling me that I couldn't have 19 as a resp rate because RR are always even numbers LOL. I told her, that is what I counted!
Dawned on me later that she must have been thinking of a manual BP where the dial is only calibrated in 2pt increments.
Speaking of counting, had a new grad nurse tell me once that she didn't get a HR on a patient yet as they weren't hooked up to the monitor yet! Whatever happened to palping and counting a pulse (and RR while your'e at it)? I must do that 100 times a night - never wait for a machine when you can do it yourself!
Had one nurse when I was an LPN and she the RN, that stated a patient had a RR of 40 during her assessment, I had just taken the patients vitals and the RR was 20. So both of us went down to the room to count. Come to find out patient was a RR of 20, she was counting the inhale as 1 and the exhale as 2, so 20 turned into 40. She wouldn't believe me that she was counting wrong.
GardenDove
962 Posts
This question is to find out how many nurses actually count resps every single time they take vitals.