Do you count resps every time you do vitals?

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  1. When do you count resps with vitals?

    • 142
      Every single time
    • 58
      Based on the diagnosis or medications given
    • 75
      I usually estimate, unless they are respiratory
    • 22
      I'll check them once, then estimate thereafter
    • 61
      I alternate between 16, 18, and 20, unless they look too slow or fast
    • 20
      truthfully, seldom
    • 18
      I always check them, and don't trust the CNAs to have really done them

241 members have participated

This question is to find out how many nurses actually count resps every single time they take vitals.

Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.
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.

Oh man. How does this happen? That is scary.

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Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.
Honestly,there just isn't enough time in one shift to do everything strictly "by the book", especially in a nursing home setting where you have 30-40 patients at a time-not to mention that most are stable anyway. I voted for,

"based on medication or diagnosis".

I strongly disagree with this and it really scares me that some nurses feel this way.

1. It doesn't matter how many patients you have or how much you have to do; if it is your job to obtain the vital signs, you obtain all of them. (And, yes, I also have 30-40 patients at a time.)

2. They are called VITAL SIGNS for a reason. Respirations are just as important as temp, bp, and pulse.

3. If you are not counting respirations, what are you writing down? Are you falsifying information, or just leaving it blank?

4. If I found a nurse or CNA routinely skipping respiration counting, I would write her/him up in a heartbeat.

I totally understand it if you can't get the resp. because they are talking to the doctor or on the phone, but you can come back later and get them.

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When I first started med surg (we were not allowed to do vitals in LTC) I was getting vitals on a pt. I was pretending to get the patient's pulse radially and looking at my watch. She told me "you can just guess, I do it all the time and I'm right most of the time."

How do you know if you're right if you don't count?

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Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.
When I first started med surg (we were not allowed to do vitals in LTC) I was getting vitals on a pt. I was pretending to get the patient's pulse radially and looking at my watch. She told me "you can just guess, I do it all the time and I'm right most of the time."

How do you know if you're right if you don't count?

That is just ridiculous.:banghead:

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Specializes in nursery, L and D.
Vamedic, is that a typo??????

I realize this question was asked a while ago, but I thought I'd answer it anyway. I believe this nurse works with kids/babies and I have seen some babies with RR over 120 with RDS, etc. Normal for term newborn is 30-60.

BTW, I've seen your screen name dozens of times and it just dawned on me what it says............love it:lol2:

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I have pts on vents that are on set rates not breathing on their own and we get all kinds of RR recorded on them. I like checking things for myself.

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Specializes in Cardiac/Telemetry, Hospice, Home Health.

[quote=

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.

I usually count for 15 secs and multiply by four - of course is why I always get an even number. I know most of the nurses on our unit fudge the rr. I don't. I pretend I am taking a pulse and use that time to also check for skin color, posture, etc.

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Specializes in ER, ICU, Infusion, peds, informatics.

when i worked icu, i would verify with my first assessement the the monitor was accuratly reflecting their resp count. after that, i wouldn't cout myself, just look at the monitor, unless something changed. if they were on the vent, sometimes i would use the count the vent had. just depended on the situation.

when working er, i don't always do a resp count with dc vs. if they came in for a non-cardiac, non-resp complaint (such as ankle pain) and don't get any narcs, then i just leave that spot on the vs form blank. probably not "by the book," but not falsifing records, either. part of the reason is that most of our rooms don't have functional clocks. i don't wear a watch (allergic to the metal), so i frequently have to use the timer button on the thermometer. thermometers (at least ones that work) can be difficult to find. (but it can be useful to count resps while the thermometer is in their mouth. esp for those who won't get off the phone)

when i do count, i usually count for 15 sec and multiply by 4, unless the results are high/low or they appear to be breathing irregularly or in distress.

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Specializes in Cardiac/Telemetry, Hospice, Home Health.

[quote=

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.

I usually count for 15 secs and multiply by four - of course is why I always get an even number. I know most of the nurses on our unit fudge the rr. I don't. I pretend I am taking a pulse and use that time to also check for skin color, posture, etc.

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Specializes in Neonatal ICU (Cardiothoracic).

All our babies are on vents or at least monitors. I look once to see if the monitor waveform is correlating with the baby's actual respirations.....then it's monitor vitals from then on...

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it is one of the vital signs after all;)

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Specializes in ICU, hospice, MS/tele, ED, corrections.

I am a CNA and I count them for 15 sec, then multiply by four; unless their RR is irregular, then I'll count for 30 - 60 sec (and multiply by two, of course, if counting for 30 sec.) I haven't figured out how to do it yet without feeling like I am making them uncomfortable by staring at their chest, lol! Sometimes the TV is on and I pretend I am watching the pt's. TV while "Molly Dolly" (as one pt. calls the Dynamap vitals machine) is reading the pt's. BP. :wink2:

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