Do you get an order to place your Patient on O2?

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Ok, when I first started working in my unit I noticed that nurses would here and there place patients on oxygen (like 2L) whenever their sats dropped a little WITHOUT an order. In nursing school, we were always taught to get an order for O2. Usually, the RNs will put them on 2LNC as needed, without an order.

To me, I don't see what the big deal is, since it's in the best interest of the patient. I asked a few nurses about it, and they said yes, technically you SHOULD have an order, but no one takes the time to actually get one. Occasionally we'll have MD orders that say something like "titrate o2 to keep >95%".

Anyway, my question, do YOU get an order for O2 or use your judgement and do it "as needed"?

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Specializes in CCU MICU Rapid Response.

Hey there, If I have a pt that has a change in condition that warrants me slappin some O2 on, theres probably something brewing that will warrant me calling the Doc, and Ill get an order then. :) Ivanna

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per our standing orders we can apply o2 but then we must call the doctor to update...this is a change in condition, so the doctor must be updated. :typing

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Specializes in ICU/Critical Care.

If my patient is being weaned from, lets say a 50% Venti mask, I don't get an order to decrease an Fi02. If my patient is desating on 2 liters of O2 nasal cannula and I turn it up to 5 liters because the patient is having respiratory distress, I don't get an order for that either BUT I let the doctor know "Hey, this patient is having trouble breathing, I just increased his/her Fi02".

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Specializes in Adolescent Psych, PICU.

No. I work in an ICU so we have patients on/off/titrating O2 all the time-- it's part of the RNs responsibility. Sometimes we will get orders to wean fio2 for sats >93% or whatever.

Now if I have a RA patient who suddenly starts having resp issues and they didn't before and I have to get them on O2 I let the doc know right away because that is a pretty big change in condition.

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Specializes in Telemetry.

Most er admit orders come with applying 02 per nc to maintain 02 sat's greater than 92% where i work.

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Specializes in Med Surg, Ortho.

We can put O2 on without an order, but we need to get an order afterwards.

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Specializes in Medical-Surgical.

You know, I always assumed it was protocol to place on up to 2 L O2 per nursing judgement, but now I have to go to work and check in the morning. These's a big difference between "what we do" and the rules sometimes. :specs:

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Specializes in Urgent Care, Step-Down, and ER.

Where I work, yes we need an order to place oxygen on a patient. If a patient is in obvious distress and oxygen saturation is low, I'm not going to wait for an order, thats your "nursing judgment", and call the doctor once I stablize the patient and use my assessment skills to figure out what caused the drop in oxygen saturation.

Watch out for those COPDers, you have to monitor their oxygen use, you don't want to kill their drive to breath.

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I think 2L NC for occasional low sat should be nursing protocol. (we should NOT have to get an order for that). Nor should we have to get an order to get saline spray for a dry nose from using o2, or something silly like that. To me, it's like calling the doctor for chapped lips and asking if you can get some chapstick ordered. silllllllllllly

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Specializes in Acute Care, Rehab, Palliative.

We don't get an order for O2. Just the other night I had to apply and put it up to 4L until her sats were up and then down to 2 afterwards. We are a small facility with one doc do we do a lot without calling her first. We can call her in the morning if someone's condition is worsening.

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Specializes in Med Surg, Ortho.
Where I work, yes we need an order to place oxygen on a patient. If a patient is in obvious distress and oxygen saturation is low, I'm not going to wait for an order, thats your "nursing judgment", and call the doctor once I stablize the patient and use my assessment skills to figure out what caused the drop in oxygen saturation.

Watch out for those COPDers, you have to monitor their oxygen use, you don't want to kill their drive to breath.

I remember studying the COPD vs O2 in school, but have forgotten all about that need for assessment. Thanks. :bowingpur

PS. That's what I like about this board.

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