How frequently do you take post op vitals? Why? Have you any evidence for what you do?
I'm researching our unit's policy because we are being expected to carry out a ridiculous number of obs (especially with our current workload) & all the research that I've seen so far actually shows little correlation between changes in obs & post operative events being discovered.
I'm talking minor to intermediate surgery by the way - not that I'm not interested in anyone elses input though & that includes international nurses lurking here too!
can the nurses where you work get to do obs at the current regiem i;ve found that every 15 r 30 isn't actually such in real life and thats while i've been the student, on a ward without those extra sets of hands it must be harder.
my trust has brouht is a policy were full sets of obs have to be done for EWS whereas at night most wards on non-post op patients only did sats and heart rate and so as not to wake patients.
This is on the ward not recovery, just to clarify.
It's because the regime being requested is just not possible that I'm interested finding out what goes on else where & if anyone has any quantitive research to back up their current practice. I know corners will be cut, maybe obs will be falsified (we all know it happens) & really important things will be missed because we're rushing around with our dynamaps trying to chart uneccessary obs.
I have become much more interested since I started looking in to it because the research that has been done (& it's not much) has actually found that frequency of obs has no correlation to the finding of complications in post op patients.
In this era of evidence based nursing & research based practice (hahaha) I just think it's time nurses were allowed to nurse again. I'm fed up of non-nurses telling me what I should do without backing it up with any research whatsoever.
the trusts are so scared of getting sued, death of injury due to medical/nursing care and protocols called into question.
i can say as a 1st student on a ENT ward i was taking obs and in a sense i had to learn how to intreput, by frequently checking with RN, they are just numbers and not a way of assesing conditions. if hca or st/n are taking the obs the figures are only as good as the ability to asses and that is why EWS i think has come in. EWS has helped me in A&E a raised EWS score made me alert medical staff to check him after i asked my mentor. however recently i was doing progess and evalution on a pt that a 1st year st/n had taken the obs, pt had raised resp low bp all charted, scoring ews=3(medics to be informed) but no action taken and the 1st year didn't know these were things you act on. pt got volume expanders and follow up fluid was on iv abx.
I know what you're saying but causing nurses to effectively spend even less time truly assessing their patients is actually going to cause more problems in the long run. I'm not talking about no obs though, just sensible amounts.
For your interest I have had cause to send a patient who "only had a gastroscopy" to the Coronary Care Unit because she developed chest pain & it turned out she'd was having an MI!
I want to add that patient was in recovery at the time, they had supposedly been doing obs but were in a hurry to get her back to the ward. they tried to persuade me her chest pain was related to gas used in the procedure - well I know that they don't do that in gastroscopies only colonoscopies! Her obs were all charted as stable but when I insisted on them putting her back on the monitor (which they are supposed to be on in recovery) her heart rate was over 200 & she was throwing off ectopics!! Where all the multitude of charted stable obs came from I don't know!!
That's why I think that a more sensible regime that allows time to properly assess the actual state of the patient is better than hundreds of obs where no-one's actually looking!
I was concerned the minute I walked into recovery, just looking at the patient. The recovery nurses were looking at their machines & writing down whatever without thinking. They were taking obs every 5 mins but failed to spot the start of an MI!! Maybe if they were only taking them every 15 mins they'd have had a chance to actually look properly at their patient instead??
RGN1
1,700 Posts
This is on the ward not recovery, just to clarify.
It's because the regime being requested is just not possible that I'm interested finding out what goes on else where & if anyone has any quantitive research to back up their current practice. I know corners will be cut, maybe obs will be falsified (we all know it happens) & really important things will be missed because we're rushing around with our dynamaps trying to chart uneccessary obs.
I have become much more interested since I started looking in to it because the research that has been done (& it's not much) has actually found that frequency of obs has no correlation to the finding of complications in post op patients.
In this era of evidence based nursing & research based practice (hahaha) I just think it's time nurses were allowed to nurse again. I'm fed up of non-nurses telling me what I should do without backing it up with any research whatsoever.