Can and/or do nurses give chest physio?

Nurses General Nursing

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I know this might sound silly, but I just watched an episode of 'Mercy' where the nurse gave chest physio and it reminded me of my COPD/Lung CA patient who needed CP over the weekend and was not treated because PT doesn't work on weekends. It looks like an interesting enough skill to learn. I remember studying postural drainage in school .. vaguely. Are we expected to perform this?

Specializes in ER, Step-Down.

at my facility, chest PT is a nursing responsibility. we learn it in school, and the ICU has some nifty little gadgets to make it easier. I just use the cupped hand method. the RT's do it as well if they are around for treatments, but usually they don't have the time to dedicate to that.

Responsible for doing it in home care if ordered.

Specializes in Critical Care.

Definitely a nursing responsibility at most institutions I've been at. Where I'm currently at, we've got a percussor that makes it easier, your hands don't tire out as quickly (I've got the beginning stages of carpal tunnel so it's hard for me to hold the "cup" position for long). We consider it a part of pulmonary tolieting which is essential in our post-op pts.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

If the policy of the hospital dictates that the RN or the RT (both) can do it...then yes. At my hospital, we have delineated very specific responsibilities so that we are clear as to what is expected of us. It can become too confusing when the RT thinks the RN has done it when the RN thinks the RT has done it. Guess what? It doesn't get done. It's the RT does the chest physio as well as runs all therapy-driven protocols for anything RESPIRATORY.

We have a huge hospital and a huge RT department. I am grateful for that because I have enough "nurse stuff" to do and although I will do anything I need to for the patient, I gladly turn over this responsibility to the RT colleagues.

Jo

Specializes in Cardiac Telemetry, ED.

RT does it at my facility, but I've assisted with it.

Specializes in ER.

RT has done it at the facilities I've worked in. That said, basic chest persussion w/ cupped hands was something the nurses frequently did when I worked on peds.

I did have an adult CF pt frequntly when I first was a new nurse. I'd walk into his room sometimes and it looked like he was doing yoga- he knew all the postural drainage stuff plus had a few of his own, lol. It worked well for him. He had great humor, and would occasionaly ask for someone to come 'beat on me' to loosen the secretions.

I also think incentive spirometer is a great thing for pts. They can be taught to do it on their own and after initial observation to make sure they are doing it properly all you have to do is remind them to use it.

RT does it at our facility.

Specializes in Peds Critical Care, Dialysis, General.

We have a wonderful staff of RTs, but during RSV season, they can be stretched pretty thin. We had an unusually busy summer.

In our facility, nurses may perform CPT, as well as the RTs. I do it quite often, especially when my patient gets really junky and just won't let go of the secretions (most of our patients are intubated). There are times we will "double team" and get the back as well as the front of the patient. Many, if not all, of the RNs I work with also do CPT. I find a great satisfaction in getting up all that junk!

Specializes in ICU/Critical Care.

I give chest PT to my patients every two hours. Sometimes a patient will have one of those wonderful beds that provide it but for the most part I do it myself. RT doesn't.

Perception of thinking you're doing something and reality of actual physiology are sometimes colored rosey.

Evidence based practice is a welcome way of performing patient care.

Nurse do here. I never thought of it as anything but a nurses job. And we do the breathing treatments too. No respiratory therapists where I work.

I worked in a big city ER for awhile - it was frustrating for me not to be able to start a breathing treatment . . . and have to wait for RT.

steph

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