Do you count resps every time you do vitals? - page 2

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

  1. by   prmenrs
    Babies: need to count @ least 30 seconds. If irregular, go for a full minute. Gently place your hand on the [sleeping, preferrably] baby's trunk, outside the blankets. Can't "feel" it? Slip your hand under some of the swaddling; watch head and neck @ same time; let the kid settle down--they'll squirm @ first and hold their breath--then count.
  2. by   UM Review RN
    I guess I must do it in my head at this point, because when I'm doing vitals and an assessment, I decide whether they're too fast or too slow.
    Then I do a quick 15-sec count for all the normal-appearing folks, but I'll go to a full minute count for those who are outside of the range of 18-24.

    I have also found people whose resps were 8 or 10 or as high as 40, and had been recorded as normal. But we need to remember that resps can change dramatically over the course of a couple of hours.
    Last edit by UM Review RN on Feb 2, '07
  3. by   vamedic4
    With our patient population, you'd be completely stupid if you DIDN'T count them each time. We have some little one's who are fine with resps of 20, some with resps > 90. It's too important not too count...each time.
    Last edit by vamedic4 on Feb 2, '07 : Reason: Forgot something.
  4. by   kimber1985
    I always count for 30 secs for a well patient with regular breathing pattern, a full minute if they have any sort of irregular breathing. I just don't feel responsible with 15 X 4.
  5. by   UM Review RN
    Quote from vamedic4
    With our patient population, you'd be completely stupid if you DIDN'T count them each time. We have some little one's who are fine with resps of 20, some with resps > 90. It's too important not too count...each time.

    Vamedic, is that a typo??????
    Last edit by UM Review RN on Feb 2, '07
  6. by   Lacie
    I always count respirations during vitals! How difficult is it when your doing the pts pulse to go the extra while they are being still to do the respirations. After I count the pulse or heartrate by steth I continue to appear to do so while counting respirations as pt tend to hold still during that time and relaxed (at least those that are able to do so). If they think I'm listening to lung sounds, etc they tend to change the breathing pattern to "help" lol. I count when they dont know I'm doing so.
  7. by   Sheri257
    I've seen so many people NOT count respirations, it's ridiculous. Yes, I know there's not always enough time for everything but, when an entire floor of patients is supposedly at 20 it's absurd.

  8. by   BlkQueenLPN
    Quote from Tweety
    Count for 15 seconds and multiply times four. That's all the time it takes.

    I agree that there isn't time to do anything by the book. But when you document respirations, unless it says "estimated count" you're falsifying medical records by guessing what you think it is. The time it takes you to look at them and guess, you could actually get a true count.

    Your kidding....
    That's too cute.
  9. by   jill48
    Well of course! Your charting it so you better be doing it.
  10. by   Tweety
    Quote from BlkQueen075
    Your kidding....
    That's too cute.

    No I'm not kidding. Don't patronize.

    Like most experienced practioners I can look at someone and tell if they are tachypic or not. However, guessing someones respirations and then documenting it as a true factual count is at it's worst falsifying information. Besides "cute" what would you call it? :spin:
    Last edit by Tweety on Feb 12, '07
  11. by   MOOSEMAN
    If you document that you did vital, I can only hope that you truely did!!!!
  12. by   jill48
    Quote from Justhere
    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.
  13. by   jill48
    Quote from new_grad06
    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.