Is it okay for an LPN to administer oxygen without an MD order?

[regineroy]

I was involved in a situation where I went to work as staff relief personnel for a nursing home. Little did I know that the nursing home was under investigation by the state. I worked with over 20 patients that night for a 12 hour shift. Upon rounds I noticed that one of my patient's was having shortness of breath. I applied 2 liters of oxygen via NC which relieved the shortness of breath. I immediately called the doctor and left a message for the doctor to call the facility to obtain an order on whether to continue oxygen therapy or transfer patient to hospital. Unfortunately the patient expired that night due to natural causes. Was I wrong to adminster the oxygen?

[heathert_kc]

That's exactly what I would have done. Luckily, I don't work agency, but have one full time gig and know the majority of my resident's physicians. I mean unfortunately when you call a doc (or anyone for that matter) at 3am they don't always answer the phone. You have to use your best judgement, if their vitals, other than just O2 sat were out of whack and you thought there was something more going on, or otherwise beyond your ability to treat; You call again. Then you have to make a judgement, if you don't get a call back, to send out or not. I mean even without an order, you cannot allow a full code/non-hospice resident to die waiting on a physican to wake up and call you back.

[tothepointeLVN, LVN]

I was always taught back in school that a licensed nurse can administer up to 2L of O2 without of MD's order/pending a MD's order

[CynicallyVexed]

you did the right thing by adm O2 up to 2LNC with out MD order it's within our scope of practice. My next judgement would be asses the lungs, heart and vitals, especially if they are full code. If they were stable I would go ahead and call the DR see if there is any labs they want done for the morning or order in Nebs if they don't have any. If not stable I would have probably sent out. I hate to say it if they are DNR/DNI, I would have applied the O2 for comfort gave any Nebs if they have anything ordered and if they were stable called the family and then the MD in the morning. PE's and Pneumonia are some of the #1 causes for SOB and decreased sats in them little nursing home patients..

[MaraLPN]

You absolutely did the right thing by adm the O2 to that patient. a+, keep up the good work.

[TheCommuter, BSN, RN]

Most of the nursing homes where I've been employed have standing orders to apply oxygen if the resident is symptomatic and has an oxygen saturation of less than 90 percent.