need an advice

[kara_vn]

Hi guys,

I am not a very experienced lpn, working in home health I need an advice regarding patient's safety. The patient receives O2 via Bipap. I don't feel comfortable leaving the oxygen concentrator on, when I leave from my night shift. There is a 2 hr hour gap from the time I leave and next nurse arrives. The patient is independent and responsible for own care. The patient requests the concentrator to be on during those 2 hr. The patient is immobile and needs full assistance. My agency told me it was ok to leave it on. But I am still concerned.

[JustBeachyNurse, LPN]

Why wouldn't it be safe? I don't understand your concern. However one cannot be independent and full assist/bed bound that makes no sense. Either they are independent in ADLs or they are full assist you can't be both.

[kara_vn]

Independent -meaning axox3, mentally fit and capable to direct own care, but in terms of ADLs is full assist, so in worse case scenario like fire for ex, will not be able to stand up and take care of the situation. My concern is that during those 2 hr. there is no one in the house and the equipment is on. But I know that homehealth is different then LTC where I used to work long time ago. It's the first time in my experience that I have to leave my shift and there is no one to take over. That's why I am asking if something like this is normal for homehealth. Thanks for your reply

[NightNurseRN13]

Is there no one in the house at all? Not even a family member? Leaving the o2 concentrator on wouldn't bother me, but leaving someone who is full assist completely alone would.

[nurseprnRN, BSN, RN]

I don't get what concerns you about leaving a patent on oxygen when there's no caregiver there. "Safety" means what to you, exactly, in this situation? Thousands and thousands of people use home oxygen, many with BiPAP or other assistive devices. Could you clarify your fears?

I suggest you take it upon yourself to learn what an oxygen concentrator is, why your patient uses it, and why removing oxygen from someone who is prescribed it for a medical condition is absolutely not your call. I also suggest you get somebody to explain the difference between these two contradictory sentences:

The patient is independent and responsible for own care ... patient is immobile and needs full assistance.

Next, I very strongly suggest that you learn that a patient, not you, is responsible for his/her own choice in adhering to any medical or nursing plan of care. You cannot refuse to give oxygen to someone who asks for it and for whom it is prescribed.

Last, you say you asked at your employer's and they told you it was safe to leave it on when you left. What makes you think they were wrong?

[Here.I.Stand, BSN, RN]

I'd be a lot more concerned about leaving a pt who needs supplemental O2 without it for 2 hours.