New pulmonary nurse

SunflowerSue · Feb 9, 2008

I too am a LTC RN transitioning to pulmonary care and am interested to see the replies you get. I wish you luck!!

Silverdragon102, BSN · Feb 10, 2008

Is there any courses you can do?

ECMOismygame · Feb 10, 2008

Is there any courses you can do?

you can go to respiratory therapy school....

RN4Research · Feb 27, 2008

Is there any courses you can do?

Having been a respiratory therapist for about 13 years, then transitioning to nursing about 4 years ago, what I found was most of my nursing collegues who did not have much respiratory experience were very nervous when called upon to take care of a pulmonary patient. (Understandably) I was very happy to act as a resource for my coworkers. They knew that they could come to me for help or if they had questions and I would teach them what they needed to know and not just do it for them.

My suggestion to new pulmonary nurses is first of all to find out exactly what your patient population is and review the disease processes. I work at a university hospital and that is a major academic teaching center, so we see very sick patients with many diverse pulmonary conditions such as lung transplant, cystic fibrosis, pulmonary hypertenstion, and COPD to name a few. I had to familiarize myself with the plan of care of CF, what exactly pulmonary hypertension was, etc, since I did not see those types of patients in my former practice.

Also, find someone on staff who can mentor you. There are usually other nurses who are experts and who love to teach. Let them take you under their wing. You can also find a good respiratory therapist and ask them questions! I loved teaching nurses when I was a therapist (ultimately it made my job much easier if they were comfortable suctioning their patient rather than callling me to do it if I was busy elsewhere). Good Luck! :nurse:

Silverdragon102, BSN · Feb 27, 2008

Having been a respiratory therapist for about 13 years, then transitioning to nursing about 4 years ago, what I found was most of my nursing collegues who did not have much respiratory experience were very nervous when called upon to take care of a pulmonary patient. (Understandably) I was very happy to act as a resource for my coworkers. They knew that they could come to me for help or if they had questions and I would teach them what they needed to know and not just do it for them.
My suggestion to new pulmonary nurses is first of all to find out exactly what your patient population is and review the disease processes. I work at a university hospital and that is a major academic teaching center, so we see very sick patients with many diverse pulmonary conditions such as lung transplant, cystic fibrosis, pulmonary hypertenstion, and COPD to name a few. I had to familiarize myself with the plan of care of CF, what exactly pulmonary hypertension was, etc, since I did not see those types of patients in my former practice.
Also, find someone on staff who can mentor you. There are usually other nurses who are experts and who love to teach. Let them take you under their wing. You can also find a good respiratory therapist and ask them questions! I loved teaching nurses when I was a therapist (ultimately it made my job much easier if they were comfortable suctioning their patient rather than callling me to do it if I was busy elsewhere). Good Luck!

It is interesting on hearing how other countries manage their respiratory patients. Here in the UK we do not have RT's but the RN will do the medication (nebulizers/inhalers etc) and will call physio if chest needs therapy. I love respiratory management and when I worked in a doctor's office I care managed asthma and COPD patients with protocols and management with one of the doctors following national guidelines. If I wasn't moving countries I think my aim would be to be a respiratory nurse specialist

ANNSY54 · Sep 21, 2012

I was a respiratory therapist for 20 years before becoming an RN. I work at a long-term acute care hospital with a pulmonary specialty. To be honest, I have not seen one single nurse, out of the 60 or so that work there, who really understands tracheostomies, ventilators, ventilator weaning, oxygen administration, or anything else having to do with respiratory. They seem to leave it up to the respiratory therapists.

I think that if you really want to know about the basics, familiarize yourself with tracheostomies, become comfortable with suctioning, do trach care everyday on your patients. Realize that the ventilators are not really for nurses to understand. RT's go to school for a long time to learn their management. It's enough to know that your patient is getting their oxygen and a certain amount of breaths from the vent. It would be helpful to understand the 2 standard modes of ventilation: CPAP mode and A/C or SIMV mode. Cpap is when the pt breathes on their own and A/C or SIMV is when the ventilator gives breaths. When you suction a patient, always give them 100% oxygen through the ventilator. There is a special button on all vents for that.

Another thing I would do if I were you would be to ask an RT to show you all the ways you can administer oxygen to your patients, such as: Nasal cannula, venti-mask, non-rebreather.

You should also become familiar with Bipap and CPAP (not to be confused with the ventilator CPAP.) These are modes of non-invasive ventilation. Bipap is used when a pt has high CO2 on their ABG's. Cpap is used when a pt has low PO2 on their ABG's.

Lastly, review your knowledge of ABG's. You should absolutely know without question that when a pt has high CO2 which is abnormal for them, that they are going to need some kind of breathing assistance, whether it be Bipap or vent. You should also be keenly aware of your pt's SPO2 at all times. Most facilities like to keep SPO2 > 92%.

You have your work cut out for you! Good luck!

Ann