o2

[pmw2007]

I have been working LTC/ subacute for about 6 months now and I am confused about some of the standards. I assumed in order to straight cath a patient, one would need an order from the doctor each and everytime. Or it would be documented it would be ok to do it. But, some of the nurses say: oh that doctor wouldn't care. and another question,

is changing a nasal cannula to a non-rebreather considered a nursing judgement? What exactly is a nurse allowed to do to help a patient before a physician is notified? I work 11-7 and I find many of my problems arise before I get there. Thanks for any input or guidance. :redbeathe

[GilaRRT]

Much will depend of facility policy. When I worked LTC, we had standing orders for several of the doctors. However, much will be nursing judgment.

If you have to upgrade from nasal cannula to a NRB, I would almost bet that the change in the patients condition needs to be reported to the doctor.

[pmw2007]

thank you

[bluegeegoo2, LPN]

For the straight cath question, we have to have an order for it. So, for new admits, I try to obtain a "May straight cath for urinary retention/UA" order, just in case. It saves time in the long run.