Oxygen

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At my work a gentleman receives O2 therapy. When he is asleep at night he gets O2 from a concentrator. On the day he has a portable tank. I don't normally fillbthe portable tank as I am thinking it is up to day staff to fill that one. The order on the MARS only has the portable tank on it as "compressed" i have been signing for that. But now my supervisor says I signed but haven't been filling it up so it is a med error. I am a bit confused as yes I signed the wrong order but he doesn't receive that type at night. So shouldn't the correct or der for "oxygen" be entered into the MARS? And if I was signing the wrong order is it really an error if he doesn't get the portable O2 at night? So confused!

Well nursing is about team work, so if you have the time and it is technically your responsibility, shouldn't you just do it? It takes two minutes.

Even if it is up to day shift, I know from my experience in LTC, I was always very grateful in the AM when oxygen tanks were filled and ready as I had about 20 patients to get up before 0800 (when I was working as a CCA).

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It's a retirement home so I am busy for the last hour as the day nurse is in her first hour. If it was team work and I missed it somehow then the day nurse could say okay she will do it. But in this case it wasn't team work at all it was putting blame on someone else.

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Specializes in PMHNP.

Do you know how to fill the oxygen tank? I had a patient once who's concentrator had an attachment to fill her O2 tank. While the patient was in bed at night with the concentrator running it was simultaneously refilling the tank. Therefore in that case it would be very important that night shift make sure the tank was connected to the concentrator- as that was the time the refill would be happening.

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No the one in the room runs on air circulating in the room. The portable one is filled manually from another large compressed tank, they would normally be using the one in their room at night not from the portable tank.

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Until someone fixes the orders on the MAR, I would sign, but note on the back of the MAR that the actual method of delivery was by concentrator.

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It's a retirement home so I am busy for the last hour as the day nurse is in her first hour. If it was team work and I missed it somehow then the day nurse could say okay she will do it. But in this case it wasn't team work at all it was putting blame on someone else.

You signed the MAR for something you didn't do. Incorrect order or not-if you read it then you should have noticed. I would have wrote a progress note about it and then proceeded to get the order fixed. That would have prevented you from making "an error."

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Just curious, how does on "fill" an O2 tank? I really don't know. I work in acute care, so our tanks are either full, partial or empty. Can you flip a switch on some machines and they "concentrate" 17% room air to 100% O2? If so, that's kind of cool. Never thought to ask.

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I do not see this as a shift issue. You are signing that there is compressed O2 available for the patient on your shift. What if there was a need to evacuate the facility for some reason such a fire? Do you really want to scramble around to get O2 for the patient?

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Specializes in Med-Tele; ED; ICU.
I can see technically where your manager is coming from, you did sign for something that is the "wrong route".
It is not the wrong route... at all times, the oxygen is being supplied at an ordered rate by a specified route (presumably NC)... from a physiologic viewpoint, and a nursing perspective, that's what matters. The rest is bookkeeping.
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Specializes in retired LTC.

To those who've asked - not all mobile oxygen systems are via the concentrator or the big/small green tanks. The old familiar green tanks are empty/partial/full, need the 'key' to crack open and you need the 'regulator' to be lined up to work. I became a pro at using them. In LTC, there's usually an oxygen delivery company that comes out to exchange the empties for full ones. Maint dept usually lines them up somewhere for the vendor to do the weekly exchange. They're chained (safety regulation) with a mobile rolling dolly. Everybody knows them!

But there is another type of delivery system in which small 'canisters' are somehow piggybacked to a LARGE condensed oxygen apparatus that does fill the small canisters (about the size of a small fire extinguisher). The small canisters are intended to be attached to a wheel chair and are for low flow use - the higher flow rates go 'empty' quicker than the slower flow rates. On 11-7 or when in bed, pts were either on concentrators or wall delivery O2. Small canisters would be used for mobility/OOB only.

They weren't difficult to refill, just another task that takes up precious nsg time. Usually NOC is assigned to refill the tanks for each OOB pt who needed O2 . The CNAs would just gather the canisters from any pt's wheelchair (they strap on the whch), fill them, and replace the canister to the whch. And they would check for any empties lying around to refill.

I was told it ensures better availability of O2 by being able to refill in-house. If the number of O2 pts decreases, the canisters just stand-bye;and are ready as the need goes up.

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We have computer MARS but yes good thinking may write that in the notes that go with the MARS!

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Precious nursing time is the issue and think that's why all this came up in my work place! Night shift is just as busy in last hour of shift that the day shift is in their first hour but day shift was only concerned with themselves and how busy they were that they complained about it not being filled for them. But that is another story!

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