Audacioustank

Unfortunately most hospitals will do this and it sucks! I just completed my new grad program and we had a few instances of having 7 am class one day then 7 pm shifts the next day. Their rationalization was "you have all evening and the whole next day to catch up on sleep." As a healthcare organization you'd think they would know the human body doesn't work like that. But unfortunately HR does not care. Do your best to sleep well for now, and know that this is temporary! Try melatonin if it helps.

Thank you for taking the time to explain this!! I didn't know CHF and the fluid buildup would cause wheezing. Of course the pt was getting lasix as well, but it takes some time for them to pee everything out, so my thought process was that a treatment could help get them more comfortable until that could happen. I also wanted to add, thank you to you and other RTs! I know you guys are a fantastic resource and a super important part of the team and I'm grateful to work with you guys! This was the first time I've had such a bad experience with someone.

I have a Littman cardiology iv! I hate those isolation stethoscopes, I can never hear anything LOL ? I feel like lung sounds are so much different sounding in real life than they are in videos/ sound clips ?

I like that. The extended version was nice too in a perfect world, but I agree I doubt he'd listen to the whole thing LOL. I was trying to explain to him my thinking and ask questions but he was already out the door.

I agree with you, but one concern is my nursing critical thinking skills, my other concern is that the RT specifically told me both patient's lungs sounded clear when I really heard otherwise- so I'm questioning my simple assessment skills. ☹ In hindsight, I do think the COPD pt was pretty stable. He was just sitting in bed and had done nothing that had aggravated his SOB, so I sat him up in bed but he was getting verbally aggressive, too (aggressive psych hx), while huffing at me demanding a breathing treatment. Not that it makes my lack of critical thinking okay, but it contributed to my panicking and going straight for RT as a resource. As for giving a CHF pt a breathing treatment, I'm not too sure of the contraindication- I did consider the side effect of tachycardia which I brought up to the RT earlier as my hesitancy to give my pt albuterol, and he had suggested xopenex instead which the provider agreed on. If not that, what else am I missing?

That's a good idea too!! I didn't think to ask those questions at the time, but I should have! It's a relief that I wasn't just hearing nothing, but now I have to start learning the critical thinking aspect. On that note, I'm so glad I work on a floor where the other nurses are so supportive and always encourage the new grads to ask questions and ask for help. I was very upset for a bit of my shift after that event, and was in tears in the break room, but I had a great pep talk from one of the more experienced nurses who told me it would come with time, and to always ask for help when I need it! I felt so much better after that.

Yeah, I think I will do that from now on before calling RT! I mentioned in my other comment that I had the charge listen to one of them after the fact, and he agreed he heard faint wheezing but not necessarily audible enough to warrant an intervention. I told the RT my assessment- 97% on RA and (at least to me) faint wheezing. I can't wait to have more nursing judgment to know when I should call (text in this case) about these things. It didn't help my anxiety that my pt was also verbally and physically aggressive and was getting angry about not getting his treatment.

It was my first experience with this RT. After he stormed off on me, I talked to my charge about it and he said "that's how he is." But also told me he handled the situation wrong. I had my charge listen to my pts lungs (the COPD one) and he also heard faint wheezing, but in his opinion not audible enough to warrant intervention.

I'm a new grad on a med surg/tele unit. I'm on week 3 on my own and I've noticed I'm having a hard time with lung sounds, and with determining if my SOB pt needs intervention or not. Today I pissed off one of the RTs, because I had a CHF pt who I felt had loud, extremely textbook wheezing and was satting at 93% on room air so I put him on oxygen and requested a PRN neb treatment. I was very confident he was wheezing! RT came and did the treatment. Later, I told him my COPD pt was short of breath, but he was satting at 97% on room air. I also told him he sounded slightly wheezy but overall I thought the he was stable, but could benefit from a treatment. When the RT came to do my second pts treatment, he told me "I'm wasting my time here, you keep telling me everyone is wheezing and EVERYONE IS FINE!" He said it in front of the pt and then left the room and said it again at the nurses station where all my coworkers could hear him. I felt so humiliated. I know I am still green and need more experience, but I listened to my lung sounds on Youtube on the way home and I still feel my pts had wheezing! But this RT has years of experience and I trust his judgment over mine. Maybe my ears are just broken. ? I understand RTs are very busy people also, but I'm not sure what to take from this experience. tldr; overly concerned new grad, I keep hearing wheezing but every time I call RT I'm told the pt lungs are clear. Does anyone have any suggestions to get better at differentiating lung sounds? And just suggestions with interventions for my pts who have subjective shortness of breath but have stable vital signs.