I have some strong feelings about the use of oximeters in hospice. As a long-time ER nurse, and now a full-time hospice nurse, I have often seen these measurements to be inaccurate and over-used(and, I saw those inaccuracies many times in the ER). Oxygen satuation measurements can be inaccurate for a variety of reasons: excessive movement,anemia (a biggie and one we see a LOT in hospice), hypoperfusion(blood loss or poor perfusion).
I often recommend to discontinue all labs, diagnostics, weights and oxygen saturation measurements in my patients...and, especially in facility patients.We treat the patient's subjective symptoms, so we ought to be looking at and listening to them instead of a number. I've found too many patients who were inappropriately intubated secondary to a nurse doing this reading and calling an ambulance!(Makes me cringe....we need to look at and listen to THE PATIENT!) What happens in facilities is that although we do educate the staff re: hospice philosophy and care, the turnover is high and many times agency nurses are working who are not familiar with the patient nor with hospice.So, if they do an oximeter reading and get 75%, the patient gets shipped out to the ER!
So many times, in so may clincial settings, I have seen nurses and docs get so wrapped up in the damn numbers, that they failed to see and hear the person/patient. Sorry....stepping off my soapbox....
