Pulse Ox

londonflo · May 3, 2023

beachynurse said:

We can only use the equipment that our school divisions allow us to use.

Put it in the budget!

beachynurse said:

My school division does not allow us to use pulse oximeters as we cannot be held responsible for the calibrating of the unit.

OKAY, tell me how to calibrate the unit.

beachynurse said:

I auscultate breath sounds,

Do you have the best stethoscope Littman or a school supplied $12.99 version? Frankly a Pulse Oximeter will provide the best quantifying evidence of O2 levels.

When I have been in the hospital, with a myriad of health problems, The Respiratory doctor asked what my pulse Oximetry was, and I provided my home one....and yeah he took it the be the assessment data. In the hospital we can never find the hospital provided pulse Ox.....most nurses bring their own.

chare · May 3, 2023

londonflo said:

Put it in the budget!

[...]

Unless the school district authorizes use of pulse oximetry his is more than a budget issue.

londonflo said:

[...]

OKAY, tell me how to calibrate the unit.

[...]

I have no idea, and suspect that @beachynurse doesn't either. This is why diagnostic medical equipment is serviced on a regular basis.

londonflo said:

[...]

Do you have the best stethoscope Littman or a school supplied $12.99 version? Frankly a Pulse Oximeter will provide the best quantifying evidence of O2 levels.

[...]

Oxygen saturation is one piece of the respiratory assessment and needs to be incorporated with the other data points mentioned here.

londonflo said:

[...]

When I have been in the hospital, with a myriad of health problems, The Respiratory doctor asked what my pulse Oximetry was, and I provided my home one....and yeah he took it the be the assessment data. ...

As he should, as it is an important piece of the assessment.

londonflo said:

[...]

... In the hospital we can never find the hospital provided pulse Ox.....most nurses bring their own.

And your hospital's leadership is okay with this?

londonflo · May 3, 2023

chare said:

Unless the school district authorizes use of pulse oximetry his is more than a budget issue.

How so? How is this more of a budget issue....identifying a student with a low oxygen level seems to be of the upmost importance. Like ABC of respiratory function. What if you school board decided we can't afford to teach the ABC's of reading?

OK, OP give in and pay the $17.00 for one from Walgreens until you actually grow bold enough to ask for this assessment measurement tool in your budget. Go on Google and find some articles to support your position. I think if you are still convinced it needs to be calibrated, let me know if you find something to support your position. (We do not calibrate the hospital provided Pulse Oxs)

I am assuming you are in a community of schools, have a telephone, have email etc.. and can ask other school nurses to support your request! It is not like you are teaching with Laura Ingalls Wilder on Little House on the Prairie, miles away from another school in the middle of 6 months of blizzards. (The Long Winter)(DeSmet South Dakota)

chare said:

Unless the school district authorizes use of pulse oximetry his is more than a budget issue.

Okay I gotta say this...what faith did you have in your "school board" during Covid. I attended the school board sessions and they were FRANKLY bamboozled about their decision making...2020...get back in school.or continue on line? a 2 hour discussion....This was no nursing advice/ support/ input in the frontline.....

Then early 2021 I was thrilled with a pediatric nurse seeking a spot on the school board. I was so pleased with her involvement I financially provided great support in her campaign. So glad she ran unopposed this year...yes RNs are RESPECTED with the voluntary role in the city.

(I have never had children, but pay my school district property taxes gladly and buy what ever the students are selling.)

I believe:

a) Nurses are a second pair of eyes to ascertain if a child is going home to a safe house.

b) Early detection of a potential health problem and a treatable regimen is why we have nurses in the schools (asthma, diabetes, early diagnosis of pneumonia, etc)

c) School Nurses provide a strong connection between student health and preventative actions such as immunization.

d) We have seen when a health care crisis happens in our communities and concurrently we need an experienced, knowledgeable, community health expert to lead.

I am going to respectfully add that school nurses do so much more than I am aware of. When I worked at the "Boys and Girls Club" I learned so much and also learned I have such a learning deficit on the care of our must precious resource.

Addendum,

If you do buy a Pulse OX, identify a crucial low O2 level it can only help the child. The tool is non-invasive so what have you got to lose????.

beachynurse, ASN, BSN · May 4, 2023

londonflo said:

How so? How is this more of a budget issue....identifying a student with a low oxygen level seems to be of the upmost importance. Like ABC of respiratory function. What if you school board decided we can't afford to teach the ABC's of reading?

OK, OP give in and pay the $17.00 for one from Walgreens until you actually grow bold enough to ask for this assessment measurement tool in your budget. Go on Google and find some articles to support your position. I think if you are still convinced it needs to be calibrated, let me know if you find something to support your position. (We do not calibrate the hospital provided Pulse Oxs)

I am assuming you are in a community of schools, have a telephone, have email etc.. and can ask other school nurses to support your request! It is not like you are teaching with Laura Ingalls Wilder on Little House on the Prairie, miles away from another school in the middle of 6 months of  blizzards. (The Long Winter)(DeSmet South Dakota)

Okay I gotta say this...what faith did you have in your "school board" during Covid. I attended the school board sessions and they were FRANKLY bamboozled about  their decision making...2020...get back in school.or continue on line? a 2 hour discussion....This was no nursing advice/ support/ input in the frontline.....

Then early 2021 I was thrilled with a pediatric nurse seeking a spot on the school board.  I was so pleased with her involvement I financially provided great support in her campaign. So glad she ran unopposed this year...yes RNs are RESPECTED with the voluntary role in the city.

(I have never had children, but pay my school district property taxes gladly and buy what ever the students are selling.)

I believe:

a) Nurses are a second pair of eyes to ascertain if a child is going home to a safe house.

b) Early detection of a potential health problem and a treatable regimen is why we have nurses in the schools (asthma, diabetes, early diagnosis of pneumonia, etc)

c) School Nurses provide a strong connection between student health and preventative actions such as immunization.

d) We have seen when a health care crisis happens in our communities and concurrently we need an experienced, knowledgeable, community health expert to lead.

I am going to respectfully add that school nurses do so much more than I am aware of. When I worked at the "Boys and Girls Club" I learned so much and also learned I  have such a learning deficit on the care of our must precious resource.

Addendum,

If you do buy a Pulse OX, identify a crucial low O2 level it can only help the child. The tool is non-invasive so what have you got to lose????.

It has nothing to do with our budget at all.. And Londonflo, why are you always so confrontational?

londonflo · May 4, 2023

beachynurse said:

It has nothing to do with our budget at all.. And Londonflo, why are you always so confrontational?

I guess Beachy, I have not felt that your arguments really show how you acted to resolve an issue, only say "that won't work". May be I am misinterpreting your energy to work out problems beyond the nursing skills you have honed through the years,

Quote

The rationale behind not using the pulse oximeter is that if we do use it we might not do as thorough a pulmonary assessment and miss something. I never rely on the pulse oximeter for anything to do with a pulmonary assessment, my stethoscope and ears are the best tools for that kind of assessment.

I had forgotten your AN name and that we differed before, we both experienced frustration with our interactions. School year is ending...I think you said you were retiring. Best wishes for your future.

londonflo · May 4, 2023

I kept asking about calibration of the pulse ox oximeter:

Quote

pulse oximeters do not need to be calibrated by the user before they will work properly. During device development, the microprocessors of pulse oximeters are calibrated using reference SaO2 measurement data that are compiled from healthy volunteers.

No calibration needed.

londonflo · May 4, 2023

If I had my choice of measuring or qualifying Pulse 02 levels in the school, outpatient clinic and hospital

As I said earlier and you replied:

Quote

When I have been in the hospital, with a myriad of health problems, The Respiratory doctor asked what my pulse Oximetry was, and I provided my home one....and yeah he took it the be the assessment data. ...

chare said:

As he should, as it is an important piece of the assessment.

And

chare said:

And your hospital's leadership is okay with this?

If It is okay for a an MD to use a personal patient device but not for an RN to use a personal device who cannot find the pulse oximeter for hours and just wait........

chare · May 4, 2023

londonflo said:

[...]

It is okay for a an MD to use a personal patient device but not for an RN to use a personal device who cannot find the pulse oximeter for hours and just wait........

You previously stated that the MD accepted the SpO2 value that you provided based on your device. Now you sayvhe or she used their device. Which one was it?

Career Columnist / Author · May 4, 2023

beachynurse said:

Of course it would, that is if your school division allows you to use one. My school division does not allow us to use pulse oximeters as we cannot be held responsible for the calibrating of the unit.

It's a liability for the school for nurses to use their own pulse oximeters.

chare · May 4, 2023

Nurse Beth said:

It's a liability for the school for nurses to use their own pulse oximeters.

Just as it would be a liability for a nurse in the hospital to use a personal pulse oximeter.

beachynurse, ASN, BSN · May 5, 2023

londonflo said:

I guess Beachy, I have not felt that your arguments really show how you acted to resolve an issue, only say "that won't work". May be I am misinterpreting your energy to work out problems beyond the nursing skills you have honed through the years,

I had forgotten your AN name and that we differed before, we both experienced frustration with our interactions. School year is ending...I think you said you were retiring. Best wishes for your future.

The problem is, I'm not arguing. That's not why I'm here, and it's not my style. I'm here to learn, and to bounce ideas off of other nurses. I feel that arguing is only counter productive, and resolves nothing. Maybe you should try a softer approach. Honestly, I dread reading your comments because of the aggressive, confrontational tone. And, though I would love to retire, I am afraid I am not quite there, 5 more years before I can do that.

**CommunityRNBSN, BSN, RN** · May 5, 2023

GetBackToClassRN said:

Our district does not allow us to do pulse ox checks without a doctor's order and the parent has to provide the oximeter. The rule is the same about blood pressure also.

The reason they gave us is because we do not have a baseline for individuals or orders for what to do if the readings are out of "normal" range.

WOW. We have an oximeter in the office and I'll throw it on pretty much whoever!