Respiration counting

[AMMLPN]

Counting respirations should be easy, right? We learned this in school. You check the patient's radial pulse and switch without telling them. I am a new nurse but I have yet to work in a clinic where I take a radial pulse. We get it from the pulse ox. I tried still playing the radial pulse trick, but then a lot of patients ask me if my PO2 is working. I have seen some nurses that can get it without ME catching on (while I was TRYING to catch on) and I have seen some that put the same thing in for everyone unless they exhibited signs of distress. So, sometimes is feel like I am paused in my noting and staring awkwardly at my patient. I just know they are wondering WHY THIS CRAZY LADY is sending 15 WHOLE SECONDS just looking at them. And of course I am looking at where ever I can see the most movement, so their chest or abdomen. But them there are those that just talk the whole time and can't spend 20 seconds quietly. So, I'm wondering, what tricks do you use? I can count but how do I not get caught?

[sallyrnrrt, ADN, RN]

I appear to be taking apical pulse with stethoscope , , but count resp for 15-30 sec.... And multiply..... But trust me you can visualize a resp distress rate of 40 or so, upon entering room.... My assessments, start with visual.....

[Been there,done that, ASN, RN]

Impressed that you realize the value of an accurate respiratory rate. As sally said, you could distract the patient by using your scope. You need to count for 30 seconds. However, after experience you will know .. visually.. that anything over 18 .. is TOO fast.

Keep up the good work.

[verene, MSN]

I still use the radial pulse trick. Very few patients or families have said anything about it. Still it's easy to explain that machines aren't 100% accurate and there is good reason to verify manually. Plus I like to know the strength and character of the pulse which the machine doesn't tell me.

[Wuzzie]

Use the timer on the thermometer and count while you're taking their temperature.

[VANurse2010]

I still use the radial pulse trick. Very few patients or families have said anything about it. Still it's easy to explain that machines aren't 100% accurate and there is good reason to verify manually. Plus I like to know the strength and character of the pulse which the machine doesn't tell me.

The character of one peripheral pulse is pretty meaningless without checking both sides, uppers and lowers, and checking other physical assessment characteristics.

[Wile E Coyote, ASN, RN]

The character of one peripheral pulse is pretty meaningless without checking both sides, uppers and lowers, and checking other physical assessment characteristics.

The person you quoted said nothing to indicate that he or she was limiting their assessment to only that one peripheral pulse.

Edit: Wanted to add another 'kudos' to the count for OP caring about something we all know gets disregarded more often than not.

[Archerlpvn, LPN, LVN]

Acting like your taking an apical pulse with your stethy works like a charm! :)

[VANurse2010]

The person you quoted said nothing to indicate that he or she was limiting their assessment to only that one peripheral pulse.

Edit: Wanted to add another 'kudos' to the count for OP caring about something we all know gets disregarded more often than not.

I interpreted it differently from you, and since this is something open to interpretation I'm allowed to give my opinion.

[Horseshoe, BSN, RN]

I interpreted it differently from you, and since this is something open to interpretation I'm allowed to give my opinion.

That person was countering the content of your post and said nothing about you not having a right to give your opinion.

[Kalohen89]

I check radial pulse and resp rate together with fingers still on the pulse as though I'm still counting it, I watch the chest area for both assessments and try to look as though I'm just trying to focus on feeling the rate and counting, so when i switch to counting resp rate the patient doesnt notice a change. If they ask about the pulse rate on the sats monitor I tell the truth and say that that reading is not always accurate and that I can get a better one from doing it manually as well as get more information by actually feeling the pulse for myself.