Too lazy to adjust your alarms? or Don't know how?

glutton4punishment · Jul 10, 2011

Great post.

:twocents:.......i have learned via nursing how bothersome background noise is to me, and some of my patients. Some nurses can work through the beeps and buzzers without a second thought. Some patients can have a conversation with their families and go for 30 mins with the IV beeping. To me, it drives me CRAZY-er....if I am in a room helping with whatever, I have noticed that some nurses just let the things beep.....not me. It's a total distraction. Just wanted to share my "aha" moment. Interesting stuff.

P.S. I will learn how to reset my alarms, I'm not lazy, I am just really sensitive to noise, and will immediately cut it off whether it's in one of my rooms, or in one of yours........

APRN., DNP, RN, APRN, NP · Jul 10, 2011

We are allowed to adjust the alarms in the ICU where I work. Being in California, we never have over a 1:2 ratio in the critical care unit, and sometimes 1:1.

There are times when an alarm will sound, and we are right there with the patient. If I'm standing there with all my eyeballs on the patient, I'm going to treat the patient, and not treat the alarm. That is actually written into the policy.

I would be interested to see if there is any evidenced based practice regarding nurse autonomy in setting alarm limits. If not, it sounds like a good research project.

linearthinker, DNP, RN · Jul 10, 2011

I don't disagree with you, I was just answering the OP. Neither lazy nor stupid, simply not empowered to contort the world to suit our preference.

My job was 8 minutes from my house via bicycle. The option: drive over 60 minutes to the next critical care job so that I may be "respected" enough to alter alarm settings? Meh. Not a high enough priority in my life.

SNIXRN · Jul 11, 2011

our alarm parameters are set for a reason. per policy and for the patient's safety, we cannot adjust the alarm parameters or volume, especially for our own convenience. i will use my "appropriate decision making" on how much oxygen they will receive to achieve an appropriate oxygen saturation

suanna · Jul 11, 2011

our alarm parameters are set for a reason. per policy and for the patient's safety, we cannot adjust the alarm parameters or volume, especially for our own convenience. i will use my "appropriate decision making" on how much oxygen they will receive to achieve an appropriate oxygen saturation

how nice that you have the ability to restore a patient with chronic end stage illness to a healthy norm:rolleyes:. i have to contend with patients who live with an o2 sat in the upper 80s that if i increase thier o2 delivered will face respiratory depression with the loss of thier hypoxia drive and hypercapnic acidosis. since there is no accurate way to monitor co2 in an extubated patient i will get less alarms, at least until they go apnic or arrest from acidosis. if you read my post - nothing is for the "convenience" of the care provider. if the alarm dosen't provoke a response from the care provider, it shouldn't be alarming. alarms are there to provide a prompt that the patient is having a change in thier condition that thier care giver needs to assess or correct. when they ring endlessly without even causing the nurse to look up at the patient they become useless backgroung noise and greatly reduce your patients safety. every patient is individual. the patient who is a daily runner may have a hr of 52 as a normal reading, my patient with end stage cardiomyopathy needs a hr of 92 just to maintain minimal perfusion. it makes no sense to have the runners alarm ringing all night because it is "less than 60bpm". i want to know if my patient's hr drops less than 75bpm. whatever magic you are using to make your patients all conform to to the default setting without risking thier survival, please share.

blondy2061h, MSN, RN · Jul 11, 2011

In the ER I work in, it is against hospital policy to adjust the alarm settings....so....I'm not too lazy or don't know how...it's that I am not allowed. Does it annoy me? Yes, but I have learned to live with it.

Seriously? We have parameters we're suppose to keep our alarms at. I think policy is to set the low HR alarm at 20% below their average and the high at 20% higher than their average. Similar policies exist for all parameters. We have certain alarms we can't turn off, ie, vtach, asystole, etc. You can't use the same set of parameters for everyone because everyone isn't the same. Some people can handle a HR of 45 fine, which another person might be near coding. Someone might live with a BP of 90/60, but for a patient who has a strong hypertensive hx that might be a clue they're going septic.

This is one of my pet peeves too. If alarms are going off all the time, you become desensitized to them.

blondy2061h, MSN, RN · Jul 11, 2011

our alarm parameters are set for a reason. per policy and for the patient's safety, we cannot adjust the alarm parameters or volume, especially for our own convenience. i will use my "appropriate decision making" on how much oxygen they will receive to achieve an appropriate oxygen saturation

adjusting alarms is a patient safety issues, not a "convenience." it's not safe to have the same parameters no matter who the patient is or what their condition. it's not safe to have alarms going off so endlessly no one pays attention to them.

SNIXRN · Jul 11, 2011

How nice that you have the ability to restore a patient with chronic end stage illness to a healthy norm:rolleyes:. I have to contend with patients who live with an O2 sat in the upper 80s that if I increase thier O2 delivered will face respiratory depression with the loss of thier hypoxia drive and hypercapnic acidosis. Since there is no accurate way to monitor CO2 in an extubated patient I will get less alarms, at least until they go apnic or arrest from acidosis. If you read my post - nothing is for the "convenience" of the care provider. If the alarm dosen't provoke a response from the care provider, it shouldn't be alarming. Alarms are there to provide a prompt that the patient is having a CHANGE in thier condition that thier care giver needs to assess or correct. When they ring endlessly without even causing the nurse to look up at the patient they become useless backgroung noise and greatly reduce your patients safety. Every patient is individual. The patient who is a daily runner may have a HR of 52 as a normal reading, my patient with end stage cardiomyopathy needs a HR of 92 just to maintain minimal perfusion. It makes no sense to have the runners alarm ringing all night because it is "less than 60bpm". I want to know if my patient's hr drops less than 75bpm. Whatever magic you are using to make your patients all conform to to the default setting without risking thier survival, please share.

Your sarcasm is immature. Way to look like a professional. Keep in mind we all have different patient populations but policies are put in place (influenced by JCAHO recommendations) for the safety of our patients and the protection of our license.

blondy2061h, MSN, RN · Jul 11, 2011

Your sarcasm is immature. Way to look like a professional. Keep in mind we all have different patient populations but policies are put in place (influenced by JCAHO recommendations) for the safety of our patients and the protection of our license.

I can't think of a single patient population where I would expect the same vitals on all patients on the unit.

SNIXRN · Jul 11, 2011

I can't think of a single patient population where I would expect the same vitals on all patients on the unit.

True, but there are normal ranges for all vitals.

I get many postops, so if my alarms are sounding, it's because they are desatting which is something I need to address immediately.

blondy2061h, MSN, RN · Jul 11, 2011

True, but there are normal ranges for all vitals.
I get many postops, so if my alarms are sounding, it's because they are desatting which is something I need to address immediately.

What do you typically monitor on your patients? Cont O2 sat + telemetry? Something else? Just curious.

SNIXRN · Jul 11, 2011

What do you typically monitor on your patients? Cont O2 sat + telemetry? Something else? Just curious.

If they are POD 0, continuous pulse ox, BP (Q15...Q30...Q1H...), HR

I occassionally get a few patients on tele - I guess if they are on tele and have a.fib, we adjust our tele to be advisory, where it doesn't warn us if they are in a.fib because that's their baseline. We just cannot adjust the VS parameters. We also have private rooms so we hear the alarms, and their neighbors might, but we can close the neighbors door.