Umm, he can't breathe!

[liveyourlife747]

Ugh, I just have to vent.

I've been sitting with one of my clients while he was in the hospital so we could be his advocate and explain to the nurses there what he has, how to do his dressings, etc. Well, he just got a trach on fri. I was with him overnight the other night, and he got this fearful expression on his face and started mouthing "i can't get air, i can't get air" I'm immediatly at the beside trying to get him to calm down. The hospital nurse was in the room and was just standing there. I was like go page respiratory because he can't breathe. and she said: his sats are 97% and then waited another minute before going to page respiratory. I mean come on, how could she just stand there? :angryfire

just makes me mad because I always thought airway was the most important thing to keep open, and he obvisously wasn't able to cough up his secretions (quad in for resp failure d/t mucous plug) and needed sx. am i overreacting?

[WalkieTalkie, RN]

Can this nurse not suction her patient?

[blondy2061h, MSN, RN]

Can this nurse not suction her patient?

My thoughts exactly. Respiratory shouldn't be needed to suction a trach.

[liveyourlife747]

well at that time, i had just came on shift, and was not aware that the nurse there could sx the patient because on the other floors, the nurses had to call respiratory to sx. I still would have had her rather sx the patient right away than just standing there

[Lovely_RN, MSN]

What about the OP....do you know how to suction a patient and do trach care? I don't understand why there were 2 nurses present and no one could suction the guy.

[liveyourlife747]

I do know how to sx, but because I am his home care private duty nurse I am not allowed to do any hospital procedures due to my agency's policies. I was about to step in though if the nurse didn't make any moves. I wish the nurse would have said "i can do it" and then gone ahead and sx him, because of the way she acted, I felt like she didn't know what to do and that kept me on edge all night

[mama_d, BSN, RN]

Yikes, how common is it to have facilities/floors where RT has to be paged for something as simple as suctioning? In the amount of time it takes them to respond, things can easily go from bad to worse. That scares me more than the fact that she took a minute to do something.

We have nurses where I work who are hesitant to NT sx if necessary, just keep gagging the patients over and over with the Yankaur (hope I spelled that right, but you all know what I'm talking about). I tend to just step in and do it with their permission if it's their patient and talk my way through it so they hopefully learn.

[Thankful RN,BSN]

sounds like the pt was more anxious than in respiratory distress.

[liveyourlife747]

yes, but its a scary thing when you feel like mucous is blocking your airway, atleast I think it is when I have a bunch of phlem and i can't catch my breath to cough it out

[Thankful RN,BSN]

yes, but its a scary thing when you feel like mucous is blocking your airway, atleast I think it is when I have a bunch of phlem and i can't catch my breath to cough it out

you are right. that is a scary feeling. suction should be set up and ready to use at all times. also, the pt may need something to decrease his anxiety.

[lpnflorida]

With sat of 97% it would be a non emergent call to Respiratory, meaning they would come based on the priorities that they already have. It is very hard to give a comment regarding why a nurse does or does not do something. An antianxiety agent might have been helpful, reassuring a patient goes a long way while holding his hand.

I do not understand a hospital policy where a nurse is unable to suction a patient though. I thought in every hospital a nurse could suction a trach. Would make a good case for looking at a change in the policies.

I admit it is not my favorite thing to do, but do it for the patient.( OFF topic Did I mention I hate mucous?)

[honeykrown, MSN, NP]

With sat of 97% it would be a non emergent call to Respiratory, meaning they would come based on the priorities that they already have. It is very hard to give a comment regarding why a nurse does or does not do something. An antianxiety agent might have been helpful, reassuring a patient goes a long way while holding his hand.

I do not understand a hospital policy where a nurse is unable to suction a patient though. I thought in every hospital a nurse could suction a trach. Would make a good case for looking at a change in the policies.

I admit it is not my favorite thing to do, but do it for the patient.( OFF topic Did I mention I hate mucous?)

His sats might be 97%, but there is a think called look at the patient and not the machine. The pt is newly trached, he's scared and that is understandable. I have a trached pt (I do home care) and he told me of his experience when he got trached. Its not easy to adjust and most of them do not have the strength to cough up. The nurse was just plain mean to stand by do nothing just based on the fact that his Sats were 97%. At least raise the head of bed and try to calm the pt before the resp therapist got there.

I think the hospital policy of resp therapist suctioning is just .....