Use of an Oxymetor

doodlemom · Jan 25, 2008

I've never heard of needing an order to take an O2 sat but the only time we do is when we are recertifying a patient for COPD.

AtlantaRN, RN · Jan 25, 2008

I use one for routine use. It is necessary for anyone with lung cancer or any primary pulmonary diagnosis. I'm the only one at my office that has one (hubby had a pe 6 yrs ago).

I let the other nurses use my pulseox when they have recerts or lung ca patients.

linda

morte, LPN, LVN · Jan 25, 2008

i am betting it is a BILLABLE activity with an order.....

leslie :-D · Jan 26, 2008

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.

think about it.

what are you going to do with the results?

hospice nurses assess their pts by their presentation, and not of assistive devices.

i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.

but because my oxi reads 96% on ra, i'm not going to administer o2?

truly, we treat by what we see in the person:

and not through electronic, inanimate devices that don't communicate otherwise.

i'm sure for many nurses, this seems implausible.

but when you think about it, it really is the most natural way of nsg.

best of everything.

leslie

CANRN, MSN, RN · Jan 26, 2008

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.
think about it.
what are you going to do with the results?
hospice nurses assess their pts by their presentation, and not of assistive devices.
i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.
but because my oxi reads 96% on ra, i'm not going to administer o2?
truly, we treat by what we see in the person:
and not through electronic, inanimate devices that don't communicate otherwise.
i'm sure for many nurses, this seems implausible.
but when you think about it, it really is the most natural way of nsg.
best of everything.
leslie

Exactly, it is not required at all. There are other presenting symptoms and behaviors to support a DX. It is true, you can have a pulse ox reading over 90 and the patient can still display behaviors of air hunger. And if they have cold hands and poor circulation they aren't accuate anyway. Our hospice director does not even recommend them. I guess it goes back to the time when I was working ICU and learned monitor reading, ACLS and the old saying "Treat the patient NOT the monitor" In hospice we "Treat the patient, not the numbers!"

caliotter3 · Jan 26, 2008

other than the criteria set forth by medicare or other insurance companies, oximeters just aren't a necessary device in hospice nursing.
think about it.
what are you going to do with the results?
hospice nurses assess their pts by their presentation, and not of assistive devices.
i've had many pts whose sats read in the 90's, but are dyspneic, diaphoretic w/rr's in the 40's.
but because my oxi reads 96% on ra, i'm not going to administer o2?
truly, we treat by what we see in the person:
and not through electronic, inanimate devices that don't communicate otherwise.
i'm sure for many nurses, this seems implausible.
but when you think about it, it really is the most natural way of nsg.
best of everything.
leslie

Leslie

You have clearly and thoroughly explained to me the comments and intentions voiced to me by a pediatrician that I've wondered about for years. I accompanied my client and her Mom to the doctor for a visit after the doctor had ordered oxygen and I asked her why she had not also ordered use of an oximeter as I thought that went automatically with use of oxygen. She told me she wanted caregivers to assess the patient and not the machine readings. I only halfway understood what she meant and could not elaborate in front of the mom (the doctor's body language somewhat told me that I shouldn't ask for clarification at that time). I never did get a chance to have it explained to me. Thanks for such an informative post. I'm always learning something here.

doodlemom · Jan 27, 2008

i am betting it is a BILLABLE activity with an order.....

No - it is not - not under hospice but maybe in home health it is.

NurseAlwaysNForever · Feb 3, 2008

It is mandatory with the copany I work for to take all Vitals, including SPO2 and weights or MAC with every visit unless it will cause the pt discomfort to do so. It can show a decline if a pt is having a drop in their sats.. My pulse ox is one of my favorite tools to use.

RNandlovingit · Feb 3, 2008

The hospice I work for requires us to use them!! They order them for us, but we pay for them over time out of our checks! For us its a requirement on the assesment! Mainly more important with the patients that have respiratory issues!!!!

Em1995 · Feb 3, 2008

What's the rationale for doing this assessment? A patient knows when they are breathless. If you have an oxygen saturation of of 80%, are you going to intubate? I don't understand this.

rnboysmom · Feb 29, 2008

nursegirl

oxometers are not a requirement in hospice nursing for gauging symptom control. If your hospice "requires" you to take an o2 sat during visits, they should provide the oximeter, I have recently found the finger oximeters for as little as $65 on several websites, the last ones I ordered for my staff at this price are quite durable and work well. Discuss with your administrator the need to provide you with the proper equipment to care for your patients. What would you need an oximeter for if you left this type of nursing? Those types of equipment, if "required" should be provided to you for proper assessment. I, personally, wouldn't work for anybody that imposes these types of hardships for their staff.