Why don't nurses consistently take patient respiratory rates?

akulahawkRN, ADN, RN, EMT-P · Apr 14, 2016

Just wondering what your thoughts are on this. I was given an article in class about a study conducted in New Zealand to find out why taking a patient's respirations isn't common practice by RN's in hospital settings, or more precisely why weren't nurses consistently taking respirations like other vitals. The question was raised if nurses have a theory-to-practice gap in the understanding of respiratory function?
So what is the policy where you work on respirations? Is there validity to their concern about missed respirations?

Policy where I work (and probably most) is that vitals are to be actually counted. That would include respiratory rate. I know we do it consistently if there's a problem... however if the patient appears to be breathing normally, regularly, and easily and is without a respiratory complaint, typically what gets charted is a respiratory rate that's in the normal range.

No, it's not a theory-practice gap problem involving understanding of respiratory function. Chances are it's just faster to run the BP machine, put the patient on the SpO2, take a temp and by the time the temp's done, the BP, pulse, and SpO2 are all done too. Then looking at the time between resps while doing all of this, if that's a 3-5 second interval each, that's a normal rate.

smf0903 · Apr 14, 2016

RR is the vital I take and record the most...because it's the easiest!! Pt doesn't have to be awake for heaven's sake! I always do a RR on my hourly rounds.

Xlorgguss · Apr 14, 2016

I work on a respiratory floor (as a tech) and ironically RR isn't done accurately. I always try to do it as accurate as possible but that isn't the norm here. How do you accurately measure RR since I was always taught that one respiration was a rise and fall of the chest. But respirations look different when you have a patient with CHF or COPD. One time I counted RR on a patient as like 34 and the respiratory therapist said it was like 24. So I dunno. I would love to get more training on it.

akulahawkRN, ADN, RN, EMT-P · Apr 14, 2016

I work on a respiratory floor (as a tech) and ironically RR isn't done accurately. I always try to do it as accurate as possible but that isn't the norm here. How do you accurately measure RR since I was always taught that one respiration was a rise and fall of the chest. But respirations look different when you have a patient with CHF or COPD. One time I counted RR on a patient as like 34 and the respiratory therapist said it was like 24. So I dunno. I would love to get more training on it.

With CHF and COPD, the rate you might get could very well be 34 when you took it and 24 when the RT took it. If the patient's breathing isn't normal, I generally will record the number and make a note about the quality of the breathing. If you saw 34 and shallow, that's what you got. The RT may have seen 24 and basically normal volume.

Just remember that COPD and asthma patients could end up stacking their breaths so watch for equal rise and fall as well as equal movement on right and left sides.

NurseGirl525, ASN, RN · Apr 14, 2016

I work in icu and ours are constantly monitored. As a tech, I often am watching the monitors. When somebody gets out of whack, we are immediately in the room. We also have our own RT. Respirations are very important.