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ED nurse cautions against skipping vital check

A Queensland RN has urged fellow nurses to not let respiratory rate checks fall by the wayside.

CQUniversity doctoral researcher Tracy Flenady said that while abnormal respiratory rates are accurate, early indicators of clinical decline, previous studies indicate that this vital sign is often missing from emergency department observation charts.

Flenady said there are a range of reasons why nurses, who are busy with other tasks in the emergency department, can be known to skip the respiratory rate check or give it only a cursory glance.

To unpack the ways these omissions are rationalised, Flenady spoke with emergency department RNs to find out what goes through their mind when skipping respiratory rate checks.

She said: “Sometimes nurses believe they are compensating for errant behaviour by adding value to the patient’s outcome with other tasks.

“In some cases, they think their lack of respiratory checks will have minimal effects and in other situations, nurses trivialise the importance of the respiratory rate and cut corners to get their job done.”

In an interview with Nursing Review, Flenady discussed what else goes through nurses’ minds when skipping these checks and why it’s important to remember to do them, and shared her advice for keeping on top of them in busy environments.

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  1. agree. This is not new

    The real question is how to educate all doctors and nurses that this is imperative.

    Education, how, when, ongoing
    set up learning competencies with scenarios
    Frequent audits then inform and educate on a generic basis follow up with individual one on one through Work Partnership Plan
    Teach nurses how to communicate with pts re importance of assessment and what he/she is doing
    Takes resp rate at time of radial pulse

    There is more to consider

    Who is availale to promote, uphold this skill



  2. This needs to be involved as part of assessment within the culture and relayed to the doctor ASAP

  3. sfleming (recently retired Div 1)

    When did basic obs go by the wayside? How bizarre. It has been TPRBPBSLGCS forever – when did EDs decide that some section of this essential combination could be ignored? Nurses are thoroughly tutored and practised in these skills, including how to take resp obs – now we have legal issues emerging.

    Nurses – stick to your training and do your job thoroughly. You are wonderful people, much loved and trusted by the communities you care for. You are the advocate for your patients, so look after them to the best of your ability.

    I remain confused and very concerned for our Nurses and patients in EDs.

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