I am an RRT working on my degree as a nurse practitioner. (My heart will always be an RRT.)I need help! I am arguing that nurses cannot maintain and do not understand the mechanics behind ventilation in thier patients. But I cannot find the literature to support the argument. Can anyone lead me to some articles for or against this debate? thank you!!
or go to www.aarc.org and go to Resources/Advocacy,Resources and Tools/Indiana University Study....
I have spoken with nurses from Australia. Those nurses oversee the ventilators. BUT they are trained to do so, not just some quickie inservice with formulas for cookbook ABG manipulation. (I always ask someone about ventilating an asthmatic or ARDS).
There is also another angle to this. It's widely touted that in Europe the RN's handle the vents. To a degree that may be true. But it is also true that the ICU's are pretty much closed and run by full time intensivists. To quote Bob Kacmarek "if you walk into an ICU at 2AM you'll see more doctors than nurses". Those MD's know in good detail the modes and nuances of the ventilator.
What irks me when I hear it proposed that nurses can/should/are able to manage the ventilator is that usually whomever is proposing this has a very reductionist perspective as to what that would entail.
Another angle is that if such a change were to happen then history would pretty much stop there. There would be very significant resistance to implementing any improvements or new technology (some might say that would be good).
Posts: 171 | Location: Palo Alto, CA USA | Registered: November 14, 2002
I have been a hospital based RRT since 1975 I have NEVER met a nurse who wants to do Respiratory Care. When a patients' respiratory status deteoriates who is the 1st clinician the nurse pages?
I went through this many years ago when patient focus care was a big thing, with decentralizing respiratory care departments. I can't remember the exact facility where this happened but one of the largest lawsuits was agaist a facility that had eliminated respiratory therapist from the hospital, and had a ventilator incident and were sued for a lot of money. Maybe someone out there can remember this lawsuit.
I agree and disagree with what you are saying... hmm how is that possible?
Well, I'm a biomed. and service ventilation devices daily. The RT's at my workplace provide education/hands-on training for our clients and their care attendents. Many of them finish the course quite are confident to tackle most vent situation/problems/procedure (trach change, suction, what to check for low pressure alarm, etc) We have also touched on extended care facilities where our RT's have trained the nurses.
So back to what you are saying, if they are trained properly, then anyone is able to perform certain vent procedures. Ofcouse, their knowledge won't be as vast as an RT so good communication is a key!
