observe

I am currently doing my cardio placement on a surgical ward. As most of you would know this involves mainly chest physiotherapy and mobilising the patient (amb, SOOB in chair etc). When it comes to getting the patient up from a bed for the first time post surgery, it is imperative that we monitor their SpO2 and make sure it does not drop dramatically. We should also check the pt's charts prior to any treatment to make sure their blood pressure is stable.

Even though monitoring the patient is quite important, I have been made aware of the fact that I seem to rely too heavily on a SATS monitor and not enough on my observational skills. This was pointed out to me a number of times by my CCT, who is encouraging me not to underestimate the reliability of these observational skills. It seems that I have been using the monitor as a security blanket. As a result I am not questioning the pt throughout the treatment about any changes in their symptoms.

The two pt's I have seen with my CCT have both displayed low SpO2's of below 94% but have been consistently asymptomatic. If this is the case what is the point of me fumbling constantly with a monitor when I know the patient is not suffering from any ill effects. In fact, there have been some instances where the added piece of equipment may potentially compromise the pt's safety.

After all this was pointed out to me I realised that a major area of improvement within my skill set was my observational skills. It is just as important if not more to monitor the pt's appearance and note any signs that they are not coping with ambulating or moving out of bed. In order to effectively learn this, we sometimes have to go easy on the SATS monitors and develop our observational skills, especially while we are still students for only 2 more weeks.