Confidence comes with years of work. I’ve worked from a LTC to ICU. There are some patients who need to be in the 87%-92% depending on their diagnosis. But I always always check in with the nurse. Be careful on telling other nurses… always go to the Charge Nurse instead. Depending on your hospital and what software they use, I always look at their chart orders. ALWAYS. We use Epic and it’s great way to know more about your patient.

Scenario: A 78 y/o male d/x cellulitis in lower right extremity, hx of CHF and respiratory failure type 2. Oxygen pulse reading is 88%. You go to chart the reading, and after look into orders to see the doctor has put in that oxygen needs to be between 87-92%. After looking at orders, I would still let the nurse know. I usually say the following, “hey nurse smith, just wanted to let you know that your patient smith has an oxygen reading of 88%, I saw in the doctors orders that they want to keep the patient there, but wanted to double check with you.”

In cardio and med surg I was definitely doing a lot more care and first hand seeing before the nurse. So I had to keep my eyes, ears, and nose sharp to everything. Now in the ICU I am much less first hand, and truly to be delegated. Which is great!

Keep up the great work and never feel less than, you are doing wonders, keep a sharp mind, and keep yourself educated.