OK.... I feel I must come to the defense of my fellow nursing professionals.
Unless you are a PACU RN, you don't know the monitoring alarms limits nor the policies which govern patient monitoring.
Generally, SpO2 alarms are set with 2 levels (if the monitoring system is capable) - a low level (well within norms) and a critical level (falling below norms). Just because you hear an alarm, it doesn't mean you are in crisis (or that it's even "your" alarm). I can also promise that you are never "left alone" to wake up on on your own. While you are still (basically) unconscious and under the influence of strong amnesiac drugs, you receive very nearly one-on-one attention until you are able to generally follow simple commands (cough, lift your head, take a deep breath). After that, you were likely observed from a slight distance.
Slinky wrote:I was just thinking .... even at one nurse per recovery patient, don't even try to tell me that if one of the patients "crashes" the other nurses do not leave their patient to assist in recovering the "crashing" patient!
Yes, I will tell you that when one patient "crashes" a FEW nurses leave their STABLE patients to assist. Other nurses also help to pick the temporary slack while the primary RN is away. You would be perfectly fine.
Komodo wrote:On a side note, after I was fully awake and had no problems breathing, just for "Fun" I took off the O2 sensor. The alarm goes off, and it took them 12 minutes (I timed it!) before someone came over to check it out!
Yes, the nurses already knew you were fully awake with no breathing difficulties and had purposefully taken the probe off. You had already to indicated (consciously or unconsciously) you were well awake, aware and in no distress (hence, all the monitoring wire attached to you). I wouldn't have come running at that moment either.
As to the OP..... take it as a lesson learned. The pulmonologist/sleep doctor had no "dog in that hunt." Why? Because the surgeon (the primary MD in the case) had not consulted him. The pulmonologist/sleep doctor could write every order conceivable on your chart, but until such time as he is consulted, the nurse cannot and will not follow those orders (s/he has no order from the
primary MD to follow those orders).
How do you avoid this in the future? That's actually pretty simple. TALK, TALK, TALK, TALK, TALK..........
** Have an in-depth chat with the MD
performing the procedure well before time about your specific needs regarding recovery.
** Ask the surgeon to call your pulmonologist/sleep doctor to discuss your needs (or even have the pulmonologist/sleep doctor send a letter detailing your needs and his recommendations).
** Discuss your medical/xPAP history in detail with the admitting RN and insist to have a note prominently placed on your chart that you are to have an order to use your xPAP machine in the PACU.
** Have another chat with your surgeon (preferably with a family member present, especially if you've been given mind-altering drugs) when he comes to see you in the pre-op area and remind him about your discussion and needs.
** Have an in-depth discussion with the anesthesiologist/CRNA (with a family member present) who comes to evaluate you in pre-op and make sure they are aware of your needs.
Just an anecdotal note..... When my hubby had outpatient shoulder surgery, he told the surgeon he used CPAP. The surgeon encouraged him to bring his machine, but made it a point to tell him he would have to be able to put it on himself (with extremely minimal assist) when he was awake enough to comprehend his need/want for it. That was their policy. In the admitting/pre-op area, we again told the RN about the CPAP and that doc wanted him to bring it and use it in PACU. She made a note, tagged the machine and put it on the bed on top of the sheets. When I was allow into the PACU (about an hour afterward), the RN was sitting immediately behind the head of his bed observing him and the monitors (as well as a patient about ready to leave). Hubby was already awake enough to don and doff his hybrid mask with little help. He later told me there was no issue about getting his machine and using it (he directed the nurse with set-up as he was not allowed out of bed).
Now.... I've said all of this to say.......
Know who is able to write orders on your chart. Preferable have a copy of the CPAP usage orders from the
primary MD in your hand before the day of the surgery and give a copy to the admitting/pre-op RN. Continue to remind the surgeon and anesthesiologist about your needs. Everyone here is quite vocal and independent about using/tracking their CPAP. It doesn't need to stop just because you're brushed off once, twice or even three time.
/steps off my soapbox/