Of the 15 patients on my list, seven of them are stroke patients who have never had a problem with their lungs in their entire lives. They are getting breathing treatments for what reason? just because their diagnosis is stroke, or MS and they have to lye in the bed.
I walk into the rooms and the patients is lying supine, awake and alert, showing no signs of respiratory distress. Lung sounds vary from crackles in the bases to diminished to a forced upper airway wheeze indicitive up secretions in the throat. And the majority of them are out to lunch.
And, upon my post treatment assessment, not one of those things I listed in the previous paragraph changes.
Five of the patients have decided on their own they don't need the therapy, so they simply refuse. Good for them. The rest just do as they are told because, "Well, the doctor thinks I still need these."
Instead of just letting doctors get away with ordering these useless therapies, I started charting things like the following:
- Treatment had no effect
- No treatment indicated
- No signs of bronchospasm
- NARDN before treatment, still NARDN after treatment
- Clear before treatment, still clear after treatment
- Pt. wonders why he's getting treatments
A couple of my coworkers and I have been charting like this for about seven years now, and neither one of us has ever been questioned about it.
My theory is that no one ever looks at our charting anyway.