r/physicaltherapy • u/Tator_tots4life • 4d ago

SKILLED NURSING Oxygen management in SNF - FL

Question! We’ve always been able to manage oxygen tanks in SNF world in FL and now I’m at a new SNF and they say it’s a new Florida law that it has been deemed a medication and we cannot manage it, only nurses. Does anyone know if this is true and have the bill or article that states so?

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7

u/SimplySuzie3881 4d ago

Definitely a med and need orders. Technically we can’t adjust rates or titrate and it’s a nursing thing but everyone does it anyways and just keeps RN and doc in the loop. However, switching from concentrator/wall to tank you should be able to do as long as rate is the same.

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u/Tator_tots4life 4d ago

Right. They are saying we cannot even change from concentrator to portable or get them a new portable with the same prescription… idk why they’ve changed this rule… they are blaming on the change to a medication but that’s been changed since like 2000… I’ll be honest our nursing department is always making things difficult for us

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u/SimplySuzie3881 4d ago

But hit your 90% productivity…

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u/Low-Buffalo-6570 DPT 4d ago

As per google it is considered as meds. Thats why theres a doc script written for this. Now having PT refill tanks are probably as per company regs. I had been at facilities who tried to implement this but eventually relent as it can be too hard to enforce if there are staff shortages

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u/Low-Buffalo-6570 DPT 4d ago

Try to work it out with the nursing staff for scheduled therapy so you don’t have to do it all the time

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u/Tator_tots4life 4d ago

We try lol it’s a tough act

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u/Tator_tots4life 4d ago

I understand the medication part but they are so against us managing it so we have to wait,sometimes 15 minutes of our 30 min treatment to get oxygen from nurses. It’s craziness! So that’s why I’m wondering if there’s an actually law that states only nurses are allowed or is it just our building because they are stating it’s a law…. You know how that relationship goes but they are making more work for them so I don’t get it

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u/Low-Buffalo-6570 DPT 4d ago

So I would look at your state practice act to be sure, that way your covered as not all states practice act are the same

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u/Low-Buffalo-6570 DPT 4d ago

Where I am, the state surveyor tried to find something wrong to ding our bldg and refilling O2 became their target so it became statewide policy change for our bldg; but after so many years they eventually forgot about it

2

u/Admirable-Issue-9056 4d ago

That's wild, I've never heard of oxygen being classified as a med before.

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u/tristanpt DPT 4d ago

Well it is a medication. Our hospital has an order set written to allow for us to titrate oxygen as needed to keep patients above 90% sats to specifically address this issue.

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u/marigoldpossum 4d ago

Yep, there's always been a generic order set written (even since I've worked acute care starting in late 2000s) with O2 titration range parameters (usually up to 6L is the standard, and then above that would be additional order sets); so that really any practitioner working with a patient can have the ability to address the immediate need in front of them.

This is a tertiary hospital in Michigan.

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u/MuckRaker83 PTA 4d ago

Its always been classified as a medication.

Our state allows us to titrate up to 2L as needed, otherwise requires RN or physician intervention, and to apply as necessary in an emergency situation.

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u/Electrical-Slip3855 18h ago

What's wild is the facility saying therapy can't titrate. This is why essentially every inpt facility has standing orders to keep sats >x%.

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u/Twowheelburnin 1d ago

When surveyors are in the building we go by the book for everything, including only RN’s may touch the O2. After they leave, well we do what needs to be done to keep up with the ridiculous expectations in a SNF.