Ask for help if you need it.

Hello everyone,

This week I learned the importance of asking for help when you need it. I was asked to do a 6 MWT for one of the patients on the ward. I was thinking a 6MWT is very straight forward process however on this occasion there were additional factors which complicated this test. First of all my patient did not speak English and his family was not around for translating. Secondly he was on portable oxygen and third the ward did not have any hand held oximeters available so I had to push the machine along side. I did not feel confident I could have control my patient. With the additional equipment I didn’t think I would be close enough to the patient to record relevant information and guard him as I administered the test.

I had seen this patient before hand which was a positive, we walked him 40 m and he de-saturated to 80 % spO2 while on 2 L of oxygen via nasal prongs. So I was aware and ready for him to de-saturate again. Despite documenting these findings in the notes the doctors still ordered a 6MWT to see if he was appropriate for home oxygen.

I prepared the hallway before hand with chairs positioned at each end of the hall. In the back of my mind I wanted to ask my supervisor to help me however did not want to be a burden therefore I convinced myself I would be alright on my own. But knew in my heart I was nervous conducting the test.

We began the test and I tried to explain to my patient the procedure. However I don’t think he understood very much. He began the test at 97 % spO2 on 2L within the first minute he was down to 87 %. At 1 min 30 he was at 84 % and I asked him how he was doing and showed him the chair was available because in class they tell us 85 % sit them down. I observed carefully for signs hypoxaemia however it was difficult as he had an abnormal breathing pattern and was unable to communicate effectively with me. He continued walking to the other end and at 2 min 20 seconds he was at 74 %. At this point I told him to sit down due to his sats and his heart rate being 165. I aborted the test. It took him 6 min to recover to 93 %. But I still had not recovered from the stress I felt during the test.

After the test I really did not feel happy with how the test was conducted. He was safe and nothing ended up happening. However I believe if I had of asked for help the test would have been much safer and more reliable. After speaking to my supervisor she said never hesitate trust your gut if you think you need a second pair of hands then just ask.

So if you find your self in a similar situation learn from what I did and ask for help.