Everyday charting

The ventilator settings you charted but did not set

RT charted the vent. Your assessment still asks what you saw: the display, the order it should match, and the alarm limits.

7 min read built on 0 cases updated 2026-11-04

Written by a med-surg RN, ten years, day shift. Why there is no name on it · How this guide is made

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RT set up the vent. RT does the vent checks and charts them on the respiratory flowsheet. Your own assessment still has a line for ventilator settings, and it's tempting to copy RT's numbers or just write per RT. Don't. That line is yours. It should say what you saw on the vent at the bedside, which order you checked it against, and what the alarm limits were.

Key points

  • Patient first. Then the vent display, then the latest vent order. Chart all three, with a time.
  • Write the settings as the vent shows them when you look. Write down the order you compared them to, with its date and time.
  • Write matched or did not match. If they didn't match, chart who you told, when, and what the display read afterward.
  • Chart the actual alarm limits on the screen. Alarms on by itself doesn't tell anyone much.
  • If RT changes something on your shift, go back to the bedside, recheck, and chart what you saw. Your name, your time.

What to write

How it often gets charted What works better
Vent settings per RT.0815: Ventilator display at bedside: AC/VC, RR 16, Vt 450 mL, PEEP 8, FiO2 40%. Compared to vent order of [DATE] 0640. Settings match order.
On vent, no changes.1200: Display rechecked at bedside: AC/VC, RR 16, Vt 450, PEEP 8, FiO2 40%. No change from 0815 check. Matches order of [DATE] 0640.
Alarms on.0815: Alarm limits as displayed: high Ppeak 40 cmH2O, low Ve 5 L/min, high RR 35, apnea 20 sec. Alarms audible at nurses' station. Limits reviewed with RT J. Smith, consistent with current settings.
FiO2 60%, RT aware.0930: Display FiO2 60%. Current order FiO2 40% (order [DATE] 0640). SpO2 97%. RT J. Smith notified at 0932. RT stated FiO2 increased for suctioning at 0900 and not returned. RT returned FiO2 to 40% at 0935. Display confirmed 40% at 0936. SpO2 95% at 0945.
Tolerating vent well.0815: Counted RR 18 (set 16), no accessory muscle use, synchronous with vent on observation. SpO2 96%. Breath sounds coarse bilateral bases, unchanged from prior shift. Ppeak 26 on display.
Weaned to PS per RT.1400: RT J. Smith placed pt on CPAP/PS 10/5, FiO2 40% per SBT order [DATE] 1330. Display confirmed at 1405. Counted RR 22, Vt on display 380 to 420 mL, SpO2 95%. Alarm limits on display: low Ve 4 L/min, high RR 35, apnea 20 sec.

Every entry in the right column has the same parts: a time, the source (display at bedside), each setting as shown, the order you checked against, and a plain match or no match. RT's name shows up only as the person you talked to. Your numbers come from the screen.

Template

Routine shift check (chart entry)

[TIME]: Patient assessed before ventilator review. Counted RR [NUMBER], SpO2 [NUMBER]%, HR [NUMBER], BP [NUMBER/NUMBER]. Breath sounds [FINDINGS], [CHANGED / UNCHANGED] from prior shift. Patient [SYNCHRONOUS / ASYNCHRONOUS] with ventilator on observation. Sedation/comfort: [SCALE AND SCORE].

Ventilator display at bedside at [TIME]: mode [MODE], set RR [NUMBER], Vt [NUMBER] mL (or inspiratory pressure [NUMBER] cmH2O), PEEP [NUMBER] cmH2O, FiO2 [NUMBER]%, pressure support [NUMBER] cmH2O. Measured Ppeak [NUMBER] cmH2O, exhaled Vt [NUMBER] mL, minute ventilation [NUMBER] L/min.

Compared to ventilator order dated [DATE] [TIME]. Settings [MATCH ORDER / DO NOT MATCH ORDER, SEE NOTE AT TIME].

Alarm limits as displayed: high pressure [NUMBER] cmH2O, low exhaled Vt or minute ventilation [NUMBER], high RR [NUMBER], apnea [NUMBER] sec. Alarms audible at [LOCATION]. Limits [REVIEWED WITH RT [NAME] AT [TIME] / CONSISTENT WITH CURRENT SETTINGS].

Bag-valve mask and suction at bedside and functional.

Settings did not match the order (chart entry)

[TIME]: Ventilator display shows [SETTING] at [DISPLAYED VALUE]. Current order dated [DATE] [TIME] specifies [SETTING] at [ORDERED VALUE]. Patient at time of finding: SpO2 [NUMBER]%, counted RR [NUMBER], [OTHER FINDINGS].

RT [NAME] notified at [TIME] by [IN PERSON / PHONE / PAGE]. Reported: displayed [SETTING] [DISPLAYED VALUE] vs ordered [ORDERED VALUE]. RT response: [WHAT RT SAID OR DID].
[IF APPLICABLE: Provider [NAME] notified at [TIME]. Response: [WHAT PROVIDER SAID OR ORDERED].]

[TIME]: Display rechecked at bedside: [SETTING] now [VALUE]. [MATCHES ORDER / NEW ORDER RECEIVED DATED [DATE] [TIME]]. Patient after change: SpO2 [NUMBER]%, counted RR [NUMBER], [OTHER FINDINGS].

Message to RT or charge nurse

[RT NAME / CHARGE NURSE NAME], this is [YOUR NAME], RN, caring for [PATIENT INITIALS OR ROOM NUMBER].

At [TIME] the ventilator display shows [SETTING] at [DISPLAYED VALUE]. The current order dated [DATE] [TIME] is [ORDERED VALUE]. Patient right now: SpO2 [NUMBER]%, RR [NUMBER], [ONE-LINE CONDITION].

[ALSO: Alarm limit for [ALARM] is set at [VALUE], which does not fit the current settings of [SETTINGS].]

Please check at bedside and let me know what you change or whether there is a newer order I am not seeing. I will recheck the display at [TIME].

Words to avoid

Word or phrase Why it causes trouble Use instead
per RTSays the numbers came from someone else's checkDisplay at bedside at [TIME] shows...
see RT flowsheetHands your assessment off to another person's entryYour own reading of the display, then the comparison to the order
WNLVent settings have no defined normal range. Normal compared to what?The actual values plus matches order of [DATE/TIME]
no changesSince when? And by whose check?No change from my [TIME] check
alarms onTells you the alarms are switched on. Says nothing about the limitsThe limits as displayed
tolerating vent wellA conclusion with no findings behind itCounted RR, synchrony, SpO2, breath sounds, Ppeak
RT awareDoesn't say what you told RT, when, or what happened nextTime notified, what you reported, what RT did, recheck value

Charting RT's numbers as your own

The usual mistake is charting RT's numbers as your own. You copy them, or you write vent settings per RT or see RT flowsheet.

That causes trouble in four ways:

  • RT's entry belongs to RT. It shows what RT saw at RT's check time, under RT's name. Nothing in it says you looked at the display, pulled up the current order and compared the two. Whoever reads your assessment later can't tell if you checked anything at all.
  • Settings change between checks. Say RT checks at 0700 and you chart at 0930. In that gap a provider may have given a verbal order. Someone may have bumped FiO2 for suctioning and never turned it back down. The patient may have gone to a different mode for a trial. Copied numbers miss all of it and put a wrong value in the chart under your name.
  • Copying spreads errors. If RT's entry has a typo, your copy repeats it. Now two records agree on a number the vent never showed. Charting settings by hand is error-prone to begin with. A second reading only helps if it's really independent.
  • Alarms are where things slip through. Limits set for yesterday's settings may not fit today's. With the high-pressure limit set too high, or the low minute-volume alarm set too wide, a problem can run for a while before anyone gets alerted. Alarms on and audible says nothing about whether the limits make sense for this order and this patient.

None of this means you're managing the vent. Setting changes are RT's job or the provider's. Yours is to look, compare and report. The chart should show you did.

Bottom line

Chart what the vent showed when you looked, the order you compared it to, and whether they matched.

Official guidance

  • Patient first, machine second. Check vital signs, oxygen saturation and breath sounds against the previous shift before you go through the vent screen. (StatPearls, American Nurse)
  • Pull up the latest vent order and compare it to what's actually set on the vent. (StatPearls, American Nurse)
  • Know what each vent alarm means and what you'd do when it goes off. (American Nurse, AACN)
  • Mode, rate, tidal volume, FiO2, PEEP and pressure support go in nurse handoff. (AACN, FreshRN)
  • Setting changes belong to RT or the provider, under an order. The nurse charts what she saw and who she notified. (StatPearls, FreshRN)

What this rests on

No published decision turned up for this question. We looked, and the searches are in the record. So this article stands on published guidance and on how the question is asked on the floor, not on a court opinion. That is a weaker footing than the rest of the guide, and you should know it before you rely on it. The decisions behind the other articles are all in one place.

From nurses online

Quoted as written. Opinion, not a source.

  • Is it in the scope of an RN to change the settings on the ventilator? My last shift my patient was on spontaneous mode on the vent (meaning they were breathing on their own) and began having periods of apnea. I called RT to change them over to another mode that was already ordered.

    r/nursing on Reddit: Is it in my scope…? (RNs & Ventilators) reddit

  • Again, alarms should have been properly set so that you are alerted when the patient isn't tolerating spontaneous mode. As my nurse buddy, I really appreciate when you keep an eye out on the variable parameter and give me a heads up that it's ...

    r/nursing on Reddit: Ventilator Basics and Modes. Study resources and quizzes. reddit

  • And I have looooved RTs at other facilities I’ve been at so I know it’s not like a professional bias thing. Archived post. New comments cannot be posted and votes cannot be cast. Locked post. New comments cannot be posted. Share ... Yeah that’s not cool. I’m required to check vent settings during sh

    Ventilator Venting : r/nursing reddit

  • PRVC is a mode that puts more limits on what the patient can do, so generally that's why this mode is more common in really sick patients. RT will flip patients between the modes balancing patient comfort, minute ventilation, ventilator compliance/synchrony, and lung protection, all while attem

    r/nursing on Reddit: Vent Settings for ICU Nurses reddit

Other guides

Advice, not law.