OSCE › Station
Respiratory: inhalers, oxygen and a nebuliser
RCSI heading: Respiratory system: related matters including clinical procedures. You get 2 minutes with the descriptor outside the door and 10 inside, marked competent or not competent on every line. RCSI publishes a sample descriptor for this station; ours follows its parts with a different patient. Check rcsi.com before your date.
Rehearse it
Stand up, say it aloud, use whatever is on your desk as the equipment. The debrief is the competency sheet and the assessor’s questions.
To assess how you deal with the clinical procedures around a chest infection: inhaler technique and teaching, oxygen and a nebuliser given as prescribed, positioning, and the checks that keep the patient safe.
Part 1: inhalers, COPD, asthma. The assessor asks questions and hands you the devices.
Part 2: Mrs Nora Keane, 71, admitted last night with an acute chest infection on a background of COPD. She is breathless and chesty, has slipped down the bed and is calling for help. A prescription for oxygen and a salbutamol nebuliser is on the medication record. You use the mannequin; the assessor answers as the patient.
- State the actions to take during an acute asthma attack
- Demonstrate a metered dose inhaler (MDI) and a breath-actuated or Turbohaler device
- State what a reliever, a preventer and a combination inhaler each do
- State the target SpO2 range for a patient with COPD
- State the consideration when giving a nebuliser to a COPD patient, and why
- Name and point to the accessory muscles of respiration and say what you do if a patient is using them
- Carry out and verbalise the patient and environment checks (identity band, allergy band, prescription, bed brakes, call bell, oxygen supply)
- Gain consent, sit the patient up, and assess the effect of positioning
- Explain the procedure, obtain consent, and say how the consent is recorded
- Give oxygen as prescribed and assess the outcome (SpO2, respiratory rate, work of breathing, colour, speech)
- State the oxygen flow rate needed to drive a nebuliser
- Give the oxygen-driven nebuliser as prescribed and assess the outcome
- Using the PCRA, explain what PPE this station needs, when and why
- Say when and why you perform hand hygiene at this station
Throughout: communicate in an accurate, clear and effective manner; demonstrate a level of competence essential for safe practice.
Competencies assessed
Every RCSI descriptor lists the same five domains from the NMBI standards.
- Professional values and conduct of the nurse
- Nursing practice and clinical decision-making
- Knowledge and cognitive competences
- Communication and interpersonal competences
- Management and team competences
Mistakes candidates report
- Turning the oxygen up to 15 L because the saturation is low, without checking that the patient has COPD and a target range on the chart.
- Running the nebuliser and walking away: the assessor wants the six-minute limit said out loud and the patient put back on the prescribed oxygen.
- Demonstrating the MDI fast, like a spray. The breath in is slow, the hold is ten seconds.
- Forgetting to breathe out away from the Turbohaler, or tipping it after loading the dose.
- Doing the environment checks in silence. Every check is said aloud: identity band, allergy band, brakes, bell, oxygen point.
Practise the parts
Sources
- RCSI sample descriptor one: respiratory (preparation page, reading list) checked 2026-09-16
- BTS Guideline for oxygen use in adults, 2017 (summary) checked 2026-09-16
- HSE: Asthma attacks checked 2026-09-16
- HSE: Salbutamol inhaler checked 2026-09-16
- NI Formulary: metered dose inhaler checklist checked 2026-09-16
- HSE PCRA poster, v1.1 March 2024 checked 2026-09-16
This descriptor is a practice piece written to the shape of the RCSI samples. It is not an exam task, and the exam may ask anything from the reading list.