The Advantage to Having Registered Nurses in Hyperbaric Facilities

  • Janet Bello, RN, ACHRN, and Laura Josefsen, RN, ACHRN
  • Volume 08 - Issue 1

The clinical world of hyperbaric medicine is truly team concept with each member (physicians, nurses, and technicians) bringing the best of each respective scope of practice. The Undersea and Hyperbaric Medical Society (UHMS) accreditation process utilizes physicians, registered nurses (CHRNs) and technicians (CHTs) to evaluate hyperbaric facilities as each professional brings his or her own perspective to the comprehensive care that patients receive.

The specialty of nursing is a multifunctional part in the medical model. Nursing is the profession representing patient rights. According to the American Nurses Association, “Nurses use theoretical and evidence- based knowledge of human experiences and responses to collaborate with health-care consumers to assess, diagnose, and identify outcomes, and plan, implement, and evaluate care.” 1

“Nurses provide management for quality improvement, documentation, infection control, patient education, and intervention as well as initial and ongoing nursing assessment of patient care,” notes HG Vincent in Hyperbaric Nursing.2,3

The perception is that the quality of documentation equates to the quality of care. Documentation is an essential aspect of the nursing process, which includes chart reviews for accurate, comprehensive charting to meet regulatory and reimbursement guidelines for patient care, patient safety, and billing/reimbursement.4
Patients receiving hyperbaric oxygen treatments benefit from having the hyperbaric-trained RNs as part of their initial and ongoing nursing evaluations. The trained hyperbaric nurse uses critical thinking skills in the areas of quality improvement by gathering, assessing and evaluating data for patients going into the altered environment of 100% oxygen under increased atmospheric pressure. This data includes the following:

  • physical and psychosocial assessments, patient attitude

  • education, how patients learn, barriers to learning

  • patient compliance, ability to deal with health-care issues

  • baseline functional status, social environment,cultural environment, emotional states, and safety issues to identify initial and ongoing nursing interventions and revisions 2,3

To further assess the potential for patient issues going into the hyperbaric chamber, including the goal/rationale and actions for each issue, the Baromedical Nurses Association (BNA) Guidelines for Standard of Care for the Patient Receiving Oxygen Therapy (HBO2) are available on the BNA website at


  1. American Nurses Association. Nursing: Scope and Standards of Practice, 2nd ed. Silver Spring, MD:;2010.

  2. Vincent HG. Documentation. In: Larson-Lohr V, Norvell H, eds. Hyperbaric Nursing. Flagstaff, AZ: Best Publishing Company; 2002. p. 5-78.

  3. Vincent HG. Documentation of the Nursing Process as it Relates to Hyperbaric Oxygen Therapy, In: Larson-Lohr V, Norvell H, eds. Hyperbaric Nursing. Flagstaff, AZ: Best Publishing Company; 2002. p. 79-119.

  4. Larson-Lohr ed. Hyperbaric Nursing and Care. Flagstaff, AZ: Best Publishing Company;2010.


About the Authors


JANET H. BELLO, RN, BSN, ACHRN, is an independent consultant for hyperbaric medicine. As an Associate member of the Undersea and Hyperbaric Medical Society (UHMS), she serves as secretary for the Associates Council, is a nursing representative on the UHMS Accreditation Council, a nurse surveyor for the UHMS Accreditation Team and on the Membership Committee. Janet has also served as an officer and board member for the UHMS NE Chapter and the Baromedical Nurses Association. Her past experience includes hyperbaric programs supervisor for the Wound Recovery and Hyperbaric Medicine Center at Kent Hospital in Warwick, RI, and program manager for Praxis Clinical Services at Our Lady of Fatima Hospital, Hyperbaric Medicine Unit, in North Providence, RI. Both facilities provide hyperbaric emergency and critical care 24/7 for patients in monoplace chambers. Other nursing experience includes critical care and cardiovascular services, critical care educator and clinical manager for cardiovascular stepdown units at Piedmont Hospital in Atlanta, GA. She is licensed in the Commonwealth of Massachusetts. She received her bachelor of science degree in nursing at the University of Virginia.



LAURA JOSEFSEN, RN, ACHRN, has been involved in hyperbaric nursing since 1982. A founding member of the Baromedical Nurses Association (BNA) in 1985, she served as BNA president from 1996 to 1998 and as a board member in several positions throughout the years. She served on the Undersea and Hyperbaric Medical Society (UHMS) Associates Council for six years, with two of those years as Nurse Representative on the UHMS Board of Directors. She has been a member of the UHMS Accreditation Team as a nurse surveyor, served for many years as an executive board member of the National Board of Diving and Hyperbaric Medical Technology and is a previous chairman of the BNA Certification Board. She is a member of the UHMS Associates, former member of Divers Alert Network, and former member of the Hyperbaric Technologists and Nurses Association (HTNA) of Australia. She has numerous publications and is an internationally recognized speaker in the field of hyperbaric medicine. Her passions are quality improvement and education to promote hyperbaric nursing, safety, and optimal standards of care and practice for patients and the community.


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