False vitals data??? - page 3

by jval, ADN, RN | 5,207 Views | 30 Comments

False vitals data! Long story short, a girl in the same room as me took a pt's vital signs. She presented me with the data and it included a b/p... I asked her how she got it because she didn't have the station's cuff or... Read More


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    For some bizarre reason, some aides seem to think there is some great "trouble" they can get into if they cannot get vitals.

    I have no clue why.

    Think about it: even the fact that a patient is refusing vitals, that is-- in and of itself-- telling you something about that patient.
    Does it hurt?
    Is there a change in mental status?
    Are they "giving up" and starting to refuse care?

    It is legitimate to report to the nurse that the patient refused and it has nothing to do with your abilities as an aide.

    As for vitals outside of parameters-- why the big freak out?
    Obviously, if everyone's vitals were normal all the time, there wouldn't be much point in getting vitals, now would there?
    Do aides assume they must have done it wrong?
    Do they fear they will be perceived as incompetent?
    Have they dealt with nurses who give them a hard time about abnormals because the nurse doesn't want to have to follow up?
    Are they dealing with crappy equipment?
    Do they really know how to use the equipment?
    Do they realize that some patients are just super hard to get vitals on, and even good nurses can struggle with getting a decent reading?
    And if it's any of these things, why aren't these aides speaking up?

    I wonder because, as an aide, you don't really have to do anything about abnormals... just report them.
    Then it's up to the nurse.

    Now, let's discuss honesty and work ethic.
    Some folks just don't have any.
    A lie is quicker than doing the work.
    They slip through the cracks and pass their class and get a job...
    And then we all have to deal with it.
    Last edit by Hygiene Queen on Sep 20, '12 : Reason: typo
    Paws2people, nguyency77, mstearns09, and 1 other like this.
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    I was told day one of training, "You'll get where you can tell who breathes 18-20 breaths." What?! Um...no. I will be counting everyone's respiratory rate myself.
    nguyency77 likes this.
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    Oh my, that is very dangerous. Vital signs are so important in determining the patients status. Many women have no signs and symptoms of hypertension and the initial start of infection can start with just a fever. Not only that, but different medications can cause bradycardia and tachycardia also. No excuse at all for making up vital signs.
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    Like everything else...even with all the juicy posts above, lazy is lazy is lazy...people crying about broken equipment and its a hassle etc...and the patients do not want it done...blah blah...what are (you) a bunch of 2 year olds...I have said it before on other posts you people that complain like this wouldn't last 1 day on a construction job. Wake up! Vitals reported wrong/false whatever the case can easily mean DEATH for the patient. If LTC is too taxing for you...leave! Go flip burgers at some poison food joint...oh no there might be a line waiting for their orders... could you handle that? And by the way at the most basic level as a CNA you are taught to take vitals by palpating the patient...remember that...touching them...actual hands on assessment at the most basic level? Radial pulse...can you multiply and count by 4? And manual BP..at least every medical facility has a manual BP cuff and a cheap stethoscope...and wow counting respirations...hmmm...look and count! Wow! I agree with some of the above posts lazy is lazy and some people have zero work ethic so much that they would endanger a life out of shear laziness.
    nguyency77 likes this.
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    "Now, let's discuss honesty and work ethic.
    Some folks just don't have any.
    A lie is quicker than doing the work.
    They slip through the cracks and pass their class and get a job...
    And then we all have to deal with it"

    Great quote...so sad and so true...I will be extremely blunt...any dimwit can pass any CNA class.
    nguyency77 and Hygiene Queen like this.
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    Not only should we aides be held accountable, but the nurses who knowingly allow this to happen should be, too.

    A fellow aide once told our hall nurse that she was "falling behind" and "couldn't get vitals." And do you know what this LPN said? He said in all seriousness, "Just make something up and I'll believe you." I was appalled.

    EDIT
    @malamud: You are so right. I have seen people whine about vitals taking too long. Once, I escorted a resident out to our patio one evening for a smoke break around 10 minutes before we were supposed to clock out, and guess what? All the whiners were sitting there... smoking. Just plain lazy.
  7. 2
    Quote from malamud69
    Like everything else...even with all the juicy posts above, lazy is lazy is lazy...people crying about broken equipment and its a hassle etc...and the patients do not want it done...blah blah...what are (you) a bunch of 2 year olds...I have said it before on other posts you people that complain like this wouldn't last 1 day on a construction job. Wake up! Vitals reported wrong/false whatever the case can easily mean DEATH for the patient. If LTC is too taxing for you...leave! Go flip burgers at some poison food joint...oh no there might be a line waiting for their orders... could you handle that? And by the way at the most basic level as a CNA you are taught to take vitals by palpating the patient...remember that...touching them...actual hands on assessment at the most basic level? Radial pulse...can you multiply and count by 4? And manual BP..at least every medical facility has a manual BP cuff and a cheap stethoscope...and wow counting respirations...hmmm...look and count! Wow! I agree with some of the above posts lazy is lazy and some people have zero work ethic so much that they would endanger a life out of shear laziness.
    Um, seriously? Calm down and get off your high horse. Someone asked what's so bad about vitals, and some people answered. None of us said that we make them up; we just explained why doing them is a drag. If we made them up, we wouldn't be here complaining about having to do them.
    WannaBNursey and Paws2people like this.
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    Quote from Hygiene Queen
    For some bizarre reason, some aides seem to think there is some great "trouble" they can get into if they cannot get vitals.

    Have they dealt with nurses who give them a hard time about abnormals because the nurse doesn't want to have to follow up?
    That would be it, in my case. I have had a nurse make me get someone's blood pressure SIX times in a row and then again every 10 minutes until it was WNL. She kept telling me to take it again, try it in the other arm, give fluids, etc. and got frustrated and acted like it was my fault when it didn't change (and then got mad when I didn't have my I&Os for her by 2 o'clock when clearly she would not let me have more than 10 minutes to change anyone!). I have reported high temperatures and had her tell me to take it in the ear so she could document that one instead. This kind of stuff only happens with 2 nurses; the rest of them are normal. These particular nurses have taught themselves to be helpless and depend on the CNAs for EVERYTHING and throw a tantrum when you tell them something they don't want to hear because they have made themselves believe that they are incapable of doing any CNA stuff. I have never seen them take vitals before. It's like, you try to feed someone who is on their way out and they cough, choke, and have food come out of their nose, so you report that and she's like, "don't feed them if they're like that!" and 5 minutes later she is treating you like an incompetent moron because their intake is low. Hello, what do you want me to do? Okay, vent over.
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    Quote from fuzzywuzzy
    That would be it, in my case. I have had a nurse make me get someone's blood pressure SIX times in a row and then again every 10 minutes until it was WNL. She kept telling me to take it again, try it in the other arm, give fluids, etc. and got frustrated and acted like it was my fault when it didn't change (and then got mad when I didn't have my I&Os for her by 2 o'clock when clearly she would not let me have more than 10 minutes to change anyone!). I have reported high temperatures and had her tell me to take it in the ear so she could document that one instead. This kind of stuff only happens with 2 nurses; the rest of them are normal. These particular nurses have taught themselves to be helpless and depend on the CNAs for EVERYTHING and throw a tantrum when you tell them something they don't want to hear because they have made themselves believe that they are incapable of doing any CNA stuff. I have never seen them take vitals before. It's like, you try to feed someone who is on their way out and they cough, choke, and have food come out of their nose, so you report that and she's like, "don't feed them if they're like that!" and 5 minutes later she is treating you like an incompetent moron because their intake is low. Hello, what do you want me to do? Okay, vent over.
    Again, this is pretty much a minor inconvenience compared to everything else nursing home CNAs put up with, and yes, its actually a lot worse in a hospital, where you run into the exact same thing, only on a contstant basis, as in every 4 hours or less on multiple patients, and yes you also haveto deal with faulty equipment.

    There are all sorts of protocols in the event of abnormal vitals. For instance if someones respiratory rate is above 20, it can set off sepsis protocols, so if you chart a rate of 24, or 22, but everything else was normal, some RNs will get annoyed, and say something like I was just in the room and the patient was breathing normal then, had they been moving around, did you count em for a full minute, check em again, or wait til they go back to sleep etc. If you get an abnormal BP, you automatically have to recheck on the other arm, which is always fun when the patient is trying to sleep and they throw a fit the first time you checked. Then if its still abnormal, they tell you to recheck with a manual cuff, etc. Or their O2 is low, so they want you to have them cough and deep breath and recheck, or raise the head of the bed, or go get an incentive spirometer and have them use that, before finally telling you to put them on or up their o2 or page respiratory.

    While doing all this you have call lights going off and still have 15 more vitals to get within a certain amount of time, not to mention repos to do, an admission that just came up, and every 3rd or 4th patient has something abnormal that requires an intervention, or a recheck in 45 minutes, or you noticed someones IV site is leaking or infiltrated. Then there is the fun of tracking down the patient's RN to report whatever.

    Of course if you charted a RR of 20 when its 24, and it really is climbing because something is wrong, when the next shift comes on and a different RN goes into the room and notices the patients RR is now 28 but the charting showed it steady at 20 all night long, that CNA is probably going to have some splaining to do, which is why I always chart exactly what it is, not what id like it to be.
  10. 0
    Ok, you win the CNA Olympics. You can stop trying to invalidate everything I say now, and I'll stop answering simple questions.


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