Help me with vital please..

nrsang97, BSN, RN · Oct 3, 2016

First of all how are all your patients heart rates (HR) 17-20? Do you know the normal heart rate for adults? A respiration rate per minute would be more like 17-20. I think you mean RR for respiration rate.

Do not just copy from the previous shift. That is falsifying charting. You need to count for the full minute to get the respiration rate. That is important. If someone is breathing too fast or too slow the nurses need to know.

Have you ever worked as a CNA before this position? Did you take CNA (certified nurse assistant training)?

I have no idea how much a CNA would make working in a hospital in CA.

GE90 · Oct 3, 2016

You patients would have been in great trouble if their HRs are 17-20....

Easiest way, feel their radial pulse.

sok92 · Oct 3, 2016

First of all how are all your patients heart rates (HR) 17-20? Do you know the normal heart rate for adults? A respiration rate per minute would be more like 17-20. I think you mean RR for respiration rate.
Do not just copy from the previous shift. That is falsifying charting. You need to count for the full minute to get the respiration rate. That is important. If someone is breathing too fast or too slow the nurses need to know.
Have you ever worked as a CNA before this position? Did you take CNA (certified nurse assistant training)?
I have no idea how much a CNA would make working in a hospital in CA.

It's says HR on the chart and I was thinking it was respiration rate also, but i don't know. Yea I work as a CNA before, but it was in a SNF unit, but they switch me to sub acute and we had to do vitals. Gonna ask the charge nurse tomorrow I guess... I didn't copy anything from the other charts. I look on the machine for people who had the vents and just left the ones without the vents blank or let my co worker fill it out.

mrsboots87 · Oct 3, 2016

It really bothers me that you completed a CNA program, passed the cert exam, and have some experience, yet don't understand how to take vitals properly or what the abbreviations mean for each vital. Did you never take vitals at the SNF or something? You need to go get some training as nurses need accurate vitals and rely on you to report abnormal vitals timely. How can you tell me Mrs so and so's HR is abnormal if you don't even know what the normal is?

NurseGirl525, ASN, RN · Oct 3, 2016

A vent is not going to give vitals. It will give the rate that is programmed for the respirations that the vent gives. It also gives the number when the person is breathing over the vent. You need to be looking at the right one which means you need to be trained on it, and by your post, it doesn't seem like you have been trained well.

There needs to be an understanding that vital signs are important. It is why the word vital is in it. A change in vital signs is an important indicator that something major is going on with that patient.

If this other tech is false charting, and they are teaching you to do that, it scares me to think what is going on in that facility and what kind of care is being given.

la_chica_suerte85, BSN, RN · Oct 4, 2016

Your pay isn't great but it's not abnormally low in California, at least until the $15/hr minimum wage becomes a thing across the board. When I was per diem, I made upwards of $18/hr. When I was full time, however, I only made $14/hr (in Los Angeles, no less). As for the issue with vitals.....

Adult vitals look something like this:

Temperature: 37 C or 98.6 F (I work with kids and Celsius is the jam so anything below 36 or higher than 38.5 is an issue)

Respirations: 12-20 (might be slightly different if you work with people on vents)

Blood Pressure: 120/80 - 130/90 (depending on age -- the more elderly the person, a 130/90 might be a little bit more normal than if you got this reading in a middle aged person)

Heart rate: 60-100 (but, it's been shown, for every 10 bpm over 80 their risk for cardiovascular disease goes up)

Pain (depending on if your facility has you guys doing that type of data gathering and not the RNs): 0-10

The easiest way to get a heart rate is by checking the radial pulse, old school-style. You can also practice getting someone's respiration rate at the same time (doing this takes practice so do them separately but don't tell the person you're counting respirations because people get self-conscious -- just take the radial pulse for one minute and then count the respirations by watching the rise and fall of the chest for an additional 15 seconds -- eventually you'll be able to do them simultaneously).

I'm not sure about vents - if you're getting a bpm of 17-20, that's not going to be their pulse (i.e. breaths per minute vs. beats per minute) -- it's going to be the breaths per minute the machine is set to. As far as getting these vitals, I think you're on the right track to check with the charge nurse in terms of what they are asking. The person who trained you probably just didn't explain things correctly or may be doing something careless and the charge nurse ideally is the person to steer you in the right direction. Good luck!

Kuriin, BSN, RN · Oct 4, 2016

I'm terrified that you are a CNA yet you don't know the basic abbreviations for vital signs are, nor does it sound like you even know how to take vital signs.

jeneroo · Oct 4, 2016

How long are you taking the heart rate? For a full minute there's no way it could be 17-20. Now if it's for 15 seconds then you need to multiply that by 4 to get your HR. I'm also not understanding how you are working as a CNA without this very basic knowledge.

suburbiafeelsu · Oct 5, 2016

Hi sok92, I'm sorry for the people here criticizing you for the honest question. That is the opposite of what they should be doing. They know better and they know it's not effective.

The HR is heart rate (normal range = 60 - 100 for adults), and it's really confusing why they're reporting it with values that are similar to RR (normal range = 12 - 20 for adults). Please do check with the charge nurse tomorrow to clarify and possibly suggest additional education. It seems from your comments that continued education is necessary if their staff that is training is also struggling to understand what they're measuring and how to do it accurately.

Jolein2003 · Oct 14, 2016

I been a CNA for almost 3 years, I worked in a LTF and now I work in my local hospital. I did vitals at the LTF and now I do vitals at the hospital too. You need to follow the protocols and the parameters of your facility. Temp, pulse, respirations Blood pressure and O2. I do my paper to put the information in, and I have the name of the nurse I'm doing vitals to let them know is somebody is below or above parameters right away. Learn the parameters for each vital. I do a table and I keep my self very organized. If you have doubts ask!!! Did you got training? Because when I started working at the hospital I was in orientation for a whole month. I was not allow to use the dynamap at first, I need to take them manually. Vital is one of my main jobs working nights. I took, people to the bathroom, turn and position them, bed checks, water, trash and such too.