LTC/Nursing Homes do all the vitals? Do they still exist really?

[downsouthlaff, LPN]

I worked at 2 Nursing homes as a C N A and at both we did vitals and pulse ox and all of that. But I know someone who works at another facility who said the nurses do all the vitals always but every now and then the CNAs would get a temperature. I'm just intrigued about how the nurse can do all of the there work and possibly have the time to get all those vitals. With ABTs, Skills, Hospice, B/P shift. Why would a facility make the nurses do all these vitals when CNAs are high competent and trained?

[JDZ344]

Many nurses prefer to do their own vitals. Some wards where I work, the assistants do all of them and some the nurses do more of them.

In LTC, most patients are not on daily vitals, maybe weekly or whatever. So they can easily split so that 5 patients on a Monday morning, 5 patients on a monday evening etc- throughout the week.

[downsouthlaff, LPN]

Well I don't know what regulations are and what has to done but at the facility I work at we have the 5 montky vitals for that day, but there is probly at least 3 residents on abt vitals, 4-5 residents on hospice vitals, and 3-5 Medicare shift blood pressures. That can add up to 18-20 vitals at one time there's just no way the floor nurse can possibly have time for this. That's why us Nurses Aides are trained in that skill. At the facility I work at you will never see a nurse touch a blood pressure cuff or thermometer that is 100 percent a CNA function every time from falls to code blues to dailys to Monthlys. In my opinion whether you are an RN, LPN, Paramedic, EMT, Physician there's only one way to take a blood pressure (do the actual skill) and we all learn the actual skill the same way and should be equally proficient at it. But once we turn over the numbers to the nurse then that's a different ball game but I'm talking the actual skill. Now it is however the nurses responsibility to look over the vitals the CNAs turn in and compare them to the baseline and recent vitals and if they notice the aides getting a drastic change they will question and possibly do it themselves to see. But I know my nurses and believe me they would have a conniption fit if they were told that they had to start doing all vitals themsekfselves.

[TheCommuter, BSN, RN]

I am in Texas and have worked in multiple local nursing homes. I've only worked at one facility where the CNAs did vital sign checks, and they only did them on the short-term rehab/Medicare wing where the residents get discharged after a few weeks or a few months.

The nurses collected their own vital signs at all other facilities where I have worked. As mentioned previously, some nurses prefer to obtain their own V/S because some CNAs will fabricate numbers or obtain vitals incorrectly.

Keep in mind that nursing home work is easier in some states than in others. Medication aides are utilized in many nursing homes here in Texas, so they take a huge amount of the workload off the nurse when they pass pills. When the nurse has a med aide, all (s)he does is finger stick blood sugars, injections, charting, assessments, wound care, breathing treatments and other random tasks.

[kbrn2002, ADN, RN]

Where I work CNA's can do monthly and weekly VS and weights. Any other reason for VS ,like a BP for a med or VS after a fall are considered part of the assessment process so the nurse does them.

[blwilliams10]

At my facility our RNAs do V/S once a week, and then if a resident is on daily monitoring then the CMTs usually does them daily. On my shift (noc) the CNAs do them during emergencies since it is usually just two CNAs and one LPN. The CNA will do them while the LPN prepares paperwork/treatments/other things for the situation. Other than that the CNA will only do them if asked to.

[MommaTy]

Where I worked at a LTC facility day (7a-3p) nurses got the vitals, evening (3p-11p) CNAs got the vitals. Not sure about the 3rd shift since I never worked it. Not all patients were done at the same time. They broke the patients up so 7-3 got some, 3-11 got some, and 11p-7a got some. At the Hospital where I work the PCTs get all the vitals unless the nurse isn't busy and they may need a stat vital of some sort.

[HippyDippyLPN]

I always do my own vitals, not all aides can take them right and if its a perimeter for a med I need to have it spot on. The cna's do the monthly vitals though at my facility.

[funtimes]

At the couple LTC facilities I worked at, the CNAs did all the vitals. Very rarely did the RNs do a full set of vitals. They had other things to do. If the RN had a med to give that was dependent on vital signs, they would tell the CNA to take them, or let them know what time they needed them by. I've seen an RN angrily waiting for a CNA to check vitals and angrily saying ok im going to do something else, let me know when you have those vitals. I should also add this place had a really long orientation and was very strict on assessing competency before you could work on your own.

Checking vitals is not rocket science, it doesn't require a degree or extensive training, but doing it accurately does take lots of practice. There is no reason why CNAs cant do vitals accurately. Its an essential part of the job description and if anything you should be better at it than the RNs because you get more practice at it, that's certainly the case in a hospital, and was also the case in LTC facilities Ive worked in. If you cant do accurate vitals you shouldn't be a CNA, period.

[kbrn2002, ADN, RN]

Sadly funtimes in my area they don't even teach VS in the CNA classes anymore. Most of our newer aides don't have a clue how to check a BP. I believe for the monthly VS the CNA's do that either the older aides are doing them or maybe teaching the newer ones themselves. I've never heard of one of the aides asking a nurse to teach them.

[downsouthlaff, LPN]

I always thought that vital signs were part of the national nurse aide standard of card. Here in Louisiana Medication aides do not exist and probly never will. Vitals are a big part of our job as CNAs, as this is a true way to assist the nurse. Vitals give us a break from the wiping. Without vitals CNAs really are just butt wipers. Getting vitals really takes up a big part of my day. I am surprised to hear that some places aren't teaching this skill anymore. It seems like as time goes the scope for Nurses RNs and LPNs is expanding but it seems like the CNA skill set just takes steps backward. CNAs use to give enemas and suppositories. Not anymore. I guess vital signs will be the next to go. And CNAs will be limited to in continent care and bathing.

[downsouthlaff, LPN]

Kbrn 2002 perhaps if the CNA course is being taught at a LTC facility they may expect the older aides to train them with vs on the floor all CNA books are written at a national standard level it's hard to believe that the class wouldn't include learning how to do vitals. I'm sure some facilities in your area must have CNAs doing vitals right? I know at one facility I did agency at the CNA students were expected to learn these kind of skills during there paid clinicalsmonnthe floor, I know boards of nursing vary from state to state but it's the nursing home nurse aide/CNA scope governed by the CMS/ NATCEP/OBRA standards?