On your med-surg floor, who routinely takes vital signs -- you or your nurse's aide? Do you rely on an automatic bp cuff or do you take the bp manually? What about when a patient comes back post-op and needs frequent signs?

The aides routinely take vital signs manually only. Of course, I always check signs prn and before a cardiac med... Also when I admit a patient from surgery, I literally try to catch them on the stretcher/bed BEFORE I settle them (and the PACU RN leaves) and take my own vitals manually -- also gives me a chance for a quick visual assessment.

From a personal note, I find that manual BP is more accurate. I helped with a mini in-service for the nurses aides to compare: bp differences in arms (alot of carotid stenosis in my patients), and manual vs. automatic bp cuffs. And we always always always check a radial or apical pulse -- don't rely on the pulse shown by the pulse ox machine.

I do my own vitals - my assessment, my responsibility. Machines are okay, but at times not really reliable especially when it comes to really low readings. I prefer manual readings. As for pulse ox, I will do a radial pulse on the opposite wrist to confirm that the pulse is in sync with the meter. I find the pulse ox monitors more inaccute with irregular heart rates.

Blood pressures

Manual is always the best. Non-invasive BP cuffs- are secondary to manual. Non-invasive can be false for a number of reasons, pts are moving arm, the cuff is too big- too small- the non-invasive (manuals) are taking the BP by vibration. And many factors can alter the vibration.

Of course, art lines are the gold standard. But on the floors, manual should be the gold standard.

I do my own vitals at the beginning of shift as part of my assessment. if there are midshift vs due and my initial ones were wnl,then I'll ask the aide to do them. I dont like the machines, and if we call our cardiologists with any situation that arises,they insist on manuals by the nurse.

Our aides do them on med surg floors. Tele floors each have their own way, some have aides do them, some have nurses, some the nurses do the first set and aides do all the rest. Machines are certainly time savers for the aides but I always do mine manually.

I work on a med-surg floor (the only aide). If I'm on a single hall, I'll get vitals at the beginning of shift along w/a nurse. With post-ops, or anyone else that needs vitals frequently, I'll know abt it, & get them. Nurses will sometimes get them, in addition, I'll go in to get a set & they'll have already gotten them. As far as what we use, we have automatic ones, but we have manual ones for backup, if they break, or we have a patient that we just can't get a BP on w/the dynamaps.

our aides do them, with the NIBP machines. If there is a prob, or one that doesn't match, then we do manuals.

Well, I work in ICU, so I have the automatic cuffs at my disposal. If there's a question about whether the BP is accurate, I always check with a manual cuff. I find our automatics in the unit tend to be more accurate than the portable models the CNAs and nurses use on the floors.

The CNAs do them. But I never, ever ever intervene in a high or low BP, nor allow "my" staff to when I'm in charge, unless someone confirms it manually. I've noticed for some reason with our machines when it's low, it's usually accurate, but when it's outrageously high and we take it manually, the manual is lower.

Originally posted by konni

Well, I work in ICU, so I have the automatic cuffs at my disposal. If there's a question about whether the BP is accurate, I always check with a manual cuff. I find our automatics in the unit tend to be more accurate than the portable models the CNAs and nurses use on the floors.

In our neuro intermediate unit, I found that to be true. I still double checked them, but the monitors seemed pretty accurate.

ever try to do a manual on a 3 year old? or an infant? not gonna happen. we occasionally do manuels on older kids if it's indicated by some wacky numbers with the machines. And i like doing my own vitals..i gotta assess the kiddo anyway, no sense in 2 people going in and botherign them....

The automatics in my CCU generally are right on target... if the BP needs to get checked quite often, you can just program the monitor to take it say q2minutes or whatever ..... it frees up your hands so you can be doing other things.

Manually is more accurate. We use a Welch-Allyn vital sign machine (aka 'Robo Nurse') but if we get an unusually high or low value we alwayscheck it manually before calling anybody.