How many nurses do their own vitals??? - page 5

Hi all, Well at my one place they just posted something stating that since they are so short on PCTs that the RNs will be responsible for doing their first set of vitals. This, I feel is insane. ... Read More

  1. by   Robinette
    I thought part of the assessment was taking the vital signs. For me, personally, I like to take the vitals myself. I have had bad experiences with inaccurate vital signs taking from techs or aides, and it's my license on the line.
  2. by   JWaldron
    Quote from canoehead
    I couldn't consider an assessment complete unless I took the vital signs. I do my own, and I think would find it hard to change.
    When I worked in Med/Surg, I did my own VS, but it would have been a relief to have the CNA do some of them. I was assessing 16 patients, checking all their labs, calling the docs, taking the orders, charting on all 16; some of the aides were wonderful, some, you wondered where they were. I also would have an LPN working w/ me, who 'had' 8 of those pts, but by hospital policy, she was/is not permitted to do many things, so: I also had to mix all the IVs that needed mixing, do all the transfusions (and there were almost always at least 2), do all the pushes, and all the central lines (about 50% 0f the pts had central lines), and probably 80% got pushes. Plus doing all all the other meds and the FS, and dressing changes and other tx on my own 8 pts. I never ate, and I never got to go to the bathroom. And I never got out on time. ANd that was working w/ a very strong LPN.

    Where I am now, I usually have only 8 pts that I am responsible for and I tell the CNA whcih pts. will need VS for cardiac meds at what time, and IF she has the time free to do it then, she does, but most of the time, she is too busy (which is what I expect to happen) and I do them myself. When they ARE done for me, if it was more than 30 minutes ago, I re-do them, or if it was out of the norm, for that person, or very high or low, I always re-do them anyway. Who wouldn't? But I have already done them once myself, earlier in the shift.

    Savvy One
  3. by   AmyRN1227
    If I have four patients, then yes, it's no big deal. But if I have seven help me out a little.

    Right! I totally agree. If I'm running around with eight and nine patients and I'm on a med/surg oncology floor. So I have assessements to do at first, plus blood sugars to check, plus tons of medications to pass and maybe even other things going like blood or bowel preps, then yes I think it would help if the PCTs could help out a little. I don't mind helping out or doing my own VS either. The problem I have is when the RNs are running around like crazy and you see the aides just sitting around. Why, what is their job if they aren't doing vitals? Literally, the other nite I was trying to find a vital sign machine that WORKED. Plus I had a lot of stuff happening at the change of shift. I was left with a bad IV, which the pt's wife was complaining about. Plus the pt had to be moved to a private room, and he had an NG tube and was vomiting all over the place. Plus I hadn't seen any of my other pts until maybe 5-6pm!!! And the aide even walked in the room TWICE with the vitals machine sitting right there. I guess she was so busy she couldn't do vitals? I'm glad that the patient's wife noticed because when the manager walked around later to ask how things were going she said she thought it was crazy that the RN has to do her job and the aide's job. She told her how nuts things were and how I was juggling a million things and that "what does the aide do?" It was pretty obvious that day. And it's easy for all you aides and nursing students to say "OH I'm going to do that" but lets wait till you are on the floor first as an actual nurse and dealing with all this stuff and then let's see how you feel. I was an aide once too and I said the same thing but it's different when you are dealing with multiple responsiblities and VERY sick people. :angryfire :angryfire :angryfire
    Amy

    Too often there is one tech for 30 patients, and the nurses have the same ratio as if there were three techs, then everyone's stressed. :angryfire[/QUOTE]
  4. by   Marie_LPN, RN
    Quote from AmyRN1227
    Too often there is one tech for 30 patients, and the nurses have the same ratio as if there were three techs, then everyone's stressed. :angryfire
    [/QUOTE]

    Yep. I swear my hair is falling out.
  5. by   rondafan
    This is a hot topic @ my facility right now. We're a small hospital, we get lots of nursing home pt's so they have to have assit to get out of bed, most need to be fed, cleaned up etc. The RN's were getting their own VS while the CNA's were doing breakfast duty, we just looked @ it as part of the morning assessment, I balked @ first but some busy days this was the only time I spent with families answering questions, giving updates etc. I feel like the families/ pt's appreciate this time spent. I also look prepared when MD's ask VS questions. Well the new DON decided that the CNA's needed to get their own AM VS, now I see that breakfast is getting served cold if the pt is @ the end of the hall, I mean she can only do so much. My VS weren't getting posted till 0930 or later, or reports of abnormals weren't in a timely manner. I've now went back to getting my own when time permits or pt's with monitoring needs I at least get them. I really like the idea of changing the VS times to 0600- 1000- 1400- 1800 etc. The VS would be known @ 1st of shift, rechecks could be done if needed, this doesn't go along with meal time VS, & the CNA's would be free to do breakfast duty when we get out of report in the AM. I'm gonna suggest this to my new DON.
  6. by   mattsmom81
    I don't float out to the floors from ICU much anymore but when I do I manage my own vitals except for a rare occasion where I might ask the CNA to catch some repeat vitals for me, during blood transfusions or post procedure for instance.

    My personal take is vital signs are part of my asessment and I can get them quickly while I do my head to toes, which are q 4 on my PCU (same as vitals).

    One CNA for 20-30 pts can only do so much and personally I prefer he/she answer lights, be available to assist patients, do physical care, etc....I like to manage my own vitals, fingersticks, AND all the documentation of the same, personally.

    This is a big brouhaha on our floors (what the aides should do) and what I sense is many of the nurses expect too much out of our good aides, while the lazy ones get by with very little work by being obstinate, refusing, and/or hiding out.

    I agree on general medsurg units or LTC there is a much greater need for CNA help with vitals; with 4-5 pts it's less an issue.
  7. by   NurseACB
    I am a senior in nursing school but I also work as a nurse tech at a local hospital. The nurses there are also required to take at least one set of vitals, preferably the first. They said it was to be done while they were doing their assessment. They only do the BP and HR to ensure that nothing is crashing first thing in that shift. IF for some reason theyu are swamped, they will request that we do them which is no problem.
    Quote from AmyRN1227
    Hi all,
    Well at my one place they just posted something stating that since they are so short on PCTs that the RNs will be responsible for doing their first set of vitals. This, I feel is insane. Especially since at around the time the first vitals are being done by the PCTs, we are doing assessments, passing meds, and like the other nite I was giving prep for a bowel procedure. And I don't mind helping out, as it was stated on the memo "We will all be expected to accommodate the needs of the unit" but when I see PCTs standing around doing nothing and I'm also doing their vitals it really angers me. I feel like they just keep dumping more and more things on us and they wonder why we have so many lawsuits...
    :uhoh21: :uhoh21:
    Just wondering if this is a requirement anywhere else...Amy
  8. by   MishlB
    Quote from AmyRN1227
    Hi all,
    Well at my one place they just posted something stating that since they are so short on PCTs that the RNs will be responsible for doing their first set of vitals. This, I feel is insane. Especially since at around the time the first vitals are being done by the PCTs, we are doing assessments, passing meds, and like the other nite I was giving prep for a bowel procedure. And I don't mind helping out, as it was stated on the memo "We will all be expected to accommodate the needs of the unit" but when I see PCTs standing around doing nothing and I'm also doing their vitals it really angers me. I feel like they just keep dumping more and more things on us and they wonder why we have so many lawsuits...
    :uhoh21: :uhoh21:
    Just wondering if this is a requirement anywhere else...Amy
    Are you a nurse? It angers you to do vitals when you see PCA's standing around? This patient is YOUR responsibility, not the PCA. You have the license, and this is part of your job. Doing vitals is not "helping out", it is DOING YOUR JOB!
  9. by   JWaldron
    Quote from MishlB
    Are you a nurse? It angers you to do vitals when you see PCA's standing around? This patient is YOUR responsibility, not the PCA. You have the license, and this is part of your job. Doing vitals is not "helping out", it is DOING YOUR JOB!
    Delegation is an appropriate and legal part of a nurse's job too. Assigning a task such as vital signs to someone who has been competencied to do them is not shirking a responsibility - it may be making the wisest use of time and skills. A properly trained aide can certainly do vitals and report them to me, but he/she cannot give meds, mix meds, call the MD, get or implement orders, chart... all of those things are also DOING YOUR JOB. It depends a great deal on how much one has to do. ONE SHIFT in my entire nusring career have I had only 4 patients. Otherwise I have had 8 or more. I don't consider it dereliction of duty to have a good aide do my vitals. There are aides I wouldn't dream of trusting to do them, and I resent that because that IS their job - to be helping me to care for the patients. We are supposed to be a team! I work with some wonderful aides, and I work with some who make it like working aolone. I cringe when I see their name next to mine on the assignment sheet. I either do their job as well as mine, or spend an emormous amount of time hunting them down, and usually find them ina confernece room on the phone w/ a boyfriend or someone else, or so helo me G-d, w/ feet up, watching TV.

    How often do you see an aide staying overtime to fininsh paperwork or patient care. Pretty rare. How often do you seen an LPN staying late? In my hospital, at least, almost the only time I see this is when one is mandated. How often do I see the RNs staying overtime to finish their work? Nearly every evening (I work evenings). I have worked w/ one or two who have stayed to help me w/ what paperwork they could, for me to co-sigh. I don't see it as much days, because they are staffed much heavier. Don't tell me this is because all those RN's are lazy and fat-assed! It irks me to hear (read) people judging others, and implying that it is irresponsible to have someone else do your vitals for you. It may take 'only 2 or 3 minutes" and 'what's 2 0r 3 minutes' to do vitals on each patient', but on 16 patients, 3x16=48 in my book. Maybe I'd like to go to the bathroom at least once a week. Maybe I'd like to eat occassionally (my aids always get to dinner, and so did my LPM. Not me; and that doesn't make me a martyr, either). Maybe, even better, I could spend some of that time teaching a patient about his/her glucometer, or stump shrinker, or self trach suctioning, or something they really need to know and THAT AN AIDE CAN"T DO. A capable aide CAN DO VS and report them. They can't, or shouldn't be, teaching a pateint or family about an up-coming test or procedure, or about a medication, or something else. Can you tell I'm really bothered?

    Savvy
  10. by   AmyRN1227
    Quote from JWaldron
    Delegation is an appropriate and legal part of a nurse's job too. Assigning a task such as vital signs to someone who has been competencied to do them is not shirking a responsibility - it may be making the wisest use of time and skills. A properly trained aide can certainly do vitals and report them to me, but he/she cannot give meds, mix meds, call the MD, get or implement orders, chart... all of those things are also DOING YOUR JOB. It depends a great deal on how much one has to do. ONE SHIFT in my entire nusring career have I had only 4 patients. Otherwise I have had 8 or more. I don't consider it dereliction of duty to have a good aide do my vitals. There are aides I wouldn't dream of trusting to do them, and I resent that because that IS their job - to be helping me to care for the patients. We are supposed to be a team! I work with some wonderful aides, and I work with some who make it like working aolone. I cringe when I see their name next to mine on the assignment sheet. I either do their job as well as mine, or spend an emormous amount of time hunting them down, and usually find them ina confernece room on the phone w/ a boyfriend or someone else, or so helo me G-d, w/ feet up, watching TV.

    How often do you see an aide staying overtime to fininsh paperwork or patient care. Pretty rare. How often do you seen an LPN staying late? In my hospital, at least, almost the only time I see this is when one is mandated. How often do I see the RNs staying overtime to finish their work? Nearly every evening (I work evenings). I have worked w/ one or two who have stayed to help me w/ what paperwork they could, for me to co-sigh. I don't see it as much days, because they are staffed much heavier. Don't tell me this is because all those RN's are lazy and fat-assed! It irks me to hear (read) people judging others, and implying that it is irresponsible to have someone else do your vitals for you. It may take 'only 2 or 3 minutes" and 'what's 2 0r 3 minutes' to do vitals on each patient', but on 16 patients, 3x16=48 in my book. Maybe I'd like to go to the bathroom at least once a week. Maybe I'd like to eat occassionally (my aids always get to dinner, and so did my LPM. Not me; and that doesn't make me a martyr, either). Maybe, even better, I could spend some of that time teaching a patient about his/her glucometer, or stump shrinker, or self trach suctioning, or something they really need to know and THAT AN AIDE CAN"T DO. A capable aide CAN DO VS and report them. They can't, or shouldn't be, teaching a pateint or family about an up-coming test or procedure, or about a medication, or something else. Can you tell I'm really bothered?

    Savvy
    You couldn't have said it better Saavy!!!
  11. by   Marie_LPN, RN
    Quote from JWaldron
    How often do you see an aide staying overtime to fininsh paperwork or patient care. Pretty rare. How often do you seen an LPN staying late? In my hospital, at least, almost the only time I see this is when one is mandated.
    (Raises hand, since scheduled to leave @ 0700 this morning, got out around 0915. AS USUAL)

    (And the LPNs will stay JUST as late as the RNs )
  12. by   mattsmom81
    Quote from MishlB
    Are you a nurse? It angers you to do vitals when you see PCA's standing around? This patient is YOUR responsibility, not the PCA. You have the license, and this is part of your job. Doing vitals is not "helping out", it is DOING YOUR JOB!
    Yes doing vital signs IS part of a nurses' job, it is part of an aides' job too.

    It would irk ME to be running around doing things an aide could do too...IF I am going 100 mph and the aide is hanging/hiding out. I would be delegating bigtime in this situation...and talking to my manager to rework the job description and job expectations for aides.
  13. by   plumrn
    Very well said, savvy. It irks me no end to see anyone standing around, when one of their co-workers is running around non-stop, be it nurse, aide, or secretary.

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