How many nurses do their own vitals??? - page 7

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   Tweety
    Quote from nekhismom
    Tweety, I know you primarily work in ER.
    Actually, I work med-surg, currently working in Telemetry as a charge nurse. I agree 100% it has everything to do with ratios. Our ratios are high, with plenty of techs on the floor to take both vitals, and do patient care.

    I also agree 100% that vitals are part of the RN assessment. On night shift, I usually have my vitals before I go into the room, have their medications (I work tele. so many are cardiac, and it's nice to have the vitals done while I'm pulling meds), and do the head to toe assessment, and settle them back into bed.

    There's no one right answer that fits all situations. I certainly am capable of taking vitals, it doesn't take much more energy, and see the advantage in that. I also see the advantage of having techs do it (if the techs have a good patient ratio as well). My preference is to have a low RN patient ratio and I do everything. My reality is a high RN patient ratio and I need help.
  2. by   Kate RN
    I never would have thought this question would generate so much talk.

    Depending on the day and the department usually I get my own v/s. and prefer to. Occasionally there is someone assigned who has done the first set. and sometimes I even find out about it before I start taking them myself.and I prefer to get the B/P manually. I think it is faster and I know it is more comfortable for the patient. I also trust my ears more than the machine most of the time.
    I work most of the time in the ED. and day and night shifts. It is on the med/surg unit that occ my v/s are done for me. It is nice to have help. There is a printout that automatically comes with oiur machine. They stick that on the front of the chart as well as documenting them on the graphic. This does seem to work.

    K
  3. by   Marie_LPN, RN
    I never mind getting vitals, i just get peezed and cranky when i have 35 sets to do twice, and 3 ppl to help to the pot, and then have a nurse whining to me when her vitals are 10 minutes late. It doesn't happen that often, but if they really want their pt.'s vitals EXACTLY 4 hours later, chances are, they're going to have to grap the Datascope and help. Or they can go clean up their two incontinent BB pts.

    One of these days i will wear a tshirt that says "i have never been stamped with the Good Housekeeping Seal of Approval"

    I'm getting tired and worn, and it's showing big time.
  4. by   JWaldron
    Quote from 3rdShiftGuy
    Actually, I work med-surg, currently working in Telemetry as a charge nurse. I agree 100% it has everything to do with ratios. Our ratios are high, with plenty of techs on the floor to take both vitals, and do patient care.

    I also agree 100% that vitals are part of the RN assessment. On night shift, I usually have my vitals before I go into the room, have their medications (I work tele. so many are cardiac, and it's nice to have the vitals done while I'm pulling meds), and do the head to toe assessment, and settle them back into bed.

    There's no one right answer that fits all situations. I certainly am capable of taking vitals, it doesn't take much more energy, and see the advantage in that. I also see the advantage of having techs do it (if the techs have a good patient ratio as well). My preference is to have a low RN patient ratio and I do everything. My reality is a high RN patient ratio and I need help.

    Your third paragraph covers it pretty well. Of course I can do my own vitals, and more often than not, I do. But a lot of times it would have been a really big help to have the NA do them, when I have a lot of patients, or patients w/ very high medical needs. It's a matter of balancing what needs to be done with who can best do it at the moment. What is best for the patient, what is w/in the scope of practice and w/in the facility's policy, and makes the most sense. NOT "I'm the boss and I can make you do it" - that's wrong, and it's going to stir up resentment as well. This is teamwork, or it should be. Adversarial relationships make it so much harder! So do poor staffing ratios, but they are a fact of life just about everywhere!

    Savvy One
  5. by   MandyInMS
    Quote from 3rdShiftGuy
    There's no one right answer that fits all situations. I certainly am capable of taking vitals, it doesn't take much more energy, and see the advantage in that. I also see the advantage of having techs do it (if the techs have a good patient ratio as well). My preference is to have a low RN patient ratio and I do everything. My reality is a high RN patient ratio and I need help.
    Dittoooo
  6. by   The Bear
    Quote from nekhismom
    I think pt. ratio does have a LOT to do with it. But I don't think it's ALWAYS unreasonable to do your own vitals. I mean, if you use a dynamap, you can have them in like 30 sec-1 min, and you can be assessing other things while the machine runs. Now sometimes, we ALL know that things are so hectic and we just don't have time. I think it's OK to ask a CNA/tech to get vitals, but it's just being safe if you check the vitals yourself once.

    Tweety, I know you primarily work in ER. What I have seen many nurses in my hospital do is this. The tech does the first set, and any other routines. The nurse does any follow up if needed, and VS upon discharge. That way, nobody is pushed to their limits. IT works well.

    I don't think there is any one correct answer to cover everything. In my dept, it would be silly for me to call a tech just to read a monitor and do a temp. I can easily do that myself, and I would rather do a count of AP and RR myself than read the monitor. BUt that's just me. I think if we have techs available, then you should use their help within reason. Nurses should use their professional judgement to determine if techs do the vs or if the nurse will do them.
    When someone else does your vital signs, you still need to check them. A Tech can not assess them . If not carefull, you might forget to check the vital sign sheet, and miss a significant change. This has happen to me! I would rather do them myself, then I could act on them right then, not two hours latter, when I am checking the v/s sheets. Perhaps if staffing was better, this would not be a question for us.
    OH! I think I just had a day dream!, I was discussing a safe pt:nurse ratio, sorry about that!!! I wish there was a easy answer for all of us.
  7. by   mattsmom81
    Quote from LPN2Be2004
    I never mind getting vitals, i just get peezed and cranky when i have 35 sets to do twice, and 3 ppl to help to the pot, and then have a nurse whining to me when her vitals are 10 minutes late. It doesn't happen that often, but if they really want their pt.'s vitals EXACTLY 4 hours later, chances are, they're going to have to grap the Datascope and help. Or they can go clean up their two incontinent BB pts.

    One of these days i will wear a tshirt that says "i have never been stamped with the Good Housekeeping Seal of Approval"

    I'm getting tired and worn, and it's showing big time.
    Hugs to you...you sound like a good person who is being used up and spit out...like so many of our good assistants do. Try suggesting a CNA practice committee and rewriting the job description with your nurses. Educating the nurses on the problems with their expectations should help.

    What you describe has been a big problem on my PCU. I would rather my CNA answer lights, assist with care rather than get bogged down by timed tasks like BSG's and vitals.

    Too many nurses expect the CNA to 'do it all' and it just ain't reasonable.

    Hang in there and keep communicating. They may eventually get it.

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