What happen to taking Vital Signs???

Jolie, BSN · Aug 23, 2005

I think this is a result of our over-reliance on technology in virtually every aspect of healthcare. Why should a physician actually examine a patient when he can order a bunch of tests instead? Why should a nurse hold and cuddle a preemie during a feeding when she can simply put it on a pump? Why should a nurse's assistant take a hands-on set of vitals when some machine can do it for her?

One answer is time, although this clearly doesn't apply here. Another is loss of skills, which may be the real problem.

ckh23, BSN, RN · Aug 23, 2005

I agree with the above poster. I would also verify that the techs know how to take a manual BP, you may be shocked by the answer. They may be so spoiled with using the machine that they may not remember or have trouble using the manual cuff.

sunnyjohn · Aug 23, 2005

I agree with the above poster. I would also verify that the techs know how to take a manual BP, you may be shocked by the answer. They may be so spoiled with using the machine that they may not remember or have trouble using the manual cuff.

They may well have forgotten or don't know how to take a manual bp.

A skills refresher and check-off may be in order.

sbic56, BSN, RN · Aug 23, 2005

I agree with the above poster. I would also verify that the techs know how to take a manual BP, you may be shocked by the answer. They may be so spoiled with using the machine that they may not remember or have trouble using the manual cuff.

Yup. Could be they haven't taken a manual B/P since they were originally taught. It seems like a no brainer, but taking a manual B/P is a skill that isn't perfected until it is done many times. Lots of people can't hear one on an obese patient, for example...or what about one with severe contractures? I think it's a skill deficit more than anything and it is getting more prevalent all the time.

pink2blue1 · Aug 23, 2005

At my hospital we have both kinds of machines. I am the CNA so when I am taking vitals on 29 patients (As is the case most days) I use the dynamap. If I have isolation patients I do manual. If I cannot get a pressure on a patient, or if the reading is way high or low, I immediately do manual and report BOTH to the RN immediately. I think at my hospital the reason for using the machine is mostly because of time and it has everything on it, pulse ox, thermometer and BP so it's much faster. I do know how to take manual BP's though and do so every shift with at least a handful of patients.

DusktilDawn · Aug 23, 2005

Same problem where dynamaps are concerned. None of our CNAs carry stethoscopes, if the machine gives a reading that doesn't correlate with a patient's previous readings they don't recheck. Heaven forbid you ask for a manual. Frankly I'd rather recheck manually myself, it's just easier. I agree manual readings are becoming a lost art. :angryfire

elthia · Aug 23, 2005

At my hospital we have both kinds of machines. I am the CNA so when I am taking vitals on 29 patients (As is the case most days) I use the dynamap. If I have isolation patients I do manual. If I cannot get a pressure on a patient, or if the reading is way high or low, I immediately do manual and report BOTH to the RN immediately. I think at my hospital the reason for using the machine is mostly because of time and it has everything on it, pulse ox, thermometer and BP so it's much faster. I do know how to take manual BP's though and do so every shift with at least a handful of patients.

You are definitely the kind of CNA I love to work with. It drives me crazy when I'm given a truly off the wall BP reading on a patient and have to gently ask for a manual BP because it's policy to have a manual before I notify the MD that the BP is outside of parameters. (It happens at least three times a week).

caroladybelle, BSN, RN · Aug 23, 2005

Yup. Could be they haven't taken a manual B/P since they were originally taught. It seems like a no brainer, but taking a manual B/P is a skill that isn't perfected until it is done many times. Lots of people can't hear one on an obese patient, for example...or what about one with severe contractures? I think it's a skill deficit more than anything and it is getting more prevalent all the time.

Many of the techs are RN students. I personally can't imagine an RN instructor that allows all dynamap use....ours made us do manuals.

It is one thing to need a dynamap on BPs on the legs or for obese patients..quite another to argue over the dynamaps or neglect VS waiting for one, IMHO

jnette, ASN, EMT-I · Aug 23, 2005

They may well have forgotten or don't know how to take a manual bp.
A skills refresher and check-off may be in order.

Couldn't agree more !

It IS rather disconcerting.......... :uhoh21: as WELL as frustrating to the nurses as Caroline states above.

allnurses Guide · Aug 23, 2005

I think it is because using a machine is faster ...

Our CNA's do carry stethoscopes and will take a bp manually that is hard to get or the numbers don't add up. They do know how to take vitals.

Also, at the beginning of the shift, the CNA and I go in to do vitals and assessment so we don't wake the patients up twice (this is 4 a.m.). So if the CNA is troubled by the machine's reading she tells me and I re-take it manually. When I work in the ER, we re-take manually any bp we are uncomfortable with. All the EMT's know how to do bp's.

So for me, it isn't that they don't know how . .. it is just that the dynamap is quicker.

steph

Jo Dirt · Aug 23, 2005

I don't even know what a dynamap is.