Why do some nurses guess on BP? - page 2

by Dixon, future NP 9,219 Views | 26 Comments

Hello Everyone! Why do some nurses guess when it comes to taking a blood pressure? I am a patient, I am a CNA and CNA instructor. When I go to the doctor I do not share this information but it really bothers me when I see... Read More


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    I think it may have been the attitude of the taker? But I admit, I have sometimes wondered about the office girls at some offices, as my BP always seemed to be identical to the last time I was there...

    I usually do look at the numbers while listening. It helps me confirm what i am hearing.
    theleaf and RURN2O11 like this.
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    you have to look at the gauge at the same time you listen to the korotkoff sounds, or you won't know what the pressure is when you hear the first and last sounds, so you won't know what to write down.

    in answer to the op's question, it's because they are lazy, never learned what the blood pressure truly measures and what systolic and diastolic indicate physiologically, or they just don't care.

    don't get me started on those autocuffs (dinamap and others). these must be applied properly or they can't "hear" the sounds, and they are not appropriate to use with anyone who has an irregular pulse and an irregular pulse pressure, like, oh, everyone in atrial fibrillation! i see them applied wrong all the time (including by the ma at my pcp's office) so the readings are useless for care decision-making, but nobody seems to care.
    orthonurse55, DLStango, nursel56, and 5 others like this.
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    Quote from Dixon, future NP
    I have been doing manual BP's for only 10 years, I have a lot to learn, so I just don't cut corners like I felt this Nurse did. I had no confidence in any of his skills for many reasons this just being one.
    10 years isn't enough time to be an expert at manual BPs?
  4. 0
    Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.
  5. 3
    Quote from BrandonLPN
    10 years isn't enough time to be an expert at manual BPs?
    I say that based on what I have read from the other Nurses here. I am not yet an RN.

    I am a CNA and CNA instructor doing manual BP for all of my career and I have never done a manual BP in 30 seconds or less. This is a skill I am comfortable with but I do it the way I was taught each time. I worked in ER for about 2 years as a CNA and I was constantly told work hard and fast but never cut corners!

    I have heard about too many CNA's fired for falsifying vitals, never want to be amongst those!
    Sugarcoma, Susie2310, and GrnTea like this.
  6. 0
    Quote from caliotter3
    Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.
    I did let his supervisor know but she was not a nurse so she said she didn't feel she could appropriately address the situation.
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    I have to admit, if I watched the needle stop at 115 and the MA said my BP was 120/80 (or something) I'd be pretty suspicious too. That doesn't add up. I suppose some might stop at the systolic and just make up a diastolic, but why not just listen for a few more seconds?
    theleaf likes this.
  8. 1
    Quote from grntea
    you have to look at the gauge at the same time you listen to the korotkoff sounds, or you won't know what the pressure is when you hear the first and last sounds, so you won't know what to write down.

    in answer to the op's question, it's because they are lazy, never learned what the blood pressure truly measures and what systolic and diastolic indicate physiologically, or they just don't care.

    don't get me started on those autocuffs (dinamap and others). these must be applied properly or they can't "hear" the sounds, and they are not appropriate to use with anyone who has an irregular pulse and an irregular pulse pressure, like, oh, everyone in atrial fibrillation! i see them applied wrong all the time (including by the ma at my pcp's office) so the readings are useless for care decision-making, but nobody seems to care.
    i actually just had this conversation with an anesthesiologist at my hospital last week. he was saying that manual bp cuffs have to be regularly calibrated and tested for accuracy, but this is rarely, if ever done. he believed the automated machines to be much more accurate than manual cuffs.
    theleaf likes this.
  9. 0
    Quote from caliotter3
    Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.
    Caliotter3 I agree completely, and I think this is good advice, only it is not always effective. A family member and I have tried doing just this (speaking to the doctor) in regards to a situation that arose with the taking of the family member's BP. The practical result was that our observation was received courteously and the person concerned continued to do what they were doing at future visits. So I no longer consider it is worth our time to bring the issue up again. We do however keep our own BP record, which we take to the doctor, and we make a point of discussing current readings, medication, etc., with the doctor, so if the office reading appears to be suspect we have plenty of BP trend data to show the big picture.
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    an automatic machine may be more accurate if the cuff is applied properly and if the patient doesn't have an irregular pulse quality. i'd probably trust an anesthesiologist to recognize that. probably.
    orthonurse55 likes this.


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