Re: Littmann 3000 = 2 questions Originally Posted by ermen 
As far as I can tell from my experience as a med student in Hong Kong, our nurses don't use stethoscopes at all so I was curious why they would want to buy one. The closest tasks they perform that require one is blood pressure taking, though in all of our hospitals they are now automated with electronic ones. I understand that the electronic sphygs could be inaccurate so it seems reasonable for a nurse to have a steth to use the mercury sphygs, but a $5 toy one would do the trick.
Please do not misunderstand my question - I was not insinuating what you referred to as a 'subtext' - but as a doctor-to-be in possession of a humble litmann classic ii these posts make me wonder how deeply american/uk nurses get involved in making diagnoses. In our system if a GP catches a murmur he'd refer him to the cardiologist who'd probably confirm his findings with his better steth (maybe a cardiology iii but certainly not an electronic one - they get laughed at using one) and diagnose with an echo. Lung, bowel and liver sounds are audible with a basic model like mine.
If you use a steth as a tendon hammer the electronic models wouldn't be your cup of tea as they probably break easily. And I hope you don't wear it when you assess reflexes...
I am not aware of the scope of practice for nurses in Hong Kong, but in the U.S. we are taught auscultation in nursing school as part of the basic physical exam. It is considered standard to auscultate heart including gallops/murmurs/rubs, lungs, and bowels for nurses in acute care settings.
In my ICU you'll see nurses auscultating for carotid bruits on certain patients. I was even taught how to grade murmurs, though, in reality, this is rarely done by nurses. If a murmur was heard that was not previously known to the patient, it is expected the nurse would document its presence and notify the appropriate physician/practitioner, who then may order further diagnostic tests such as an echo.
I apologize for reading into your question. There are many people-- even within the medical profession-- that do not understand the role or scope of nursing.
I don't have an electronic scope-- I honestly forget the model of mine. It was given as a gift and it works for my purposes.
edit: Looking at litmann's catalog, I think it's a Master Cardiology.
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