Asked to use machine for vital recheck?

[HCpednurse]

I just started to work at a pediatric office. At my practice we usually take pulse rate with a pulse ox machine. I did intake on a school age patient whose pulse rate was high. I checked twice, it was still high so I put that in my assessment. The doctor goes in to see the patient and of course comes out and asks that the pulse be rechecked. So I go in this time and do an apical pulse, to ensure accuracy. In walks the doctor in the middle of my pulse check, so when I’m done I tell her the pulse is still high. She then asks me to use the pulse machine. This is what I’m confused about, if the vital is abnormal on the machine, it should be done manually right? Why ask me to check again with a machine? I felt like she didn’t trust my apical pulse reading (maybe because I’m new at this practice). Do any of you new nurses or new nurses at a new jobs feel like the providers don’t trust you as much as the ones who’ve worked there for a long time?

[JKL33]

Maybe she didn't trust your reading. Maybe she wanted to check her machine. Maybe she wanted to observe your use of the machine. Who knows.

It isn't terribly unusual that it takes a little time for coworkers to know what to expect from each other. I wouldn't make too much of it.

So when you got the machine and rechecked it, then what happened? This is too much suspense for a Saturday morning....?

[HCpednurse]

I got the same high pulse reading with the machine again as I did taking it manually. And then she started talking to the patient’s mom about the pulse reading and left me alone. I can’t believe she made me leave the room to grab a machine just because she didn’t trust my assessment ??‍♀️ These doctors man...

Question: what should I do if she keeps making me recheck assessments I took that she thinks are inaccurate? Should I address it with her?

[CalicoKitty, BSN, MSN, RN]

The finger pulseox things can often be wrong. I find that they may double pulses. Apical is the right thing to check. Maybe she was just trying to wait a few minutes to see if the pulse would come down before getting concerned. Maybe her machine does the beep beep beep thing for pulse which. Just because she prefers an instrument doesn't mean she doesn't trust your assessment.

[GrumpyRN, NP]

She should have checked the pulse manually herself to get an idea of the "feel" of it.

[caliotter3]

2 minutes ago, GrumpyRN said:

She should have checked the pulse manually herself to get an idea of the "feel" of it.

I can't think of a doctor who wouldn't then check it her/himself.  For that matter, any other person.  Like Grumpy said, you want to get the "feel" of it.

[JKL33]

2 hours ago, HCpednurse said:

Question: what should I do if she keeps making me recheck assessments I took that she thinks are inaccurate? Should I address it with her?

I would, but only in a friendly/humorous casual way, not in some goofy, overly-emotional you-need-to-respect-me kind of way (cause that is just too annoying and belabored and...massively annoying).

I've had a few scenarios similar to what you describe and they've ended with the doctor saying, "You were right..." and that's when I chuckle and say something like, "Oh, good...I was pretty sure I knew how to check someone's pulse, [ha ha ha]...."

2 hours ago, HCpednurse said:

These doctors man...

Also, if you don't want doctors to have an "ugh, these nurses..." attitude, make sure you don't have an "ugh, these doctors" attitude.  People are just people; there is no (reasonable) cosmic battle between our two professions.  You're new to her, she's new to you. I trust she learned a little bit more about your assessment skills as a result of this incident. ??

[HCpednurse]

Sounds like you’re right. I need to check the attitude. But after being put down as nurse, especially when I first started working, I’ve developed a way to not internalize the criticism, to not blame myself. I shouldn’t reflect it on others though. Thanks