Best automatic bp cuff?

[babynurse73]

I have been reading this forum for a long time and have posted several times about switching from hospital to home health. So I've been in hh since mid May and its going along. Started doing OASIS on my own (although receiving lots of help) for a couple of weeks and boy what a learning curve. Not that it's hard stuff to understand, just the number of pages and vagaries of some of the questions...all while trying to do it in the home as much as you can while you have the patient asking questions, family dynamics going on around you, etc. I feel a bit stupid at times but try to fake confidence for the patient if you know what I mean, and fill in the blanks later. It takes me about 6 hours to complete an admission, this includes the visit which is about 2 hours. I don't know how Im going to manage this with a full case load! I still get boggled about med recs and doctors orders due to working in hosp environ for 15 years. For example, my bka pt's incisions are healing well. So after she sees her ortho he tells her to stop using santyl and puracol on the wound, just dsd and kerlix. She tells me this in the home and I do it, however I get stumped (no pun intended)....it's not actually a doctors order right? So, I fax the MD to see if wants to change the orders in McKesson and then dc the santyl in med rec? I don't know why this overwhelms me. Maybe because I don't have a fax machine in my bag of tricks. It seems like a lot of steps. And Coumadin and Prednisone..have to change that in med rec every week if dosage changes and fax MD.....I hope this all gets easier. I think I'm really going to like it once my speed and confidence increase. It takes a year to feel comfortable is the mantra.

Another issue is that because Im new, Im getting other NCM's pt's. I had a situation (I will try to be brief) where the daughter in law and her two sons were present. The pt was diabetic and O2 dependent. The DIL was downright nasty to the pt, to her sons and to me during the entire visit. I mean nasty. I worked inpt psych for two years and she was definitely borderline pd. I left that visit shaken...not because I couldn't handle her but because I just felt helpless trying to fumble around with the computer etc etc etc... I felt so bad for that family. So I call the NCM who never calls back. This pt has been with the agency on and off for a long time. I was thinking maybe MSW involvement at the very least. I wrote a case management note in chart with specific details of the visit but NCM never contacted me. I've never even seen her in the office. My supervisor was out doing joint visits that day and my preceptor on vaca. So I just let it go. I looked in his chart recently and he is discharging. I guess my point is, collaboration could be lacking here depending on the NCM. I feel maybe she didn't want to open a can of worms or something. That couldn't have been the only time this daughter in law behaved that way in all those visits??!! Anyway I let that one go as a learning experience. I think psychosocial stuff gets missed a lot in home care. Is this anyone else's experience?

Wow.....I originally wanted to know if anyone carries an automatic bp cuff and if so which one? Just looking for anything to make life easier!

[Libby1987]

I use a Panasonic arm cuff for my non cardiac patients.

Get a fax machine. We have a new nurse at work dragging her feet on that one, she literally drives miles out of her way all the time because of it. I on the other hand work from home.

I work in two offices now, one full of seasoned staff who provide comprehensive care, the other all new to HH and trying to get them to a point where they can perform as well.

It's really hard to learn without being surrounded by mentors, including other disciplines who will also pick up in patients' needs.

[MauraRN]

Panasonic or Omron are good. I don't use them often because most of my patients are cardiac/heart failure. Sound and quality of BP and HR are important in these patients, lots of stuff gets missed in the hospital because they use nurse on a stick or CNA's for vitals. I can often pick up impending fluid overload by the muffled BP sounds even if the numbers are still ok.

[PurpleDaisy🌸]

It's really hard to learn without being surrounded by mentors

You just summed up my work frustrations!

[melaniekrn97]

We are not permitted to use automated blood pressure monitoring devices where I work. Even PT, OT, ST and HHA are required to do manual readings.

[grateful_RN]

We do manual BP readings, really doesn't take that much more time to do.