Failed PULSE!!

Try tapping your fingers with each beat and count the number of taps. Technically if they have an irregular heart beat you can come up with different HR's, that's why the are irregular.

Practice. Friends, roommates, classmates, boyfriend, parents. Anyone that is willing to give you 1 minute of their time. We used to joke in school that it wasn't just us going through nursing school- our family and friends were going through it too. :) You can also practice the different pulses- PT, DP, radial, brachial, etc. Doing it a few times will help you get used to counting at different rates. Careful though about bugging your family/friends too much- you have a long way to go still and you don't want to burn them out yet, haha:roll

Hang in there, you can do it. People can mess up things here and there and still make it through. I remember I bombed my first foley check off, and at the time it felt like the end of the world. Stay positive, and good luck on your second try.

Try listening to the apical pulse with your stethescope while feeling the radial other peripheral pulse. Most of the time they match up. It can help you get the "feel of things " when are hearing them. Somethimes the rhythm is so irregular that some beats are not strong enough to produce a peripheral pulse, therefore the peripheral pulse is different than the apical pulse. In that instance, the apical pulse should be documented. This seems to happen often with dynamaps in patients with very irregular afib. The dynamap will only read a portion of the heartbeats, falsely lowering the actual heart rate.

McGyverRN & ArmyKitten

Gave you some excellent advice, I agree 100%.

ONe more thing, don't beat yourself up over it. It happens, and for your test subject to have an irregular pulse, didn't help. Regradless, it happens. In fact the other day (i'm a senior by the way ready to graduate), I had to take a newborns RR, I haven't done that in over 8mo, and even back then I don't think I was that good at it. That kid was breathing so fast, I just couldn't get it. I felt like a complete idot. I stared at her chest for over 5min. I placed my hand over her belly to feel it, whiped out a stethoscope, and still fumbled over getting a number, I actually had to get the nurse. Of course I was hoping it wasn't me, like maybe the nurse would have a problem, or that perhaps the kid, was breathing abnormally fast....nope....just me, couldn't get it. So just practice, and know that skills will come.

Thank you so much for help--I feel better about it and yes, I'll be practicing on everyone that'll let me....lol.

If I have the problem in the future, would I listen to the apical and count from that? Would that be permissible? Do experienced nurses need to do that sometimes?

Thanks for your help!

Yes, the apical pulse is the actual heart rate. I often use the apical pulse when documenting heart rate.

Thank you so much for help--I feel better about it and yes, I'll be practicing on everyone that'll let me....lol.

If I have the problem in the future, would I listen to the apical and count from that? Would that be permissible? Do experienced nurses need to do that sometimes?

Thanks for your help!

Shh... secret... I always do that! Mostly in peds but even in adults. I've got my stethoscope there anyway and listening to the apical gives me extra time to really hone into the heart rhythm or extra sounds. I would especially do it if the rhythm was very irregular or pulse thready. Since adults aren't my thing I do sometimes have trouble picking up a pulse on an elderly person or at least keeping it for a full minute without compressing the artery too much. So... apical for me. That's the good news, the bad news is you still have to get tested on it and after that continue to practice until you're comfortable. And you will be!