Funny - Tech Broken, Use "Old School" Sphygmomanometer

Nursing Students CNA/MA

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I passed my state CNA exam a month ago. Taking blood pressure is no longer part of the required skills for CT CNAs, to my surprise. Third graders are still taught long multuplication using pencil and paper before being allowed to use a calculator in 7th grade pre-algebra.

I was given a list of residents (LTCF) to get vitals, so I got the "nurse-on-a-pole" (the rolling vitals machine), and went to the resident on the top of my list. The cuff wouldn't inflate. I told the nurse, and she said to use hers, and handed me a sphygmomanometer. I was impressed she was even able to pronounce it; I said, "oooohhhhh, you mean the manual blood pressure cuff thingy. What do you want me to do with this?" The nurse ended up taking the vitals.

My CNA course took about 10 minutes on the manual blood pressure cuff thingy - I practiced it in class twice; that was 2 months ago.

Any CNAs know how to use the manual blood pressure cuff thingy?

Is knowing how to use it part of your state's exam?

I live in CT (hence CT Pixie :)

I didn't know manual BP's were not required on the State Exam.

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Specializes in Pediatric Home Care, Dr Office/Clinic.

Here in California for our state test you have to be able to use a blood pressure cuff. 99% of facilities & hospitals use the electric ones though but I actually like being required to know how to use the "old school" one because sometimes electric ones fail, then what are you going to do?

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Hmmm working in Home Care I don't get the fancy machines. So yes indeed I have to know how to take a blood pressure using the tried and true. Our state had only taken blood pressure off the states test about 3 years ago. BUT that did not mean that we did not have to learn how to do it in class. I always feel it is a hard thing to learn to do it accurately, especially if you are not doing it on a regular bases. You never know when you will have to do it manually so for your and your patients best intrest it is a great thing to get use to doing

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Specializes in Geriatrics, Dialysis.

Just about every nurse I work with takes manual BP's instead of using the rolling nurse...she even has a name which escapes me at the moment. The machine we have tends to read high, I can take a BP with that and get a 150/80 reading and immediately check it again manually and get 130/60 ...I trust my own ears way more than a machine.

But every time I've been to a doctors office I have never seen a nurse take a manual BP, so I guess it may depend on where you work as well.

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Specializes in hospice.

Arizona requires it and it's the number one reason people fail the state exam. I can't imagine not teaching people whose jobs include regularly taking vitals signs not to do manual BP. Sometimes Nurse Nancy (the vitals machine....don't want anyone going off on me) is being a cranky little witch and you've gotta get that BP anyway.

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Specializes in hospice.
Anyway, if an RN tells the doc "Mr. G had a pressure of 78/40" the doc will almost always come back with "was that a manual BP?" Yes, the machines have to be calibrated regularly, but they are not always correct

Yep. My own personal health history includes nearly being classified as pre-hypertensive based on an auto BP. When re-done manually it was within normal range. This incident did serve as my weight loss wake up call, but still, my BP did not qualify as pre-hypertensive when read correctly.

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Yep Those machines a lot of times messures on the high side. I once was going through a procedure which I was not feeling good. The nurse took my BP with those automatic cuffs and it was 90 for my systolic. Low but not totally unnormal for me I usually run 20s to teens, sometimes low 100s. But when she took it manually it was 85 systolic. Big differance really and more of a clearer picture of why I felt as crappy as I did. 5 points can make a huge differance when you are dealing with low and high blood pressures.

When I started not to feel good, she thought maybe your blood pressure is droping. I said I need to lie down, and she said are you going to faint on me. I said I have never fainted in my life but there can be a first time.

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Prometric is the CNA testing provider for the states of Alabama, Arkansas, Connecticut, Delaware, Florida, Hawaii, Idaho, Michigan, Nevada, New Mexico, New York, Oklahoma:

www.prometric.com/en-us/clients/Nurseaide/Pages/select-state.aspx

The Clinical Skills Checklist is identical for all 12 states listed above:

https://www.prometric.com/en-us/clients/nurseaide/documents/NAClinicalSkillsChecklist.pdf

To quote from Prometric's Clinical Skills Checklist:

"Measure and record the resident’s blood pressure...THIS SKILL IS ONLY TESTED IN NEVADA."

I don't know about the other states, but for the 12 states listed above, only Nevada requires taking blood pressure (manually) as a CNA skill.

For the record, I think taking BP manually should be required for all CNAs everywhere.

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Specializes in hospice.

Never mind, Arizona wasn't one of the mentioned states. Deleted.

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To make it clear prometric is only stating that BP will not be on the skills states test, BUT I don't think that prometric is stating or promoting that knowing how to take a BP is unimportant and should not be learned in class. The reason it is not a skills test anymore is that really it is not a very concrete thing to test people on and I think that some people were passing and others failing and it was all hinged totally on what the the person testing the student was hearing and deciding on their own to pass or fail a student. You can always have two people taking a BP and get different numbers. I think they also had a hard time as to where that differance could be at to pass someone or fail them. The student could get a BP of 125/65 The tester could get 129/68. Would that be a pass or fail? It's too hard for a concrete judgement call so they decided to just take it out.

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Nothing aggravated me more when I worked in LTC than the CNAs who whined about having to get vitals and having to do them manually. I usually just told them to let me do it if it was a mandatory manual BP because I could do it in half the time they wasted complaining. Little do some of them know that once they get into hospitals, it's going to be essential. I get that they think it's hard and more convenient to use the machine but the first time they screw up not following an order, I don't want to be in the room when the provider blows a gasket.

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I just wanted to mention a couple of things that I don't think have been thrown in yet. Some people have little dinky arms and some people have great big arms--they won't measure well on "Nurse Nancy," even with the special cuffs. People who have very low BPs and very high BPs won't measure right. However, the night when you have to do 40 sets of vitals (which I have), you'll be thanking God for Nurse Nancy because after you pump up that cuff about 20 times, your fingers will never want to straighten out again ;p

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