Hey, CNAs.......got a question for all of you!

allnurses Guide · Sep 15, 2006

My daughter is taking a CNA course through her ROP program. This week they're learning how to take VS, and she said the instructor told them they do NOT need to get stethoscopes. I told her to ask what they're expected to do if the machine does not register a BP for a pt......when I was an aide (back in the dinosaur days!) we were expected to then take it manually. For that I needed a scope. Is this not taught anymore? Her 17th birthday is next week and we were going to get her a scope of her own.

Tazzi - I think your first post (above) was confusing, which is why people are responding to "Is this not taught anymore?".

However, you are right - since that post you HAVE cleared up the issue more than once.

Waving madly back . . . .

steph

TazziRN, RN · Sep 15, 2006

Hi Steph!!

What I meant was, is it no longer taught to double check with a manual if the machine will not read. Sorry about the confusion.

fgoff · Sep 15, 2006

Sorry for the misinterpertation. A light weight scope is a great gift of a NA & it can be engraved to help keep up with it.

I wish your dd the best of luck in her class!

Balder_LPN, LPN · Sep 15, 2006

I teach a CNA course at a local community college and I do not encourage my students to get their own stethoscopes. I do teach them how to take a BP manually and they are tested on that, but I don't feel it is necessary for them to have their own. All places that I have ever worked have plenty of stethoscopes avaliable. Since the amount of time in an 8 hour day spent taking VS is so minimal, when most CNA's are done with VS for the shift, they put away the equipment. If she has her own, she might put it down and then never see it again, someone may pick it up thinking it belongs to the facility. In my opinion, buy her some scrubs for her birthday. When she gets a job, she will know if she needs one and then you can buy her one for Christmas. Good Luck to your daughter!

Thats how they do it here in our course. The state may test an NAC on this at thier state board exam.

godsgift2 · Sep 15, 2006

at the hospital i work at before we started on the floor we had to prove we new how to do manual blood pressures we also have the automatic blood pressure machines and i find them to be inaccurate at times giving false readings so i always do a manual bp some aides dont recheck and this causes some patients to receive or to not receive their bloodpressure medicines some drop and sky rocket so i myself think all people should learn to do manual bp

km5v6r, EdD, RN · Sep 16, 2006

Now that we have throughly hashed out the "should manuel b/p be taught" issue; they should; and the "does a CNA need their own scope" issue will be debated for several more pages I wish to introduce another aspect of this discussion. Several people have mentioned rechecking a questional automatic b/p with a manuel pressure. I just have one question. How? My very large teaching facility has done away with the manual cuffs. It seems the cuffs were the mercury type and removed. Personally, I rather enjoyed chasing mercury balls when someone ran the bed into the wall mount and broke the thing. I have seen instances of people refusing to believe the b/p the machine was getting so they go and get another machine, and another machine and another. Meanwhile the pt is nearly coding. Excuse me, if the machine can't pick up a b/p and the pt is pale, diaphoretic, tachy and looks like #$%^ maybe it's because they don't have a b/p. A manual cuff and a quick check would settle the issue quickly. I remember during 1999 a new nurse (well new then) talking of how she wasn't working on New Year's Eve in case of the big Y2K thing and all the hospital equipment failing. I got thinking that in a crisis a very through assesment can be done without electrial monitoring if needed. Manual b/p, listening to an apical, listening for irregularities, comparing the apical heart sound to the radial pulse, determining the CVP with a manual manometer, having a fairly good idea of oxygenation based on skin or mucus membrane color, calculating IV rates by counting gtts and piece of tape on the bag etc. It wouldn't be easy but sometimes it seems we don't see the pt for the machinary surrounding the pt. I have also seen to many times of treating monitor not the pt. Anyway does your facility still have manual b/p cuffs, thermometers etc and do you know where to find them?

lovingtheunloved, ASN, RN · Sep 16, 2006

Being an aid in an LTC facility is very hard work. She should make it her goal to get into a hospital ASAP the work is easier and the pay is usually quite a bit more! Cheers.

????? Maybe it's my exhaustion from working a 12 hour shift in LTC talking, but I'm somewhat offended by that. It IS very hard work. And I love it. It ain't for everyone, but hospital work isn't necessarily better.

TazziRN, RN · Sep 16, 2006

????? Maybe it's my exhaustion from working a 12 hour shift in LTC talking, but I'm somewhat offended by that. It IS very hard work. And I love it. It ain't for everyone, but hospital work isn't necessarily better.

I knew someone would be offended by that comment. I was hoping it would be ignored. You're right, hospital work isn't necessarily easier. My daughter will eventually end up in an acute care facility because she wants to be an ER nurse, but she knows she will have to put in her time at an LTC. I hope I have taught her how to treat our eldery citizens with respect, and I think she will do well at an LTC. I admire those who can work LTC, because it's got its own degree of difficulty and it's something that I would not enjoy doing.

lovingtheunloved, ASN, RN · Sep 16, 2006

I knew someone would be offended by that comment. I was hoping it would be ignored. You're right, hospital work isn't necessarily easier. My daughter will eventually end up in an acute care facility because she wants to be an ER nurse, but she knows she will have to put in her time at an LTC. I hope I have taught her how to treat our eldery citizens with respect, and I think she will do well at an LTC. I admire those who can work LTC, because it's got its own degree of difficulty and it's something that I would not enjoy doing.

Eh, my panties aren't in too bad of a bunch.:wink2:

chadash · Sep 16, 2006

In LTC, I always used manual sphygmonometer (sp?) and stephoscope. We did not have the dynamaps. Some of the girls had a real problem hearing the BP, and would literally guess. For these folks, the automatic ones are probably best, with a check from the nurse if there is a question.

If it were my daughter, I would buy her a cuff and stephoscope and teach her myself. I still think it is more accurate.

mmom51 · Sep 20, 2006

It is a new experience , it is a valuable skill, there is absolutely no harm in learning how to take a manual b/p. While she is at it tell her what it means for example the importance of knowing what diastolic and systolic actually mean, how high is high .. how low is low. the usual tacit knowledge. What if she gets stuck in an emergency situation where there is no power... it happens..... Buy her one, they are not that expensive.

Regards

mmom51

vampiregirl, BSN, RN · Sep 20, 2006

My daughter will eventually end up in an acute care facility because she wants to be an ER nurse, but she knows she will have to put in her time at an LTC.

I work as a CNA in a LTC that has an acute care unit- mostly geriatric patients in for rehab. So it's the best of both worlds, experience with geriatrics and experience with (mostly stable) acute care cases. I've also cared for hospice patients on that unit, another unique experience. Also we have had an occasional isolation precautions patient. If there are any facilities like this near where you folks live, this might be something worth pursuing. I know the nurses I work with love it when they have a CNA who is interested in pursuing a career in nursing. It's a great opportunity to learn. It is by no means easy to work on this type of unit- high patient turnover, patients who are usually used to living on their own, etc.