Published Jan 26, 2010
supernurse1230
25 Posts
when i give my vital sign list to my cnas, sometimes they come back way to fast with them, for the amount that they had to do, and they hand over results like, 171/53, 95.0, 27, 110, (thats just a combination of some of the results i've been givin) and even if they made em up, why would you make up abnormal vs? and i have found that alot of cnas really dont kno how to do vs, where i live, the course is generally 2 weeks, and only a small portion of that is spent on learning how to do them, then they are sent to hosp and nh, and can barely take a bp, unless they have an electronic bp cuff! uhh hello? but aside from pt care, is obtaining vs not a major part of being a cna? especially in a nursing home, my cnas usually have about 10-15 to get on average, and most dont seem to recognize when they are abnormal, why is this area not hit harder during their course? but more time is spent on learning abbrev they really wont use, and how to give a shower (not that thats not important), but i mean come on
MsLVN-BSN2009
10 Posts
That's crazy. Do you work in a hospital or long-term care facility? Either way they should be required to do a skills check-off during their orientations. May this could be addressed with the management so that someone could do an in-service about taking correct vital signs. :)
kathy313
123 Posts
I found out that even if you teach someone the right way, doesn't mean it's really gonna get done. I used to work with one aide who simply moved the dynamap up and down the hall with her, looked like she was using it....
I started taking my own vitals, depending on who I was working with.
caliotter3
38,333 Posts
The wrong person observed a CNA go into a room and come out again, without a bp cuff, or other equipment, then write down the "VS". Terminated on the spot. This incident was described to me by one of the CNAs. It must have made an impact at the time, to be talked about years later. Taking VS is one of the most important functions of CNAs. I always made certain that the CNAs knew this. Spot checking, clandestine observing, taking action when poor results are presented, like with any other job parameter, will get the practice of writing down meaningless numbers to stop.
Another tactic is to learn the average values for a resident, then always "get" a value near that and write it on the paper. This is harder to catch, as it is quite possible that the value is very near accurate. The facility can obtain a dual-headed steth for use in teaching and spot checking CNAs. Some might call this wasting time, but it shows the CNAs that the nurse cares about seeing that they know how to do their job and that it gets done the right way.
Ruthiegal
280 Posts
I worked LTC a long time, one night we had an agency CNA on board, she came back and wrote down vitals, when I looked at them they didn't jive either, so I asked her did she actually take them.... she admitted she did not but not because she didn't want to. She couldn't find a stethoscope and was embarrassed to ask. I gave her one, and told her never to be to shy or embarrassed to ask for needed equipment. She came back with VS that were much more in line with normal for her residents. She was afraid to ask although I'm still not sure why....
rotteluvr31, ADN, RN
208 Posts
The LTC I previously worked at did not allow CNA's to take vitals. Most of the CNA's were glad not to do it as they all ready had a heavy enough load. On NOC shift there were a few CNA's that were very reliable and could be trusted to provide accurate, but for the most part I never asked the aides to do this part of the job.
mondkmondk
336 Posts
My CNA's are busy. I always take all my own vitals because I have to do the assessments anyway. What better way to assess a resident then to get their vitals first anyway? Plus, I only do apical pulses...I like to hear the heart beat, esp. in those with histories of cardiac problems. If you don't trust your CNA's to do them correctly, why don't you just do them yourself?
Blessings, Michelle
SuesquatchRN, BSN, RN
10,263 Posts
The vitals you listed all sound WNL for my old folks depending on their conditions and how they run.
FrogKissingNurse
118 Posts
That is scary! why do you think they make up the vitals? Is it because they have too much to do or do not understand the importance of vital signs.
Also I just wanted to remind you that it is not the CNA's job to Interpret the data. They just need to obtain the numbers- it is the nurses job to determine what the numbers mean...well at least according to the NCLEX, I know the real world is different though...
CathyLew
463 Posts
when the CNA gives you the VS, how do you chart it? Do you chart that they were taken by the CNA? If the CNA does them, why arn't they the ones that have to chart them?
I would not chart things I did not do without having a place to state who got the values.
maybe its time that someone caught them in the act. How bad is it going to look when you find a patient that has crashed....with normal VS just minutes before. VS are taken for a reason.
My CNA's are busy. I always take all my own vitals because I have to do the assessments anyway. What better way to assess a resident then to get their vitals first anyway? Plus, I only do apical pulses...I like to hear the heart beat, esp. in those with histories of cardiac problems. If you don't trust your CNA's to do them correctly, why don't you just do them yourself?Blessings, Michelle well michelle i dont know where you work, but that is alot easier said than done, wouldnt we all like to go do real assessments on our patients, and get our own vital signs, and much more, but when the nurse to pt ratio is 1:45, that becomes a little unrealistic sweetie, when your working 8 hours, have meds, treatments, orders, family, and more than 15 charts to chart on, (including skilled charting), you should be able to at least know that someone who was supposed to be trained in this area could be trusted to get a set of v/s, but best believe, if i do suspect that the v/s were falsified, then i do either ask a cna who i trust, or, i do them myself, i kno my username is "supernurse", but if you work in ltc, and u have a similar workload to what i described, then i retire my name, and give it to you, thanks for your god bless:rolleyes:
well michelle i dont know where you work, but that is alot easier said than done, wouldnt we all like to go do real assessments on our patients, and get our own vital signs, and much more, but when the nurse to pt ratio is 1:45, that becomes a little unrealistic sweetie, when your working 8 hours, have meds, treatments, orders, family, and more than 15 charts to chart on, (including skilled charting), you should be able to at least know that someone who was supposed to be trained in this area could be trusted to get a set of v/s, but best believe, if i do suspect that the v/s were falsified, then i do either ask a cna who i trust, or, i do them myself, i kno my username is "supernurse", but if you work in ltc, and u have a similar workload to what i described, then i retire my name, and give it to you, thanks for your god bless:rolleyes: