Having Trouble Hearing BP's

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Hi All!

I need some constructive advice. I had been told last year that I would probably need a hearing aid by the time I was fifty. Well, just turned 48 and I have noticed that last few times I did a manual BP that I didn't hear anything. Kinda freaking me out!

Now both of these times, the doctor told me following his exam, that the patient had a systolic BP >180 and that the BP was faint. I am a relatively new, inexperienced nurse as well so I question whether this is truly my hearing (because I DO hear it most times) or my technique.

Any thoughts? And, if it is the hearing, anyone found an enhanced stethoscope for the hearing-impaired nurse that they found helpful?

Thanks in advance.

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Thinklabs Electronic Stethoscopes - Thinklabs Electronic Stethoscopes

Prob crazy expensive but you can turn up the volume and noise-cancel.

I think it's also supposed to plug into your iPhone and have accompanying software where you can visualize the sound waves.

Thinklabs Electronic Stethoscopes - Thinklabs Sound Library

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Thank You for the information!

Thinklabs Electronic Stethoscopes - Thinklabs Electronic Stethoscopes

Prob crazy expensive but you can turn up the volume and noise-cancel.

I think it's also supposed to plug into your iPhone and have accompanying software where you can visualize the sound waves.

Thinklabs Electronic Stethoscopes - Thinklabs Sound Library

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Littman also has an electronic stethoscope that amplifies 24x and blocks out ambient noise. It's really expensive but the reviews for it are really good and it might be a wise investment.

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Before you go for the expensive technology, try this: Be sure that your stethoscope tips are pointing forward, towards the tip of your nose. If you wear them like they do on TV, pointing backwards towards the pinna, they fetch up against the wall of your ear canal and you hear nothing. Many's the student who's gotten that wrong!

You can twist them to get the angle right for your individual anatomy. You'll even find yourself hearing breath sounds and heart sounds better.

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Specializes in Public Health, L&D, NICU.

Really great advice so far, and I'd like to add that you might want to try different ear pieces. For years I used a Littman Cardiology, but found that it was useless if I had the soft ear pieces on it. I couldn't hear a thing! I had to go with the harder, less comfortable ear pieces in order to hear. My Littman finally bit the dust, and now I use one of those really heavy Spragues and love it.

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Type of scope and how it fits your ear really does matter. I used a cheapie Sprague and heard everything just fine, I just didn't like the weight of it. I got a Littman Select after hearing all the Littman praise, and was surprised to find I couldn't hear a blessed thing out of it, no matter how I tried. Ok, I heard, but very poorly.

I got a Master Cardiology (also Littman) and am hooked: I joke that I can hear a bee fart at twenty paces :)

Trial and error, I think.

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I don't have any problems hearing, but I had a hard time finding a stethoscope that my ears could handle. My ears are really small and it would literally hurt to wear a stethoscope. I'm not a wimp, but it was so painful that I could barely stand to leave the stethoscope in long enough to hear the BP and also be able to concentrate bc of the pain. I can't even wear ear buds for phones or music because my canals are so small they won't fit or stay in. Luckily, I found some soft tips that work well and don't hurt.

Anyhow, I first blamed the trouble hearing on the stethoscope and discomfort, but after I found a good stethoscope I realized that I couldn't hear the BP's unless I was inside the patient's room with the door shut, TV muted, etc. However, as I got more experience, it got easier to hear. Now, it's easier to hear when it's quiet, but if I focus then I can hear even in a room full of people talking, etc. So, I think it is just one of those "skills" that gets easier with time after you figure out a good technique and gain confidence.

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Yeah...my nursing instructor was kind enough to share her personal story of not learning this lesson until she had been on the job for two years and someone suggested she try it. Thankfully, that was one lesson I did get while in school!

BTW, I worked today at two different places (junior high nurse sub) and a volunteer clinic for adults, and I am happy to say I was able to hear all of the BP's using different equipment at both places. Maybe the problem is more to do with especially faint BP's and the amount of fluid in my ears during allergy season (I get a December to Mid-February ear infection with fluid each year).

I will check out the products suggested. They sound interesting, and more reliable than my ears! Thanks everyone!

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Specializes in Medical Surgical.

Sometimes you just have to twist the stem that goes into the stethoscope, if you have one that has a chest piece on the other side of the diaphragm, because it will be sitting sideways in there and no sound gets out.

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Don't be afraid to ask for silence either. You're perfectly within your rights to tell the pt to turn the TV down or to ask family members to be quiet.

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