Well at my one place they just posted something stating that since they are so short on PCTs that the RNs will be responsible for doing their first set of vitals. This, I feel is insane. Especially since at around the time the first vitals are being done by the PCTs, we are doing assessments, passing meds, and like the other nite I was giving prep for a bowel procedure. And I don't mind helping out, as it was stated on the memo "We will all be expected to accommodate the needs of the unit" but when I see PCTs standing around doing nothing and I'm also doing their vitals it really angers me. I feel like they just keep dumping more and more things on us and they wonder why we have so many lawsuits...
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Just wondering if this is a requirement anywhere else...Amy
Well since we do a minimum of hourly VS (or more frequent), I always do my own. Occasionally, if I'm in a crunch, I'll ask another nurse to do them for me, but even that is rare. We do have one CNA who is in nursing school and I will let her do my vitals sometimes, but just because she's very enthusiastic about learning and not because she's required to.
In ICU, it's very important to watch for trends and subtle changes in VS because patients are so unstable. Preventing them from crashing and burning is much more appealling than have to deal with a code.
We also have some crazy parameters for certain patients and the MDs may want their SBP to be in the 180-200 range. No matter how fabulous a CNA we may have, he/she is simply not trained to deal with all these variations.
Seems like Tweety and I are alone in this vital signs debate. I am not now nor have I ever been a lazy nurse.When we do have an assistant do do our vitals they are usually all done shortly after we get out of report, so we have time to reveiw them, recheck abnormals,ect..this is SO helpful with 7-8 pt ratio.Gives me time to do a quick chart check, grab my steth,pulse ox and give more time for my actual physical assessment...oh, and while I'm doing my assessment , if they are poopie I change them, if they need a prn I get it for them, if they want juice,a blanket, whatever they need..which is always something.. I do that as well..I'm not lazy or uncaring..just overworked and overwhelmed most nights...I am not alone...we all help each other on our shift which is a MUST..whatever the task..I wish to goodness I only had a FEW pts and had time to do my own vitals...maybe I'm just talking to myself here.....sighs :/
Seems like Tweety and I are alone in this vital signs debate. I am not now nor have I ever been a lazy nurse.When we do have an assistant do do our vitals they are usually all done shortly after we get out of report, so we have time to reveiw them, recheck abnormals,ect..this is SO helpful with 7-8 pt ratio.Gives me time to do a quick chart check, grab my steth,pulse ox and give more time for my actual physical assessment...oh, and while I'm doing my assessment , if they are poopie I change them, if they need a prn I get it for them, if they want juice,a blanket, whatever they need..which is always something.. I do that as well..I'm not lazy or uncaring..just overworked and overwhelmed most nights...I am not alone...we all help each other on our shift which is a MUST..whatever the task..I wish to goodness I only had a FEW pts and had time to do my own vitals...maybe I'm just talking to myself here.....sighs :/
You're not talking to yourself, I agree completely. Getting VS on 7 patients, calling the MD for various problems, doing neuro assessments and passing meds is a little stressful. Forgot to mention the requests for food, water blankets, bathroom trips...I help with. If my tech can't do my VS because they are busy fine. If I can't trust my tech to tell my about problems then there is no point in them being there. I love to hear nursing students say how they are going to do things when they graduate...it doesn't work like that at least not at my hospital.
Well since we do a minimum of hourly VS (or more frequent), I always do my own. Occasionally, if I'm in a crunch, I'll ask another nurse to do them for me, but even that is rare. We do have one CNA who is in nursing school and I will let her do my vitals sometimes, but just because she's very enthusiastic about learning and not because she's required to.
In ICU, it's very important to watch for trends and subtle changes in VS because patients are so unstable. Preventing them from crashing and burning is much more appealling than have to deal with a code.
We also have some crazy parameters for certain patients and the MDs may want their SBP to be in the 180-200 range. No matter how fabulous a CNA we may have, he/she is simply not trained to deal with all these variations.
You also, I presume have a monitor and the patient constantly connected to a BP cuff and perhaps an art. line, and taking your vitals is a matter of walking in the room and interpreting them. We, who have six patients it a bit different.
I will add that it is part of the nurses assessment to know what those vitals are, what the trend is and how it fits into that assessment. I whole heartedly agree the CNA is simply not trained to deail with the variations. Vitals are a vital (hehehe) part of the med-surg assessment as well. :)
To the hardworking CNA who has the whole floor with 30 or more patients, I know what an impossible task it is to do those vitals. Been there and done that when I was a tech in school. You shouldn't have to do 35 sets of vitals.
I would really like to do all my vitals at the beginning of my shift, but in addition to taking over the 8 patients from the offgoing nurse, I am already recieving another patient from triage. I RARELY ask my techs to do anything for me except EKG's, but if I am behind I need to ask them to help me out. As far as accu checks go, I like to do my own because if I am the one covering the patient with insulin, I want to know that I am looking at a result from the correct patient. I know there are plenty of techs that work hard, but there are just as many that are lazy. Nothing burns me more than to see a tech sitting on his/her butt when I am running around like crazy! :angryfire
Oh Tweety, I totally agree with you. I'm sorry if you thought I meant my way was best, I was just describing what we do and why. I can completely understand if you have 6,7,8 patients the need for enlisting the help of your CNAs.
I would also like to add, a good CNA is worth his or her weight in gold!
We have to take our own vitals. Most times this is fine with me because many of my meds are dependent upon vital signs. I would rather take them myself and know what they are rather than searching for the CNA or PCT to get them. Now, I also agree that when we are really busy, I would rather have the vitals taken by the CNA. I certainly would not and do not support CNA's sitting/standing around with nothing to do while the RN's and LPN's bust their hump to get the work done. I expect the unit to function as a whole and everyone work together. Just my 2 cents.
I work on a surgical floor in an all RN hospital....we do everything. Not only am I doing vitals and routine nursing duties but I am also the person to fix the phone, the tv, the you name it.....(we do have people to do this kind of stuff but the nurse always gets asked first!) Besides how long does it really take to do a set of vitals?? 2-3mins???
I work on a surgical floor in an all RN hospital....we do everything. Not only am I doing vitals and routine nursing duties but I am also the person to fix the phone, the tv, the you name it.....(we do have people to do this kind of stuff but the nurse always gets asked first!) Besides how long does it really take to do a set of vitals?? 2-3mins???
I am always fixing TVs, phones, etc. Today, I had to unclog a sink- someone had poured mushroom soup down the sink, and it was clogged up w/ mushroom bits.
How long does it take to do vitals when you are already doing a shift assessment from head to toe anyhow????? Really?
In theory this is how it should be but on our unit, we have 30 patients and a couple machines. Trying to find the BP machines at first assessment/med pass would be inefficient and a nightmare.
However, there are times of course when I do my own vitals such as I'm discharging a patient, change in status, giving certain meds etc...
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Elenaster
244 Posts
Well since we do a minimum of hourly VS (or more frequent), I always do my own. Occasionally, if I'm in a crunch, I'll ask another nurse to do them for me, but even that is rare. We do have one CNA who is in nursing school and I will let her do my vitals sometimes, but just because she's very enthusiastic about learning and not because she's required to.
In ICU, it's very important to watch for trends and subtle changes in VS because patients are so unstable. Preventing them from crashing and burning is much more appealling than have to deal with a code.
We also have some crazy parameters for certain patients and the MDs may want their SBP to be in the 180-200 range. No matter how fabulous a CNA we may have, he/she is simply not trained to deal with all these variations.