How many nurses do their own vitals???

Anniekins · Mar 20, 2004

I am graduating May 8th with my BSN :balloons:

Meanwhile, I'm a tech, and I always am asking the nurses what I can do to help them if I am caught up on vitals...call lights, accu checks, etc.....

Why not.......to me, I'd rather help out the nurses and patients than stand around! Thats boring and makes time go SLOW!!!!!!

Heartattaq · Mar 20, 2004

Every floor other than surgical floors I have been on RN's do all their own vitals at all times. Personally I am more comfortabel doing them myself, I do them when I first walk in in the morning and am speaking with the patient and getting a mini assessment done.

JWaldron · Mar 20, 2004

Lately the short end of this stick has left me with a chewed-up toothpick. I'd love to have just one **** day to stand around and do nothing. Wouldn't know what to do with myself. Someone would hunt me down.
Although one word that's sent me into a laughing fit was the word delegate. Such a pretty little term that all of the books use. I've never been delegated any sort of task. What i HAVE gotten: "YOU need to NOW"s followed with the occasional point in the direction of the room and the fingersnap. You know, the kind that is supposed to get a kid's attention. I've seen people do that to their dogs to send them outside. That's not delegation, that's degradation. I could tell them to cut it out, but it's not fair (or professional) to the pt. to hear me tell the "delegator" where to put her fingers. :)
And the floor i floated to LAST night, I'M the one that ran my butt off for 12 straight hours while the nurse spent two straight hours of her 6 hour shift reading the lastest issue of Cosmo!!!

That's a shame, but I know what you're talking about. I floated for a number of years, and floats typically get the worst assignment on a unit, and often get assigned with the people nobody else wants to work with; definitely a challange. And not at all appropriate. We talk about professionalism, and wanting nurser to be taken seriously as capable professionals. Well, that kind of behavior sure doesn't demonstrate it. (Neither does the typical eating our young - what kind of caregiver behavior is THAT modeling?) I have never had time to do anything like that no matter what the aide did. Sounds like there was a whole lot more that nurse was not doing w/ regard to patient care than just answering call bells. I've worked every inpatient dept except ICU and Surgical Services from Presurgical to PAR, nor have I worked L&D, but just about everywhere else, and there sure wasn't time to do that anywhere. Or was I doing stuff that didn't need to be done, like taking care of patients? But I have seen RNs like that, and wondered how they cold keep getting away with it - the ons who do their assessment form the doorway, and don't even take their stethescopes out of their lockers.... and get their cigarette breaks and their meals and get out on time and talk a lot about how hard they work....

Fingersnap? Well, not only is that not my style, I'd come out with more of a fingerthlub! After I get report and do a fast scan of the Kardex I give 'my' aide report and tell her what we need to do, and what I need at what time, and let her know that if she runs into any problems with the timing to let me know. We are teammates - neither of us can do as good a job by ourselves, and together we can make each other shine and take the best possible care of OUR patients. I don't and can't do it by myself and neither can she. The aides are the ones the make the patients feel the best - they are the ones with the greatest amount of hands-on time in many cases. No matter how much I may WANT to give a backrub, I can't be starting an IV, on the phone with the doc or a family, and inserting a foley and doing that all at the same time.

When I worked with an LPN, it was the same - we were a team, at least in my mind, and I depended tremendously on the skill and wisdom of that LPN, because at that time I was responsible for 16 severely ill people.. I learned and am still learning from wonderful LPNs. Now I work only with an aide or a shared aide, and am only responsible for 8 people, on a REHAB unit, instead of a M/S unit, but most of my patienst are nearly as sick, and they are up OOB and dressed, and they are still a 4-person sliding board transfer to a commode, because we don't use bedpans except in rare occassions. and We straight-cath our patients instead of having indwelling foleys (and we don't have a bladder scanner, so anybody who doesn't viod, or void very mcuh, gets cathed. And all the neurogenic bladders get cathed, and on and on.

Savvy

Hellllllo Nurse, BSN, RN · Mar 20, 2004

I am graduating May 8th with my BSN :balloons:
Meanwhile, I'm a tech, and I always am asking the nurses what I can do to help them if I am caught up on vitals...call lights, accu checks, etc.....
Why not.......to me, I'd rather help out the nurses and patients than stand around! Thats boring and makes time go SLOW!!!!!!

Hey, wanna come to work with me? :)

TinyNurse, RN · Mar 21, 2004

In the ER, I do my own vitals once an hour, and before giving meds. I mean you are in the room doing a pain assessment, checking namebands, repositioning,talking to the patient etc, why not grab a set of vitals while you are there???

The Bear · Mar 22, 2004

Hi all,
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...
:uhoh21: :uhoh21:
Just wondering if this is a requirement anywhere else...Amy

The vitals are needed by us to make our assessments. I rather see the PCTs or what ever, doing the blood draws, transfers, stocking, and bed changing. The time it takes to do vitals is not that much more, when they are done with the assessments. We all got too use to having these "nurse helpers" do "OUR" pts vital signs! We need to embrace this job again and see it as necessary for our total assessment of out pts.

nekhismom · Mar 22, 2004

I think pt. ratio does have a LOT to do with it. But I don't think it's ALWAYS unreasonable to do your own vitals. I mean, if you use a dynamap, you can have them in like 30 sec-1 min, and you can be assessing other things while the machine runs. Now sometimes, we ALL know that things are so hectic and we just don't have time. I think it's OK to ask a CNA/tech to get vitals, but it's just being safe if you check the vitals yourself once.

Tweety, I know you primarily work in ER. What I have seen many nurses in my hospital do is this. The tech does the first set, and any other routines. The nurse does any follow up if needed, and VS upon discharge. That way, nobody is pushed to their limits. IT works well.

I don't think there is any one correct answer to cover everything. In my dept, it would be silly for me to call a tech just to read a monitor and do a temp. I can easily do that myself, and I would rather do a count of AP and RR myself than read the monitor. BUt that's just me. I think if we have techs available, then you should use their help within reason. Nurses should use their professional judgement to determine if techs do the vs or if the nurse will do them.

sandy06 · Mar 22, 2004

This has been a very interesting post. I am a CNA in an ICU/Tele unit. I am also a nursing student. We do all the v/s q4 and frankly, I don't mind. I think it is a good thing for me to make rounds, meet my patients and get v/s, check trash, check for i&o, etc. Nurses get just as slammed as we do and I think we all need to work together. How hard is it to take v/s and when abnormal go to the nurses station and mention it before charting?

I mean really, it seems as though we are talking about unusual situations when we find RNs and CNAs sitting around. I am sure there are lazy nurses and lazy CNAs, but for those of us who are doing our jobs - patient care - then that may mean staying busy for a shift - and mine are 12 hours. Like others, I would rather be busy then bored. Not to mention, being a student it only helps me by getting more patient contact and learning so I am ready for the future!

Tweety, BSN, RN · Mar 22, 2004

Tweety, I know you primarily work in ER.

Actually, I work med-surg, currently working in Telemetry as a charge nurse. I agree 100% it has everything to do with ratios. Our ratios are high, with plenty of techs on the floor to take both vitals, and do patient care.

I also agree 100% that vitals are part of the RN assessment. On night shift, I usually have my vitals before I go into the room, have their medications (I work tele. so many are cardiac, and it's nice to have the vitals done while I'm pulling meds), and do the head to toe assessment, and settle them back into bed.

There's no one right answer that fits all situations. I certainly am capable of taking vitals, it doesn't take much more energy, and see the advantage in that. I also see the advantage of having techs do it (if the techs have a good patient ratio as well). My preference is to have a low RN patient ratio and I do everything. My reality is a high RN patient ratio and I need help.

Kate RN · Mar 22, 2004

I never would have thought this question would generate so much talk.

Depending on the day and the department usually I get my own v/s. and prefer to. Occasionally there is someone assigned who has done the first set. and sometimes I even find out about it before I start taking them myself.and I prefer to get the B/P manually. I think it is faster and I know it is more comfortable for the patient. I also trust my ears more than the machine most of the time.

I work most of the time in the ED. and day and night shifts. It is on the med/surg unit that occ my v/s are done for me. It is nice to have help. There is a printout that automatically comes with oiur machine. They stick that on the front of the chart as well as documenting them on the graphic. This does seem to work.

K

Marie_LPN, RN, LPN, RN · Mar 23, 2004

I never mind getting vitals, i just get peezed and cranky when i have 35 sets to do twice, and 3 ppl to help to the pot, and then have a nurse whining to me when her vitals are 10 minutes late. It doesn't happen that often, but if they really want their pt.'s vitals EXACTLY 4 hours later, chances are, they're going to have to grap the Datascope and help. Or they can go clean up their two incontinent BB pts.

One of these days i will wear a tshirt that says "i have never been stamped with the Good Housekeeping Seal of Approval"

I'm getting tired and worn, and it's showing big time.

JWaldron · Mar 23, 2004

Actually, I work med-surg, currently working in Telemetry as a charge nurse. I agree 100% it has everything to do with ratios. Our ratios are high, with plenty of techs on the floor to take both vitals, and do patient care.
I also agree 100% that vitals are part of the RN assessment. On night shift, I usually have my vitals before I go into the room, have their medications (I work tele. so many are cardiac, and it's nice to have the vitals done while I'm pulling meds), and do the head to toe assessment, and settle them back into bed.
There's no one right answer that fits all situations. I certainly am capable of taking vitals, it doesn't take much more energy, and see the advantage in that. I also see the advantage of having techs do it (if the techs have a good patient ratio as well). My preference is to have a low RN patient ratio and I do everything. My reality is a high RN patient ratio and I need help.

Your third paragraph covers it pretty well. Of course I can do my own vitals, and more often than not, I do. But a lot of times it would have been a really big help to have the NA do them, when I have a lot of patients, or patients w/ very high medical needs. It's a matter of balancing what needs to be done with who can best do it at the moment. What is best for the patient, what is w/in the scope of practice and w/in the facility's policy, and makes the most sense. NOT "I'm the boss and I can make you do it" - that's wrong, and it's going to stir up resentment as well. This is teamwork, or it should be. Adversarial relationships make it so much harder! So do poor staffing ratios, but they are a fact of life just about everywhere!

Savvy One