How to read allergy test results

[SleeepyRN]

I work in an asthma/allergy office and we do a lot of allergy testing. I'm confused on how you measure the results. The scale we use is 1+ to 4+ for a reaction. But thats not in mm. I asked my nursing supervisor whose been doing this for over 20 years (the dr even asks her opinion sometimes, she's so good at it.) She just eye balls it. Doesn't use any measuring device. But when I look on youtube it shows the nurses actually measuring it. But I can't quite see what they are reading. Any pointers?

[roser13, ASN, RN]

If I were a patient in your practice, I would seriously want to know that the one responsible for reading my (my child's) allergy reactions was very well trained in the science of allergy test analysis.

I would truly be appalled if I knew that the responsible party was using tips & tricks obtained from an online forum.

Demand an appropriate orientation/education. You deserve it.

[SleeepyRN]

Thank you. Ultimately it is the Doctor that truly "reads" the results. They don't train me, and I started not even feeling like a nurse anymore. I only work there now as needed while my main job is now sub-acute rehab

[nursel56]

I worked in allergy, and personally felt very much like a nurse, but maybe I just worked in a better environment. There's a lot to learn in this field, and if they aren't willing to give you comprehensive training, from start to finish I wouldn't place myself in a situation that required evaluating the results. With the intradermal tests in particular, the area can quickly blow up like a balloon and cause systemic symptoms.

Your co-worker may initially have referred to the cards and images that depict positive reactions of 1-4+ but experience definitely helps! Best wishes!

[SleeepyRN]

I worked in allergy, and personally felt very much like a nurse, but maybe I just worked in a better environment. There's a lot to learn in this field, and if they aren't willing to give you comprehensive training, from start to finish I wouldn't place myself in a situation that required evaluating the results. With the intradermal tests in particular, the area can quickly blow up like a balloon and cause systemic symptoms.

Your co-worker may initially have referred to the cards and images that depict positive reactions of 1-4+ but experience definitely helps! Best wishes!

Oh, it was DEFINITELY the work environment. It bothers me when I hear nurses say office nursing is less sttessful. Not in my experience. Its just a different kind of stress than bedside. I filled in at another practice doing phone triage, skin testing on lots of kids, and a lot of patient education. I only work for this place PRN now. I didn't have a choice but to work there. My mom taught me most of what I learned in her office. Ironically her boss who is my boss's brother, has no problem with me doing the actual job of a nurse. Probably because it was free for him. I just did an internship type thing so that I could learn, because his brother, my boss the doctor, doesn't let me do anything. I applied for nursing jobs for almost a year and a half. I even took seasonal minimum wage jobs to try to scrape by with the bills. Finally 2 months ago I was hired at a sub acute rehab facility. I only had that job 10 hours a week. The doctor doesn't trust anyone but the nurse my mom trained for him 20+ years ago. So all I did was allergy shots. Period. He wanted to hire an MA for that! No way!. While I don't like that it was the ONLY thing he allowed me to do for the last 1.5 years, it takes nursing judgment to do it. There was a lot of patient education with it, and assessing if they even should get their shots that day. I'm not valued in that office. He only pays me what I made as a nursing assistant. The nurse manager let me do allergy testing when she knew the dr wouldn't see it was me doing it.