New Grad RN...Why can't I hear lung sounds!!

Published

I am a new nurse. Only been on the floor about 3 weeks. However, I am growing concerned over my inability to hear lung sounds. I am under the gown, they are taking deep breaths, I'm listening intently...nothing. I am almost always charting decreased in lower lobes because I just can't hear anything beyond the upper ant/post lobes. I look back at what previous nurses have charted and they have described what they hear on the lower lobes. How am I missing these sounds?? In nursing school I blamed my measly $50 stethoscope. However, I bought a nice stethoscope since and the sounds have not improved. Has anyone else had this problem? What do you suggest?

Up Vote Up Vote ×

No sarcasm intended, but have you had your hearing checked? Have you ever had a co-worker evaluate your technique? If you are experiencing this with every patient then I would think either you have a bad stethoscope or you need your hearing evaluated. But if it's hit or miss, maybe it's your technique.

Up Vote Up Vote ×

where are you listening?, make sure you do it in a quiet area of course but most importantly i always close my eyes when i listen to them because you will be able to focus more on the sound then looking around and not focusing. Also you have to consider and diagnoses this person has that can relate to why they have decreased lung sounds, did they smoke before, COPD, any respiratory issues?. if not you can ask other nurses on you floor what they do differently then you.

Up Vote Up Vote ×

Buy a 150 dollar stethoscope and i guaranteed you hear all the lung sound u need to hear

Up Vote Up Vote ×
Specializes in Infusion, Med/Surg/Tele, Outpatient.

I had a problem...and my bell/diaphragm mechanism had gotten stuck in between. Could hear bowel sounds, young heart sounds but no lungs! Frustrating and slightly humiliating.

Up Vote Up Vote ×

agree with all posters prior. you know you gotta take your scope out and listen to yourself. i bet you might possibly be laying it over bone? if you are too quick, that is easy to do (see .pdf below for ideas for placement). tell the patient, "i need you to take in a good breath for me" if they don't, there will be no sound generated.

youtube - assessing lung sounds (part 1)

youtube - lung sounds (part 2)

http://www.infiressources.ca/fer/depotdocument_anglais/pulmonary_auscultation.pdf

Up Vote Up Vote ×
Specializes in Family Medicine.

It is possible that you really are hearing diminished lung sounds and the other nurses are charting "clear" without really listening. I wouldn't automatically assume the problem is with you.

Up Vote Up Vote ×
I am a new nurse. Only been on the floor about 3 weeks. However, I am growing concerned over my inability to hear lung sounds. I am under the gown, they are taking deep breaths, I'm listening intently...nothing. I am almost always charting decreased in lower lobes because I just can't hear anything beyond the upper ant/post lobes. I look back at what previous nurses have charted and they have described what they hear on the lower lobes. How am I missing these sounds?? In nursing school I blamed my measly $50 stethoscope. However, I bought a nice stethoscope since and the sounds have not improved. Has anyone else had this problem? What do you suggest?

One of my professors suggested, when I was complaining about how hard a time I was having hearing BP, that I get one of those ear wax removal kits and clean my ears out. Maybe have your PCP look in your ears and see if you have a wax buildup that needs attending to? Also...maybe you have some hearing loss?

Up Vote Up Vote ×

I would suggest have another nurse listen after/with you, check your stethoscope (may be damaged) get your hearing check or do a OTC ear wax removal, or try to use someone else stethoscope.

Up Vote Up Vote ×
Specializes in Home health was tops, 2nd was L&D.

I have to tilt my head just so to hear lung sounds. Dr said it has to do with my ear canal.. Try it.. can't hurt!

Up Vote Up Vote ×
Specializes in Emergency, Internal Medicine, Sports Med.

I'll say this: you might want to check your stethescope is turned "on" (some Littmans have this function). You do this by swiveling/rotating where the bell meets the plastic tube. There is a HUGE difference in ability to hear when it's on vs off...just by tapping the bell you should be able to tell.

Otherwise, I'd get your hearing checked (not trying to sound rude- I mean it quite literally).

Perhaps take your new stethescope and compare side by side with another RN on a patient with noisy lungs...(pneumonia/COPD'er etc).... see what comes of it.

Also keep in mind lung sounds can change over the course of a shift so if you're looking for Cr in the same place as the last nurse found them, they might not be there (for example)

Up Vote Up Vote ×

Thank you all for your replies. I have a nice littman cardiac II stethoscope that was $190, so I am not blaming my stethoscope at this point.

I have rotated/swiveled the bell to make sure that it is lined up. Only because I have made that mistake before :)

As many of you suggested I think I need to have my hearing checked out. As a child I had ear issues (multiple ear infections, avoided swimming bc the water would pool in my ears for days, even went to the doc periodically to have the wax drained out). Those kind of issues have not bothered me for a while. However, I am constantly "popping" my ears to clear them. I am going to listen to my own lungs today and schedule an appt to have my ears looked at. I want to get this figured out!

Up Vote Up Vote ×
+ Add a Comment