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

[tiroka03, LPN]

In school, I was taught to listen and document. However, I wasn't really taught how the sounds actually sounded. When I got report form nurses, they said the lungs sounded really bad, or junky ect. Well what does that mean? I know that a doctor can listen to lungs and pretty much know what the condition is, COPD, Pnuemonia, asthma, ect. So, if they can learn, why couldn't I? I found a good tape seriers that recorded and explain the sounds. I don't remember the seriers of the tape set, it was kind of expensive. Then I followed respiration therapist around and asked them questions. Finanlly I was able to tell one sound from another. Here is one thing, if you hear any sounds at the beginning of and inspiration or expiration - it is an acute process. However, if you hear the sound at the end of an ispiration or expiration it is chronic. So, COPD you would hear the wheezes begin toward the end of the inspiration and expiration. Pnuemonia you would hear at the begining.

[mazy]

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.

Unfortunately true.

Maybe you can take your stethescope to your ear Dr. appointment and have the dr. take a stab at it?

[carolmaccas66, BSN, RN]

Ensure you turn the bell of the stethoscope so it CLICKS into place, so it is on, cos you won't hear anything. Get an alcohol swab and thoroughly clean it all as well. Getting your ears checked is a good thing to do as well, and getting them cleaned helps.

Also grab a patient one day with really gunky, yukky lungs, ask if you can listen to them, and I guarantee you WILL hear the rasping gasping sounds of people in respiratory distress. You also need to press the stethoscope quite hard into some big people in the right areas to hear anything at all.

Try listening to your own heart and chest to see if the stethoscope actually works! You might have got a dud one.

Practice on family members and friends as well - if you never hear anything at all, it's either your ears or your steth.

Get an experience nurse to stand and watch your technique as well.

Let us know how you get on.

[brownbook]

Cut the cord....the rubber hose that goes from the metal tubing to the diaphragm is a standard length, usually fairly long. Cut the rubber tubing to around 12 inches, shorter distance, sound doesn't have so far to travel, you hear it better.