nurses not using stethoscopes

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new grad here, noticed ALL the nurses on my unit (med surg) do not use their stethoscopes...and just compare their notes to the previous shift notes..... i just bought a new stethoscope and hung it around my neck and the nurse told me to leave it in my bag. so how am i supposed to do assessments???? patient hasnt pooped in 3 days but do you think any of the nurses would pull out their stethoscopes to listen to bowel sounds??..... im still on orientation and i feel like this hospital is making me crazy... i still do my full assessments regardless!

I find a short assessment helps the patient feel like you are looking out for them. It gives them confidence in your ability to keep them safe. It makes them feel like you know what you're doing. You can also do some teaching while you're doing it. Remember the Miss America contestant and the ladies on The View wondering why she had a "doctor's stethoscope" That was a big brouhaha and all of these indignant nurses insisting that it was an important part of their nursing duties to use that stethoscope. Of course, the assessment will vary according to the patient population and acuity but I would simply never chart anything I hadn't personally assessed and I sure as heck wouldn't want to be missing something 30 seconds with a stethoscope might have caught. I was charge on a floor when a 4 days post op lap chole who came in for N/V threw a PE. It was caught very early by a nurse with a stethoscope who I'm quite sure never expected a respiratory event. The patient seemed anxious but never complained of any respiratory issue. What if that nurse had said "oh she's here for N/V" and focused assessment on only that? Listening to those lungs for all of 30 seconds could quite possibly have saved that woman's life.

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first of all thanks so much to everyone who commented.

and to answer this comment...by Miss.LeoRN and sevensonnets

negative.

It's more of when I was with different preceptors and observing how they are doing SINCE I AM STILL ON ORIENTATION, I had noticed none of them pulled out a stethoscope even on admission patients. It's the doctors who check with their stethoscopes and nurses have admitted that their stethoscopes are at HOME.

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anyone reading your assessment to check on the patient's condition during the time you cared for the patient would likely conclude that by checking WNL you actually HAD auscultated the patient's heart and lungs.

Actually "WNL" should be defined within the EMR for each body system/area in which that notation is an option. The only way "WNL" can ever hold up legally is if it is clearly defined.

And, right or wrong, WNL Respiratory may mean something like "rate and rhythm normal for age, even and unlabored" as defined within the EMR for that particular section.

I would do a CV assessment on a post-op patient. However I've given more clear-cut examples where focused assessments are more appropriate earlier in the thread.

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You are doing it right and if you are taking your own assignments, you practice the way you feel comfortable. Your co-workers are lazy.

Caution: Don't wear the stethoscope around your neck while in a patient's room. If you get a patient that grabs the ends, you cannot break free. Major safety hazard.

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I noticed the lack of stethoscope usage as well. Keep using yours and don't lower your standard of care.

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You are doing it right and if you are taking your own assignments, you practice the way you feel comfortable. Your co-workers are lazy.

Caution: Don't wear the stethoscope around your neck while in a patient's room. If you get a patient that grabs the ends, you cannot break free. Major safety hazard.

I had a patient attempt to strangle me with mine. She had dementia but it was scary as heck. Still had it around my neck afterwards though. In ICU I felt like I needed it handy.

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Specializes in Anesthesia, Trauma, Palliative, Tele.

Yes!! Always be the exception! Be extraordinary. Be different and always strive to do the right thing for your patients. Don't conform but transform. You have to answer to yourself at the end of the day, make that person be someone you love and respect.

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I was charge on a floor when a 4 days post op lap chole who came in for N/V threw a PE. It was caught very early by a nurse with a stethoscope who I'm quite sure never expected a respiratory event. The patient seemed anxious but never complained of any respiratory issue. What if that nurse had said "oh she's here for N/V" and focused assessment on only that? Listening to those lungs for all of 30 seconds could quite possibly have saved that woman's life.

No, that was expected of her. The patient being a 4 day post op doesn't even matter. She came in for N/V, meaning she was a new admission. A full head to toe assessment is absolutely required in that case.

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I worked in a PACU a few years ago and received tremendous grief from fellow nurses when I insisted upon listening to the lung sounds of every one of my patients that entered my bay. The other PACU nurses wanted to stress "Focused Assessments" but in actuality I think they did not want to engage in a practice change for them. I was the only nurse that utilized my stethoscope the entire time I worked there, and I got bullied mercilessly for it. But I knew I had to follow peri-anesthesia guidelines; my recently extubated patients right to comprehensive care, and my own integrity. ALWAYS FOLLOW YOUR OWN INTEGRITY... A PATIENT WILL THANK YOU!! YOU MAY JUST SAVE A LIFE.

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Specializes in ER, ICU plus many other.

Thats the problem, many don't do assessments sadly!

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Quoting NurseMSBSNRN:

"I was the only nurse that utilized my stethoscope the entire time I worked there, and I got bullied mercilessly for it."

Really? Bullied? Holy cow. And mercilessly? I would understand teased, occasionally, maybe. Some eye rolls, not that I think that's warranted, but BULLIED? Hmmm.

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Specializes in Pediatric Critical Care.
I worked in a PACU a few years ago and received tremendous grief from fellow nurses when I insisted upon listening to the lung sounds of every one of my patients that entered my bay. The other PACU nurses wanted to stress "Focused Assessments" but in actuality I think they did not want to engage in a practice change for them. I was the only nurse that utilized my stethoscope the entire time I worked there, and I got bullied mercilessly for it. But I knew I had to follow peri-anesthesia guidelines; my recently extubated patients right to comprehensive care, and my own integrity. ALWAYS FOLLOW YOUR OWN INTEGRITY... A PATIENT WILL THANK YOU!! YOU MAY JUST SAVE A LIFE.

Those other PACU nurses must not have understood that part of a focused exam for a recently extubated patient IS listening to lung sounds (and for stridor!)

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