I suppose I should post this on the student forum but I think I need the help & advice of seasoned nurses. I just started nursing school (LPN) 3 weeks ago. I have no former experience in the health field so one of my classes is designed to get us all on a par with the CNAs who have those skills down pat. I'm doing OK with most everything but vital signs, most specifically, blood pressures.
I can't seem to "hear" that first beat or realize that it was the first clear beat, so my systolic is usually a bit low. And then the beats stop & I don't realize it until too late. I also just plain have a difficult time hearing the beats with all the other extraneous sounds probably caused by movement of the person or the stethoscope. I am an older student & my hearing isn't what it used to be but I'm not deaf by no means. The more frustrated I get the worse it is. I have to test out with an instructor soon & I have to match her numbers within 2. The way things are going, it's not going to happen. This is realy stressing me & it's carrying over to my other studies. Yesterday I took a quiz that was pretty easy & I made two very stupid mistakes. I know it's because I am letting this get to me.
PLEASE, do you have any suggestions or advice? Any "tricks of the trade" you'd be willing to share?
EMS is a wonderful source! Another tip would be to feel for the radial pulse at the wrist while you are deflating the cuff. When you can feel the pulse is the systolic.
Next place the diaphragm of the steth. over the inside of the elbow (antecubital fossa) reinflate, and see if you can hear the systolic at the number it was when you felt the pulse.
I sometimes have to cock my head so my shoulder will stabilize the earpiece at my ear. Keep trying. If you can't hear it, then try a different steth. Ask your coworkers/other students for help. Once you learn, then be available to teach the next bunch of students.
I had the same problem until I switched out the earpieces. I need earpieces with bigger holes.
One of the earpieces fell off my el cheapo Prestige school-issued stethoscope last week. I bought some replacement earpieces for $1.99. I can't believe how much better I can hear! It's like I have a new stethoscope! I can hear the S2 split on inspiration! And when I take BPs I can hear the whoosh of the blood as it rushes past rather than just a dull thump.
I bought some replacement earpieces for $1.99. I can't believe how much better I can hear! It's like I have a new stethoscope! I can hear the S2 split on inspiration! And when I take BPs I can hear the whoosh of the blood as it rushes past rather than just a dull thump.
I'm amazed at the difference.
Meloney,
Hi! Can you tell me what type you bought? I'm going to try this as well.
Specializes in LTC, home health, critical care, pulmonary nursing.
So I've been a CNA for years, and I still have this problem. I hear the systolic, see something shiny, look away, hear the diastolic but was looking at whatever shiny thing diverted my attention, and have to start all over.
Next place the diaphragm of the steth. over the inside of the elbow (antecubital fossa) reinflate, and see if you can hear the systolic at the number it was when you felt the pulse
I would always do this until you get the hang of it. The textbooks say to anyways, so it is a must for testing. Also one other "obvious" thing. Make sure you tap your stethoscope to make sure it is open on the side you will use. I fidget with mine and sometimes find it closed when I go to use it. I'd just start taking everyone's Bp. Practice being assertive an explaining that quiet is necessary. And then try to trust yourself and go for it.
In the hospital the time when you will need that manual might be when someone is changing status (i.e., near code) and the floor machine isn't picking it up. Then you will need to trust yourself to listen way low down until you actually hear it, even if it is way out of range. Keep practicing!
Dieselmota
29 Posts
I had the same problem until I switched out the earpieces. I need earpieces with bigger holes.