Published Aug 25, 2012
DawnJ
312 Posts
OK, so I'm an older student, but I didn't think my hearing was going already. I have the American Diagnostic Corp, school issued scope. And I got a Littmann Cardio III scope because I read that a better scope will help me to hear and learn.
So, today we hauled them out for the first time and I really can hardly hear anything. I hear a faint beat in the chest, but next to nothing when I'm at the brachial for a BP and nothing when I listen for bowel sounds. I have to really concentrate and it has to be very quiet in the room for me to hear anything at all. Surprisingly, what I thought of as the inferior school scope is slightly louder.
OK, so.....I have the earpieces in my ears the right way, I have the scope head turned so it is "on", I changed out earpeices to see if that would help. I seem to be able to hear room conversations through the scope diaphram better than I can hear body sounds.
My teacher said that I need to "tune out" other noise and once I learn what to listen for, I will be able to do that. How can I learn to listen to it if I can't hear it? When I hear recorded heart sounds, they seem much louder than what I'm hearing myself.
Another suggestion from my instructor is to get an amplified scope, but they are very expensive (and I already have bought 2 scopes) and if I'm doing something wrong with these, I'd rather not pay out more money.
Any ideas? Thanks
Jammin' RN
50 Posts
I had the same problem when I started school. I know they are expensive, but the electronic scopes are really the way to go if you are HOH. I actually contacted a few local programs to see if they had any grants available and to my surprise I was given a $150 grant towards my stethoscope. It's worth a shot! (I do remember that I did have to provide financial information... A few pay stubs.. I was 22 at the time and didn't make much!!!!)
Don't hold off! And if you are having a hard time hearing through your stethoscope, I really suggest to get your hearing checked. I didn't have hearing aids when I entered NS but I knew my hearing was AWFUL (I had worn aids younger but never had money to purchase another pair.) My professor suggested to me that I should really get a set... She was worried that I may not hear my patients say something important. I listened to her advice and was able to finance a set of hearing aids. Hearing properly is breathtaking!
You will be amazed at what you can hear with an electronic stethoscope!! Other students loved to borrow it!! The downside to them is you have to be very still because they will pick up a lot.
I know finances are usually tight in NS, but don't be afraid to check into your local resources.
Is there an electronic scope you recommend?
Esme12, ASN, BSN, RN
20,908 Posts
Before you go and buy an electronic scope.....the heart tones, lung sounds aren't always either. Those recordings are loud to teach you what to listen for....you need to learn to drown out the extraneous noises and concentrate on the noise that you want to hear. I am "older" as well and although I have a few speciality scopes, like the master cardiology (which you don't need unless speciality in cardiac surgery), but I still LOVE my cardiology III.
Lower your expectations on the clarity of what you hear on the human body. If you think your hearing is affected see you PCP before investing that money in a new scope. Yes the electronic scopes give you the ability to hear louder but is it worth the expense to have it walk away someday at clinical. MDs/residents/staff are notorious thieves.
Littmann has an electronic device.....for about $300.00. 3M Littmann Master Cardiology Stethoscope 2159, 22 inch, Black tube-Shop 3M
Thanks for the input. I don't think my hearing is going, I've always had good hearing and this is the only time I'm having issues. So I'm more likely to think it is something I'm doing wrong rather than a problem with the equipment (purchased as well as built in).
So, I'm really not supposed to be able to hear it clearly, that helps. I also noticed that if I really jam the earpieces in my noggin I hear better. I ordered a Thinklabs ds32a+ Limited Edition Digital Stethoscope but may be returning it if it doesn't help.
Camwill, ASN, BSN, MSN, DNP, LPN, APRN, NP
526 Posts
The cardiology III is amplified if you push down slightly. It can make a difference.
I'm impressed with the Thinklabs digital scope. I think it will be my primary scope
neldel
20 Posts
Have you had someone else (fellow student or instructor) try them out to see if they have the same problem?
guest64485
722 Posts
I'm surprised to hear of this issue with the Cardio III scope as that's a really good stethoscope. It has been my stethoscope for 7 years and it has served me very well. Make sure the head is turned until it clicks in place - not turning it all the way will greatly decrease the sound. Put it in your ears and give the diaphragm the teeniest, tiniest, lightest touch you possibly can and take your finger away -- this should produce a loud sound. If it doesn't, turn the head until it clicks and try again. If this still doesn't work and your earpieces are in properly then you may have a defective steth. Have another nurse try it out to be sure, and consider sending it back to the manufacturer.
If the teeny-tiny touch does give you a loud sound, then there are few other explanations as to what is going on.
A possibility is that a few patients are just plain hard to hear the internal sounds on - it may be weight or blood pressure issues, for example. I've had patients where it is very difficult to hear the blood pressure sounds, and I've had one patient that I couldn't hear a single bowel sound on to save the life on me, nor could another nurse whom I pulled to listen (patient was just fine).
So perhaps you were listening to a person who falls in that category. Bowel sounds especially should be very easy to hear. So, experiment on yourself and a family member, and make sure you have the proper pressure and keep your steth on your belly a full minute if need be after doing the touch-test above.
Yes, I've been experimenting with everyone who will let me near them Including my cats and dogs!
It is far more likely to be user error than anything else. I suspect that if I go back to the Cardio III in a couple years, I will be able to appreciate it. I know the Cardio III is working because I can hear the tapping of the diaphram and I can certainly hear ALL the room noise through it.
Even just with a week of dedicated practice I can "hear" more with the American Diagnostic. I think it is my inexperience more than any problem with the scopes or my ears. My brain hasn't learned to interpret what my ears are hearing yet.