Three sets of vitals in a 12-hour shift?

Nursing Students Technicians

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Hello everyone. I have a question. I am a pct at a major hospital. There was just a policy change and now instead of the pct's taking two sets of vitals they are adding a third set right before the shift change which is the busiest time for the pct's. Honestly, all of my co-workers are wondering how we are going to do this with are already busy crazy schedule. Each tech has as many as 14 patients and sometimes it can be up to 19 if the census is low at the hospital. This means that we have to do vitals on all those patients times three. The time that we are supposed to clock out is 7:15 but we aren't supposed to start vitals until 6:30. Personally, it takes me over an hour to do twelve vitals as I help my patients to the bathroom if needed, pick up the room, get fresh water, empty trash, etc while I am in their room as not to disturb them later. I don't know how I am going to accomplish this extra set of vitals without being at work until 8:00 Am. Also, call lights are going off at that time in the morning so what should I do? Ignore the other patients? This is really upsetting to me as I believe I am a really good pct and a hard worker but it seems like too much is being loaded onto the techs. Any feedback would be appreciated. Thanks for allowing me to vent.

I think your reply was directed at me, but I'm not positive. If it was, I am so very glad I could help you! I am in an ADN program with a year left. I appreciate your compliments very much. Just remember that anything in a PCT/CNAs scope of practice is within the nurses. (Excluding specialized training) Good Luck!

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Well, you can only do what you can do and vitals are more important that emptying trash, etc. You may have to start telling the nurses that you're tied up and unavailable during that last 45 mins or so that you're doing the last set of vitals.

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So you will be taking vitals at 10:30, 2:30 and 6:30?

Ask if the times can be changed to what others have said they do, 8, 12 and 4. This makes it much more practical and allows you to get off when your supposed to and not feel so rushed.

Management needs to be shown that their goal of ever 4 hours is possible, but the timing needs to be changed.

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I do what I can to help out the RNs, but I don't particularly care for it when I have things that NEED to be done at a certain time like blood sugar checks and vitals and they are continually coming up to me like a chicken with their head cut off expecting me to drop everything and do a complete linen change that minute because one of their patients missed a urinal and got some pee on their bed.

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Specializes in hospice.
RNs....are continually coming up to me like a chicken with their head cut off expecting me to drop everything and do a complete linen change that minute because one of their patients missed a urinal and got some pee on their bed.

Because of course RNs can't do an occupied bed change, right? It takes more time to come and find you than to just do it and move on! That is the kind of utter crap that used to anger me and make my stomach churn when I worked in the hospital. I will never forget the night we were running shorter than usual, and I had 16 telemetry patients assigned to me and was the only aide on the floor. A nurse came up to me and in all seriousness told me to get a Sprite for the patient whose room she had just left, from the cabinet ten steps away behind the nurses' station. No one could have failed to notice that I never sat down (not even to chart) and literally ran that entire night trying to do Q4 vitals, 2 rounds of blood sugars, all those varying toileting needs, replacing electrodes and batteries in the tele monitors, and baths..... It took all I had not to tell that nurse to get the @%*#ing Sprite herself, and to jump off a bridge along the way. This nurse was notorious among the aides for being the type who would look for one of us for ten minutes to put a patient on the commode rather than just helping the patient herself. She also never, and I mean NEVER, answered call lights.

I know there are lots of good nurses out there who don't treat their aides/techs like gum to be scraped off a shoe, but there are plenty of nurses who do treat us that way. If only they knew the black thoughts running through our heads underneath the professional facade... Trust me, we find ways to reward the nurses who treat us well. Their stuff ALWAYS gets done first. ;)

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Because of course RNs can't do an occupied bed change, right? It takes more time to come and find you than to just do it and move on! That is the kind of utter crap that used to anger me and make my stomach churn when I worked in the hospital. I will never forget the night we were running shorter than usual, and I had 16 telemetry patients assigned to me and was the only aide on the floor. A nurse came up to me and in all seriousness told me to get a Sprite for the patient whose room she had just left, from the cabinet ten steps away behind the nurses' station.

Yikes! Depending on how snarky you want to be perhaps reply.... "Do you have an aluminum allergy or some other medical reason meaning you can't come in contact with pop cans?" or "Sure! Mind doing the bed baths in room 321 for me then?" :p

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Some nurses are empathetic and self sufficient....others are lazy with **** poor work ethic! Those that value you, will offer help because they empathize and do their part when you have so many people to take care of verses her 5 or 6 pts! It amazes me the tolerance level of executive and managerial staff of lazy, non-team oriented people!

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I've done 3 sets of vitals on 12 to 16 patients during a 12 hour shift, both at 1930 to 2000, 2330 to midnight, and 0330 to 0400. Then I've also done them at midnight, 0400, and at the end of the shift. It was FAR easier on everybody concerned to do them the first way at the beginning of your shift than to have to scramble at the end to do them along with everything else. Yes it makes it hectic at the beginning of the shift, but its easier to get caught up then it is at the end of the shift.

It's also a good way to meet all your patients starting a shift and find out right off the bat who might be deteriorating or having problems. I cant think of any good reason to do it the other way, where you outgoing shift does a last set and you skip the first. It makes things a lot more stressful and results in a lot of OT.

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Specializes in LTC, Agency, HHC.

Is your last set of vitals for the next shift? And before you come on shift, is the last set of vitals taken by the prior shift count as your fist set? What was the reasoning for 3 sets of vitals in a 12 hour shift? If it were me, as the nurse, if I had patients that needed BP meds or something like that, I would prefer to get my own vitals, perhaps that should be suggested to your supervisor (although, in my mind it should be done by the nurse anyway. I worked in a facility where the RN was required to give one bath to one of his/her patients each shift.)

If the shift is over at 7, I would venture to guess since it is change of shift, the nurses need to finish up their end of shift things which is why VS are assigned to the aide.....and sometimes that isn't always just charting. We have to prioritize things differently than aides do, and, again, that is why VS are assigned to you. Kind of like.....so and so needs pain medication and so and so needs AM medications, and so and so needs to go to the bathroom......who do you take care of first? Each patient needs attention, and each need is important. (example.) AND, we always need to be prepared in case someone starts to code, or someone falls. Not being prepared for something like that really screws things up! And those 5-6 patients she has may be a higher acquity than your 10-15 you need to do vitals on. If you plan to go to nursing school, you will find out what I mean. I've heard and had my share of griping CNA's who whine about how "lazy" nurses are, when some really don't have a clue about what it is we have to do, and don't realize there's a reason we only have 5-6 patients, while they have 10-15. And, sure, there are some lazy nurses out there, too, who don't want to change a bed or help a patient to the bathroom. That is their problem, and it doesn't do the aides any good to gripe about it, because really.....does it solve anything? What can you do about it? Is that the kind of environment you want to work in, one where everyone gripes about what others don't do? I sure don't. As a nurse with 8+ years of experience I have learned which aides I can help and which ones gripe no matter what......and those are the ones I let work alone. I don't want to be around them! It makes the shift go by faster and is much more pleasant if everyone works as a team....but they also need to do their own jobs. And my aides know they can come to me and ask for help. If I can't help right away, I say so. Either they understand, or they don't. I used to work in management and I told them....if my door is open and you need me, ask. If I can, I will help. If you don't ask, I won't know you need help. They took me up on that when needed, and never took advantage. The plus side.....a good shift, and fun to work with coworkers. Its not "my" patient, or "your" patient. It's OUR patients. Once people learn the value of teamwork, its amazing how much the OT drops and morale improves. I worked in a facility that was frequently short staffed of aides. Morning or bedtime when they needed to get people up, I would prioritize the things I needed to do first, then we'd get people up or put people to bed. They start at one end of the hall, I'd be at the other and we'd meet in the middle. Then when I wasn't working they'd tell me how much smoother things went when I was. Examples. Teamwork. People should try it more often.

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At my work, when I come in at 6:45am to get report before my shift starts the night shift usually gets vitals for me. I return the favor before they come on too. I know the feeling of vitals taking forever, and at dinner time if I have patients that are unable to eat due to the diet they are on, I do their vitals first and check them before I leave them. When call lights are going off I typically have to leave my vital machine in the hallway to the side turned off, and go as quickly as I can to that patient, and sometimes if they need something as simple as more water, I get it for them and before I give it to them I get their vitals. I wish I could say challenge your policy, but that may get you in trouble, or maybe just go up to the DON and ask that person about how to make this new policy work.

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Specializes in Long term care.

All you can do is your best.

Set priorities. If some patients don't get fresh water at the end of the shift and the trash isn't taken out or the rooms not tidy....so be it.

You can only do what you can do. So do the important things first and all the others as time allows. If supervisors want to know why no fresh water was passed tell them vitals needed to be done and patients needed to be toileted...

It is what it is.

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I've worked for two major hospitals and thats pretty basic. On med/surg its basic to get three vitals a shift. For night shift its 1900/0100 and 0500. ICU is q1 hour, and rehab is once a shift. Its very doable.Where we are at we can have up to 18 patients per tech. We come on shift, get report, ( i then always look at my own orders) while getting report you hope no lights go off. Then I clean my vital machine, get ready and go get vitals. While im doing vitals i change the boards of who the staff is, get I/Os, and anything each patient needs or wants. I am usually done by 8, and finish charting by 830. Then its time for accuchecks and nighttime snacks, as well as another round of I/Os, turning, repositioning or bathrooming people.

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