Vital Signs - what's your routine??

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Specializes in School Nurse.

Hey guys -

Not sure if I am posting in the right place, but I am a nurse intern (read: nurse aide, but I am in nursing school so I get this title ;) and I just do NOT have my routine down for getting vital signs. I usually have to do ~12 patients as soon as I start my shift and often that takes me 1.5 - 2 hours. I think I talk too much, and I also ask the patients if I can get them anything while I am there which opens up a whole can o' worms.

So...how do you do it? In what order? And WHEN do you count respirations? I can not seem to get that one down without the patient saying "why are you staring at me?".

Thanks for your help -

L.

Specializes in CNA in OB,ER,ICU,MS.

What I normally do, is when the cuff is inflating, I empty the trashcan,foleys etc. To get respirations I either check the pulse manually and at the same time count resp or when I'm taking their temp I count resp for 15 sec and multiply x 4. I asked pt if they need anything or what they would like for a snack , and I write it down and explain I will be back w/ it in a little bit. If they are diabetic I explain that after the nurse checks their bs I will get their snack. Our medsurg unit is set up in "pods" with 8 rooms in each pod ( except for 2 pods) so once I am done w/ each pod, I chart my vitals and get the snacks or whatever it is they needed.

Specializes in LTC.

I always slap the bp cuff on their arm and the thermometer in their mouth so they can't talk to me while I'm counting respirations.

I count respirations after I take the pulse. I keep my fingurs on the wrist and act like I am still taking the pulse so my pt's won't know that im am watching them breath (somtimes they will breath diffrent if they know your watching them). Then I take bp and temp.

I agree with the poster above. It makes things easier to take respirations after taking the pulse. Since if they know you are watching them breathe they may inhale a little faster, ect. Also I would do my vitals in the order they are known TPR's,( Temp,Pulse,Respirations) after BP. I guess doing BP gets them in the mode of knowning you are about to do their vitals and be there a minute,lol.

Specializes in School Nurse.

Thank you all for your responses! At my hospital we use a dynamap and the pulseox takes the pulse. We also use a temporal thermometer which takes 1 second. I usually try to count respirations while the BP cuff is inflating, but inevitably the pt asks a question and I lose track. Ugh. I know I will get a rhythm eventually, but it feels like it's taking a while!

L.

Specializes in LTC.

If you can't get respirations while taking a BP, do a fake pulse. I'll just toss my fingers on their wrist and count their respirations instead.

:heartbeat:heartbeat:heartbeatI am also completing my internship. . and I sometimes feel uncomforable counting respers by pretending to take the pulse . . I feel awkward standing there that long not talking. . .SO. . .when I'm doing my heart and lung sound assessment. . I will put my stethescope on their chest to listen to heart sounds (tell them to breath normally) after I have listened to the heart I'll just keep my stethescpe there and count their respers. works for me!:heartbeat:heartbeat:heartbeat

Specializes in ICU.

Just like everyone else, I do the same, when I take the BP I count or I do the fake pulse one.

About the staying to long in the room, same with me. I come in and start the vitals and it takes me over an hour with just 9 or 10 patients. Don't feel bad, I can't leave my patients dirty if they need to me change, or want water, another blanket, coffee or etc., I need to do it right away. That's ME!

Same goes with me, usually i place the patient's wrist on their chest,and count the pulse for 15 sec times by 4 and the other 15 second for their respiration. Stick thermometer in their mouth if using manually. Then will only ask them what they need while checking the BP.

Specializes in Nursing Home ,Dementia Care,Neurology..
Same goes with me, usually i place the patient's wrist on their chest,and count the pulse for 15 sec times by 4 and the other 15 second for their respiration. Stick thermometer in their mouth if using manually. Then will only ask them what they need while checking the BP.

15 secsx4 works fine for regular heartbeats but an irregular one would require a full minutes count.Same with anyone with an irregular respiration pattern.

Specializes in CNA.

You must talk too much! :nono:

We had to do vitals in the hospital at beginning of shift, and during the shift too. We basically did 12 patients in an hour. There were too many other chores that needed to be started to take any longer. We had machines for this --- I assume you're doing this automatically rather than taking manual BP's (unless we had to use standard precautions and used a steth left in the room for that patient.

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