What happen to taking Vital Signs???

Nurses General Nursing

Published

Sorry, but I must vent.

I am at a hospital, that has a BP cuff and a stethoscope in EVERY room.

So why is it that no one can possibly get vital signs without access to a dynamap???

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When I was a tech, I worked in a facility that did not have access to dynamaps on the MS floor, and we did VS manually...ALL of them. But it seems that the techs at the facilities that have been at, are physically and or mentally incapable of taking a manual BP. They have little tiff fights over who gets to use the dynamap first.

If the machine cannot get a reading, they keep trying to again until it does. And if it just will not read, they are completely mystified as to what to do.(a clue...if the patient has Afib or an arrythmia..the machine may not be able to read or may give an incorrect reading)

They get a totally absurd result but don't recheck it manually.

They spend 30 minutes trying to find the dynamap....they could have been finished with vitals if they did them manually by the time that they find it.

I have given up on the "I need a set of VS, stat."..because they would go running for the machine..it is faster to do it myself.

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The other night of my patients needed to be on the dynamap for two hours as he was having serious issues. I ask the tech for a set of VS on another patient getting blood. I find that he didn't do it...because he couldn't find the machine. Of course, he didn't let me know either. Thankfully, both patients were fine.

Really, how hard is it to do a manual BP? Especially when EVERY single room has access to the equipment.

Do any of y'all have problems with this issue?

Specializes in Hemodialysis, Home Health.
I think it is because using a machine is faster ...

So for me, it isn't that they don't know how . .. it is just that the dynamap is quicker.

steph

Yeh.. except that as the OP states, that if they are fussing and feuding over who gets it and waiting around with their thumb up their hind end to USE it........... :rolleyes:

this negates all the "quicker" and is precious time lost that could be spent doing other things that need done.

I'm sure all the techs have learned to do manuals, and it's not like you can really "forget" how... but they are wasting time with all the fussing and hunting down a dynamap.

Sheeesh... and to think that's all we used, was manual cuffs (well.. SOME of us "oldies") :chuckle ... and GLASS thermometers which had to be soaked in ETOH... :D

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Specializes in Ortho, Med surg and L&D.
Sorry, but I must vent.

...

Do any of y'all have problems with this issue?

Hi there,

Vent away, hope you feel a little better about it.

I have also been surprised by my cohorts, (I am still a tech) reliance on those machines. While at my last job on the ms floor I made it a point to not use those. I preferred manual and did not want to loose my touch, feel or sight over taking...vitals, plus, by doing them manually the patient is the main focus, not the machine.

Gennaver

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Specializes in LTC, med-surg, critial care.

I know a lot of CNA's that worry they might give an incorrect result themselves. They aren't very confidant in thier skills and they figure that the machine will be correct.

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Sorry, but I must vent.

I am at a hospital, that has a BP cuff and a stethoscope in EVERY room.

So why is it that no one can possibly get vital signs without access to a dynamap???

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Well, every time a patient moves "different" we take vital signs. It's standard for us to take vital signs every four hours and most of the RN's and RPN's don't seem to mind. Every time there's a fall, we go running but one of us always gets the B.P. cuff. Ours are portable and very accessable. We wish we could get the mercury B.P. meters but around here it seems to be "old days" stuff.

I work in oncology and palliative care. A lot of our patients go for treatment so vital signs is real important. The rest of the hospital and region seem to think we're funny taking all those vitals signs but it's a simple basic assessment tool that helps us out a great deal.

We also have two dynamaps. Yes they get used frequently, but if a blood pressure or heart rate seems a little too unreal, we get the manual cuffs. They seem to be more accurate.

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I know a lot of CNA's that worry they might give an incorrect result themselves. They aren't very confidant in thier skills and they figure that the machine will be correct.

Personally, I have more confidence in the accuracy of a manual BP. I find that with the dynamaps, rarely are they calibrated on a routine basis.

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Specializes in Obstetrics, M/S, Psych.
Many of the techs are RN students. I personally can't imagine an RN instructor that allows all dynamap use....ours made us do manuals.

It is one thing to need a dynamap on BPs on the legs or for obese patients..quite another to argue over the dynamaps or neglect VS waiting for one, IMHO

Your right, I was digressing and wasn't clear. My thought was, they can't do them on a normal arm, let alone a complicated patient. They need the dynamap or so they think. Just because they are nursing students doesn't mean they have learned the skill. I bet if you cornered one with a manual cuff and asked them to show their stuff, they'd break out into a cold sweat!;) Actually, that isn't a bad idea...

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Specializes in ICU, telemetry, LTAC.

Checkoffs gave me cold sweats in nursing school. Then came clinical days where we helped the cna's and did the hall's vitals manually. Pulse ox and thermometer in hand, steth around neck, notebook in pocket. (That is still my preferred way to start a shift. I never fail to find the pulse ox and thermometer when I want one.) Basically you do 'em till you can stand in front of a doctor with a ridiculous reading and say that you are absolutely sure that is the correct reading.

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Specializes in Cardiac.

I would love it if someone "cornered me" to verify how to do a BP. I can guarentee that I have done manual BPs tons and tons of time more that the average nurse.

But here's the real reason. Some cna/techs want to minimize the amount of time that they spend in the room. So the dynamap is faster and while that is working they can do the temp and the pulse ox, resp and then get out of the room before the pt realizes that they need something. They the call light goes off, but they are already in another room so they can't answer it.

But to be honest, if I have 15 or 20 pts (which I never do) then I'm not taking manual BPs. Obviously, it the reading is not WNL then that is one thing, but in general most aren't. Yes, most CNAs/techs do not have steths. I lost so many when I first started that I vowed never to bring a steth to work again.

I really think there are a lot of staff members that don't really like helping pts :crying2:

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
I think this is a result of our over-reliance on technology in virtually every aspect of healthcare.

I agree.

Come to think of it, that wasn't a part of my orientation at my last job as a tech (knew how before that though).

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I am aide at a local hospital and am an RN student as well. At work, as an aide, we usually use the machine for those that are not on telemetry and are only in for maybe URI or something minor. If we do get an out of the ordinary reading, I do go and get the manual. IF we have someone who is in for HTN, CVA, Heart problems, etc. we do manuals. Isolation, they have their own equipment in the rooms. Our hospital is a very small one, so our patient to aide ratio is low, so we do have time to do manuals.

As a student, it depends on the instructor. Some don't mind if we use the machine, some want only manuals. To me, manuals are more accurate, but if we are busy and the patient is stable, we use the machines.

My instructor had told me that if she is passing meds for say HTN or other related diagnosis, she will PERSONALLY take the BP and Pulse so that she can determine if the readings are in the parameters set by the doc's orders for the meds.

Personally, when and if I become an RN, I plan to do manual BP's on my patients whenever possible, even if the aides got them. It is utimately my a** if something goes wrong, right? I am working hard to get my licence and prefer to keep it!

:p

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Specializes in LTC, med-surg, critial care.
Personally, I have more confidence in the accuracy of a manual BP. I find that with the dynamaps, rarely are they calibrated on a routine basis.

Right, but there are people out there that are not confidant in their skills especially new CNA's/Techs. Lord knows how many new CNA's I've orientated who've looked at me and said "Um...142 over 96?" because all they've ever learned is "Normal blood pressure is 120 over 80..." They get thrown into a situation where there is no "normal", most of the time patient's base line is nowhere near "normal" so they think they themselves are wrong. What do they do? They grab the BP stand and rely on that so much so they never gain confidance in themselves.

You also have to remember that the schooling for CNA's/Techs is so short that they don't have months of clinical (like nurses do) on the general public. It's generally a few weeks, you practice on (relatively) healthy classmates, take your test and hit the floor.

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Its just not practical. I am a nursing student and I work as a tech. I know how to do manual vitals, and when I am at clinical with my 1 to 3 patients and all the time in the world I take them manually. But when I work as a tech and am responsible for a whole group of patients (9-15) I just dont have time. The dynamap allows you to take bp, pulse, temp, pulse ox all on one machine, in seconds. It usually takes almost an hour to take vitals using the machine, because everytime you go in a room someone needs something (water, help to bathroom, needs to be cleaned, etc...). So I could imagine how long it would take taking each set of vitals manually. Now if it comes up abnormal- sure, I go get my stethescope and take it manually. But I would think as a nurse, if a tech came to me with abnormal vitals from the machine, I would want to recheck them manually myself. Why would I rely on the tech when there is a potential problem and I might have to give drugs based on this or call the doctor, etc.? I have heard of techs making up vitals and some will just tell you that they retook it manually. I would not want to risk my patient or my liscence that I am working so hard for.

just my opinion though. :wink2:

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