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 ER, ICU, Infusion, peds, informatics.
i worked with some fellow aides in ltc who would guess at bps, because they could not hear them...

these were folks who had been doing the work along time, and it was just plane too embarrassing for them to admit they needed training. the nurse alway commented that it took twice as long for me to get my vitals than it did the other girls. oh well.;)

i briefly worked as a cna in a ltc facility while i was in nursing school. one of the aides laughed at me for taking a bp with the cuff/scope. he told me to double the pulse to use as the systolic, and then use the pulse itself for the diastolic. :nono: i'm a little surprised none of the nurses ever noticed.

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Specializes in ACNP-BC.
i briefly worked as a cna in a ltc facility while i was in nursing school. one of the aides laughed at me for taking a bp with the cuff/scope. he told me to double the pulse to use as the systolic, and then use the pulse itself for the diastolic. :nono: i'm a little surprised none of the nurses ever noticed.

ok, that is horrible! :uhoh3: why do people work in healthcare if they're not going to be responsible? that cna should be fired!

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I worked with some fellow aides in LTC who would guess at bps, because they could not hear them...

These were folks who had been doing the work along time, and it was just plane too embarrassing for them to admit they needed training. The nurse alway commented that it took twice as long for me to get my vitals than it did the other girls. Oh well.;)

Guessing VS places the patients in danger. :nono: :nono: Are the nurses aware that this is going on? This is serious.

Initially as an RPN student (many years ago) I had trouble listening for Korotkoff sounds when I was learning to do manual BPs. I worked with my instructor until I felt confident that I was doing it right. On patients that I have trouble finding the sounds, I locate the brachial artery to ensure proper placement of the stethoscope.

BTW I would have no problem helping any tech become more proficient at manual BPs, pulses, etc.

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I was working for a home health agency, actually hospice, and was being observed by an RN ( I am an aide). The RN took the pt pulse and BP with an electronic cuff. I took it manually. I Kept getting a pulse of about 68, and she kept telling me, no that is wrong, and eventually she told me it was 120. She never just reached over and felt the pts. pulse. The pt had a tremor in her arm. Her pulse was hard to feel, but I took it several times and got 68, sometimes 70. After the RN left, the patients spouse said to me, her pulse is never 120! Well, I know that it could have been elevated, but, darn it, though I did not pass my pulse taking in that evaluation, I could not for the life of me get 120. That made me wonder, am I that bad at counting, or are those darn electronic cuffs sometimes goofy?

The RN was WRONG in this situation. She should have re-checked manually. ANY pulse reported that high should be checked apically.

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Specializes in Telemetry, ICU, Psych.
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.

This is so true!!!

CrazyPremed

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I want to comment on the post above. I am a student also and exposed myself to the used of manual bp taking. but i have a problem of it. Sometimes i can not hear the exact systolic and diastolic for my patient during our hospital exposure. especially you are caring for 2 pt. i hate doing it and repeating to pt. soemtimes its too painful for the patient to feel because of repeated procedure. I guess it's better to use an automated bp . however if the hospital your working with, does not have one its really disgusting and a problem anyway. If i were to ask,I would prefer to use the operated one, but how can i have one if its forbidden to use in the practice of nursing while you are still a student. I wish when i work i would use the automated one..... Gud luck and pray for better health care facility in my country philippines.

I pray you become more proficient with manual BPs. Palpate for the brachial artery for proper placement of your stethoscope. Automated equipment does not equate better health care.

KUDOS to all nursing instructors who do not allow students to use automatic BP cuffs.

BTW as a nurse, I do not have a problem helping any student who told me they were having difficulty with BPs or anything. They are there to learn and I do consider it part of my job to facilitate that learning when they are on the unit.

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by a CNA to take a manual bp, I feel I cannot trust them to do a good job if they resent doing it.

Couldn't agree more !

It IS rather disconcerting.......... :uhoh21: as WELL as frustrating to the nurses as Caroline states above.

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Specializes in Telemetry, ICU, Psych.

I've worked as a phlebotomist in hospitals for five years. Whenever a bleeding time (an archaic clotting time test) is ordered, we have to ask a nurse on the unit for a manual blood pressure cuff. 9 times out of ten, the first two don't know where it is kept, and we are off a wild goose hunt. When we do find one (or if we try to use the one in the room), it is broken, or not the right size.

I hate to say it, but (at least in the hospital setting), I think just as many nurses as techs rely too much on the automatic BP machines!

Because this happens so much, my lab mangers just bought a manual cuff for us to carry up to the floors! :chuckle

CrazyPremed

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Specializes in Oncology/Haemetology/HIV.

Because this happens so much, my lab mangers just bought a manual cuff for us to carry up to the floors! :chuckle

And what does Infection control have to say about that???

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Specializes in Obstetrics, M/S, Psych.
And what does Infection control have to say about that???

Do most facilities have disposables now? Curious. I haven't seen them used around here, but that's Maine for you anyway. :p

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Specializes in Oncology/Haemetology/HIV.

No, but taking one cuff throughout an entire facility sounds pretty hinky to me.

Then, I work hemo/onco...way too many neutropenics with resistant infections and high risk for Cdiff to go room to room with the same cuff. That is why the scopes and BP cuffs in each room.

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Specializes in Utilization Management.
I briefly worked as a CNA in a LTC facility while I was in nursing school. One of the aides laughed at me for taking a bp with the cuff/scope. He told me to double the pulse to use as the systolic, and then use the pulse itself for the diastolic. I'm a little surprised none of the nurses ever noticed.

Yanno, that might explain the time I found a NH patient with a BP of

44/20. Yes, it was THAT LOW. I had two other nurses confirm it because I couldn't believe my ears.

I don't know how that patient remained sitting in her W/C!! At that facility, the CNAs took vitals and patients were medicated based on those vitals.

Now I wonder how long it'd been since someone actually took her real vital signs! Don't these CNAs who fake vitals realize that they could literally cost a life??? :madface:

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