Why do some nurses guess on BP?

BrandonLPN, LPN · Aug 3, 2012

I have been doing manual BP's for only 10 years, I have a lot to learn, so I just don't cut corners like I felt this Nurse did. I had no confidence in any of his skills for many reasons this just being one.

10 years isn't enough time to be an expert at manual BPs?

caliotter3 · Aug 3, 2012

Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.

Dixon, future NP · Aug 3, 2012

10 years isn't enough time to be an expert at manual BPs?

I say that based on what I have read from the other Nurses here. I am not yet an RN.

I am a CNA and CNA instructor doing manual BP for all of my career and I have never done a manual BP in 30 seconds or less. This is a skill I am comfortable with but I do it the way I was taught each time. I worked in ER for about 2 years as a CNA and I was constantly told work hard and fast but never cut corners!

I have heard about too many CNA's fired for falsifying vitals, never want to be amongst those!

Dixon, future NP · Aug 3, 2012

Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.

I did let his supervisor know but she was not a nurse so she said she didn't feel she could appropriately address the situation.

BrandonLPN, LPN · Aug 3, 2012

I have to admit, if I watched the needle stop at 115 and the MA said my BP was 120/80 (or something) I'd be pretty suspicious too. That doesn't add up. I suppose some might stop at the systolic and just make up a diastolic, but why not just listen for a few more seconds?

Double-Helix, BSN, RN · Aug 3, 2012

you have to look at the gauge at the same time you listen to the korotkoff sounds, or you won't know what the pressure is when you hear the first and last sounds, so you won't know what to write down.

in answer to the op's question, it's because they are lazy, never learned what the blood pressure truly measures and what systolic and diastolic indicate physiologically, or they just don't care.

don't get me started on those autocuffs (dinamap and others). these must be applied properly or they can't "hear" the sounds, and they are not appropriate to use with anyone who has an irregular pulse and an irregular pulse pressure, like, oh, everyone in atrial fibrillation! i see them applied wrong all the time (including by the ma at my pcp's office) so the readings are useless for care decision-making, but nobody seems to care.

i actually just had this conversation with an anesthesiologist at my hospital last week. he was saying that manual bp cuffs have to be regularly calibrated and tested for accuracy, but this is rarely, if ever done. he believed the automated machines to be much more accurate than manual cuffs.

Susie2310 · Aug 3, 2012

Whenever you a displeased with how someone is doing their job, you can speak to that person directly, or you can bring up the issue with their supervisor.

Caliotter3 I agree completely, and I think this is good advice, only it is not always effective. A family member and I have tried doing just this (speaking to the doctor) in regards to a situation that arose with the taking of the family member's BP. The practical result was that our observation was received courteously and the person concerned continued to do what they were doing at future visits. So I no longer consider it is worth our time to bring the issue up again. We do however keep our own BP record, which we take to the doctor, and we make a point of discussing current readings, medication, etc., with the doctor, so if the office reading appears to be suspect we have plenty of BP trend data to show the big picture.

nurseprnRN, BSN, RN · Aug 3, 2012

an automatic machine may be more accurate if the cuff is applied properly and if the patient doesn't have an irregular pulse quality. i'd probably trust an anesthesiologist to recognize that. probably.

knitsocks77 · Aug 4, 2012

Many times the patients at the clinic where I work want their home bp cuff checked so they bring it in for us to check. I always take a manual bp and write it down and then I put the patient's auto cuff on and get the reading. The numbers usually match unless, like some have said, it is a pt. with a-fib or irregular pulse for some other reason.

IsmeAmanda, LPN · Aug 4, 2012

Hello Everyone!
Why do some nurses guess when it comes to taking a blood pressure?
I am a patient, I am a CNA and CNA instructor. When I go to the doctor I do not share this information but it really bothers me when I see nurses make mistakes at the patients expense.
Yesterday I went to the doctor for a physical. I had my blood pressure checked by an LVN, a nurse, I was shocked that he guessed on my blood pressure. It took him about 30 seconds from placing the cuff to reading my BP. He didn't bother checking for brachial artery, stethoscope placement was wrong, blood pressure cuff placement was wrong and in my opinion BP was just a guess based on looking at sphygmomanometer. We all know that you cannot get an accurate blood pressure reading this way.
I tried to be very nice about it by saying my blood pressure is never that high, can you please re take it? He did but he did it the same way as the first time.
Please explain if you know, is reading a blood pressure that hard?

I've seen people take BP crazy different ways. I think they dont want to take the whole minute to do something. I have been to LTC facilities where CNA's didnt even know how to take BP.

SORRY BUT ITS NOT ROCKET SCIENCE YA'LL.

nurse doll face · Aug 4, 2012

I hear what you are saying. As a nurse, I do admit to taking short cuts. But it's not hard to take a bp once you have done it a few times. Even though that nurse took that bp in 30sec or less doesn't mean it's not accurate. As far as checking for placement ; once you know the anatomy of the body and where things are located there is no need to palpate the brachial artery everytime for a bp. But yeah, the bp is suppose to be checked until the cuff completely deflates. As CNAs do you know the rationale for listening to the bp until the bp cuff completely deflates and understand the concept of bp?

there are certain things to know about the bp besides placement and how long it take to get a bp. Even if a person has been taking a bp for 20 yrs good placement and all. One must understand how the heart works and the rationale. Not knocking the cna role. I worked as a cna for years before I became a nurse and even though I knew how to take a bp I didn't understand the bp, heart or the rationale

Behind it.

Dixon, future NP · Aug 4, 2012

I hear what you are saying. As a nurse, I do admit to taking short cuts. But it's not hard to take a bp once you have done it a few times. Even though that nurse took that bp in 30sec or less doesn't mean it's not accurate. As far as checking for placement ; once you know the anatomy of the body and where things are located there is no need to palpate the brachial artery everytime for a bp. But yeah, the bp is suppose to be checked until the cuff completely deflates. As CNAs do you know the rationale for listening to the bp until the bp cuff completely deflates and understand the concept of bp?
there are certain things to know about the bp besides placement and how long it take to get a bp. Even if a person has been taking a bp for 20 yrs good placement and all. One must understand how the heart works and the rationale. Not knocking the cna role. I worked as a cna for years before I became a nurse and even though I knew how to take a bp I didn't understand the bp, heart or the rationale
Behind it.

Honestly, I didn't learn the rationale behind the BP when I did my CNA training, I learned it on the job. This is not something that they teach CNA's.

Now that I am an instructor I teach all my students because I don't believe in performing skills unless I understand why I am performing them. I believe blood pressure is 1 of our baseline skills and also very important. But the drawback is that a lot of CNA's don't understand the anatomy of the body so it is more difficult to teach.