I am trying to help my wife out. She is in her senior year of her nursing program. She has never been able to take blood pressures accurately. The way she describes her problem is that she hears her own pulse in the stethoscope instead of the patients. She doesn't seem to be getting any help from her instructors, in fact the current instructor is "God's infallible gift to nursing" so therefore can not imagine anyone else having problem that is legitimate. Has anyone heard of someone else having a similar problem? How did they work around it? My wife's instructor says she aware of some nurses paying other nurses to take BP's for them because for one reason or another they are unable to. Thanks in advance for your help.
Dan
I've never heard of paying someone to take blood pressures for you but you can hear your own pulse in your ears. Does your wife have a friend in the program who can help her listen to b/p's with a dual headed stethescope I'd hope they have at the school? Sometimes they are very difficult to hear. Maybe she needs a different stethescope. In the program I was in and the one I teach in they wouldn't make it out of 1st semester if you can't take a b/p. Is she able to listen to a pulse?
I would say she needs a better stethoscope- I also have never heard of nurses paying others to take blood pressures, and I also have never heard of a nurse making it to her senior year without being able to take a blood pressure. Most facilities now have automated blood pressure cuffs, but taking a manual blood pressure is still a "must-have" basic nursing skill. I use the Littmann Cardiology III, and I like that it is dual-sided, so if I have a hard time hearing something with the regular diaphragm, I can turn it around & use the higher-frequency bell. A good stethoscope may cost more, but you definetly get what you pay for.
Could she be using her thumb to hold down the bell? The thumb DOES have a pulse of its own. And yes, some places do have electric BP kits. Is she able to use those?
'Cat'
djmac; ask your wife to register here & post her own description of the BP process. Then, we can get a better picture of the problem.
... my 2 cents
I have seen a few nurses place a pillow under the arm of the patient the bp is being assessed in. I agree, she needs a better stethoscope too. There are alot of shabby sthethoscopes out there. Better to buy a good one then continue with this problem.
With the limited knowledge provided I agree that a quality stethoscope such as the Littman Cardio III could help. Ensure she reviews the procedure for using a diaphragmatic stethoscope.
I had that same problem during my first semester of nursing school. The problem was my stethoscope. The bell of it was turned around so I couldn't hear anything. Don't know if that could be the problem or not but thought I'd share because I know how frusterating it can be.
Just my .02 here but I have to agree with the person who commented on making sure her thumb isn't on the bell, and also the person who said to make sure the bell was in the right position to hear thru it. I have an Adscope and a Littman (the Littman was a freebie).
Craig
Good News! I found a digital scope with volume control and she said it works great. Thanks for all your helpful comments.
:houra: Glad to hear it, dj! I know for a fact that, nowadays, students in my area are required to be CNA's before hitting the floor
clinical-wise. Probably because there is soooo much to learn 'LPN/RN' wise....
Hope your wife drops by the forum; we'd love to have her here, too!
'Cat'
djmac wrote:I am trying to help my wife out. ... The way she describes her problem is that she hears her own pulse in the stethoscope instead of the patients...
Dan
How about asking her to check and make sure she is not touching the diaphram part of the scope with her fingers but rather holding the end like a pen, just before the bell?
Also, tell her to ditch the scope for a second and place her fingers where the scope would be and to feel for a pulse. Once she has a pulse have her inflate the cuff until beyond where she can feel the pulse. Next have her slowly deflate the cuff-->at the point she feels the pulse returns ought to give her a great idea of where this patients Systolic pressure is.
Now she also knows exactly where the pulse to place the scope on is and (also don't forget to make sure that the part that leads to the head is turned open to the side she is putting down on to the patient). If she is unsure which side of her scope head is open have her put the earpeices in and tap on one side then tap on the other, this should give her a GOOD indication as to which side of the scope the piece is listening to. If she puts her fingers over the open side then she is only going to hear her own pulse too.
Give us an update, okay?
Gen
djmac wrote:Good News! I found a digital scope with volume control and she said it works great. Thanks for all your helpful comments.
Hi,
A digital scope with volume control?
I like the volume control but, what is the digital part?
Gen
Gennaver wrote:Hi,
A digital scope with volume control?
I like the volume control but, what is the digital part?
Gen
I don't know the precise technology involved but the somehow this battery operated steth amplifies the sound as much or as little as you need. Even the amount of tension place on you ears by the ear piece is adjustable.
