Sunday, 29 March 2009

The Stethoscope Tag

I was tagged by both Little D, S.N. and Undergrad RN for this one.

Here are the rules:
1) Post a picture of your stethoscope
2) Tell what you love about it
3) Tell what you hate about it
4) Tell me what your dream stethoscope would be
5) Does it have a name?
6) Tag all your nursing friends (Including the one that tagged you) and don't forget to leave a comment on their blog telling them that you tagged them!

So they are both about to have a WTF moment.

We don't have stethoscopes as nurses or student nurses over here. Actually that's a little inaccurate. We do HAVE them. We just don't use them so prolifically.

From what I can tell Student Nurses / RNs across the pond (like we do just not as often) use them for measuring BPs and listening to lung sounds and heart rates. We don't commonly take manual Blood Pressure measurements. For some patients we have to but mostly we use digital machines like Dinamaps. OK mine doesn't have a thermometer on the side but it's just the same thing.

I have done manual BPs but not in a long time. When you have say 12 patients under your care and you need obs on all of them it's not really enough time to do manual BPs.

As for listening to hearts? I've done that. I've heard the sounds of mechanical heart valves. But again we don't do any of this routinely.

Lung sounds? Only in my ITU placement so far and really only then because of the risk of Ventilator Acquired Pneumonia. So there you were checking for air entry into the lungs at the top and bottom and any other noises like crepitus.

If you're looking for a stethoscope on the average ward around here you better start by finding the crash trolley. There'll usually be one hanging off of that.

I remember working the neonatal clinic in an outpatient's department as agency one day when I walked into the consulting room and the docs stethoscope was lying on the desk. He caught me staring at it and I said "That's a tiny stethoscope."
"It's for tiny patients." He replied. See because I'm working with adults most of the day it's easy to forget that we start of as little human beings, who need equally little equipment.

Sorry guys I don't have my own stethoscope. I have a pen torch for doing neuro obs and measuring tape for sizing TED stockings if they count as specialist equipment.

I have no-one to tag I guess. Unless of course Cellar Door has a stethoscope moment she would like to contribute?


undergrad RN said...

why, yes, that IS a wtf moment! :)

little d, S.N. said...'s routine over here to do lung and heart sound checks every shift or every day, depending on how stable the pt. is. Also, we do bowel sounds post-op, and daily if the pt. has any signs of distress.

WardBunny said...

Bowel sounds is the doctor's department. We leave that up to them. Well I guess after some operations in some wards we might be expected to check but paralytic ileus has other symptoms that we look for first though.

Ah I've not picked up a stethoscope in maybe a year? We don't get to play with the good stuff!

cellar_door said...

Hah! You're kidding, right? :o) If the general nurses don't have 'scopes then the mental ones certainly don't! I did a few manual BP's on my first and second placements, but only because I wanted the practice - everyone else uses the digitals. You will almost never find a stethoscope on a psyche ward, and you usually have to hunt around the unit for the BP machine...

WardBunny said...

I was slightly kidding. Thought you might have had a opinion on the subject.

Yea digital machines are everywhere! Guess psych wards don't really need that stuff.

cellar_door said...

Well, we should have that stuff, given that most of our patients are on pretty serious medications that can really fuck you up, but this is the NHS :o)

I do wish I got to play with more fun nursey gear though...a pool cue doesn't really cut it as a fun piece of gadgetery....

Karin RN said...

Wow, my first required toy in nursing school was stethoscopes, before scissors, hemostat, and penlight. I can't almost work without it now. It lives in my purse.

Sandra May said...

Do you really not do manual BPs? I do them all the time! In fact, I prefer it. I have my own steth too. It has my name on it!

I do listen for bowel sounds, and breath sounds, and also i have listened to heart sounds but i don't understand what the hell i'm listening to!

WardBunny said...

Never listened for bowel sounds, never had to. I did 5 weeks of listening to breath sounds so I at least think I know what I'm going for there.

Haven't done a manual BP since I left community and that was over a year ago now.

We aren't required to buy anything except a couple of textbooks. Everything I carry in my pockets is mostly stolen!

lifeinthenhs said...

I do listen for bowel sounds, and breath sounds, and also i have listened to heart sounds but i don't understand what the hell i'm listening to!

I guess that means that this is the time to question why you carry a stethoscope, since no nurse would do something they didn't understand would they?

differentlysane said...

I have my own stethoscope...

We do manual BPs (mental health ward) otherwise one of the qualifieds will go off a rant about the inaccuracies of the digital machines.

Is it just my Trust that's full of sphyg snobs?

Take care,

WardBunny said...

lifeinthenhs - Julie - Like say handing out drugs when you don't know what they do or what a standard dose would be?

differently - Not met a sphyg snob yet... We just want those 12 obs done FAST. So long as it is in the ballpark of accurate. Digital is probably better than my Manual BP anyway.

I want my own stethoscope now!

Karin RN said...

Manual BP is superior to digital especially when the blood pressure is very low, say 70/30. Digitals are not as accurate when the actual reading is very low...

WardBunny said...

Yea our machines can't handle extremes of BP readings but in a surgical ward where mostly the patients are stable it's not a biggie.

The most accurate I've seen was an Arterial Line (fiddly little things to set up!) but you won't see those outside of the ITU/HDU.

sandra may said...

The reason, you see, that I don't know what the hell im listening to with heart sounds is because i'm a student and i'm learning! Breath sounds and bowel sounds is fine. Although obviously I don't understand it fully, but I can recognise what SHOULDN'T be happening because I know what normal sounds like. I'm clearly no expert.

I listen because I am taken to the patients and asked to listen by the nurses i am with and i will tell them what I can hear, which they explain to me.

That is how I am learning- if that is quite alright with you!

Lelo said...

its good but tell me how can one love his/her Stethescope when its a routine for them...

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