Some time you see nurses resuscitating a patient without a stethoscope hung around their neck to check heart sounds, apex beat etc
- Facts revealed that a Nurse can use a stethoscope to perform the following:
Heart Sounds
Respiratory Sounds
Bowel Sounds
Apex Beat
Blood Pressure
If you have a post op patient, you are suppose to monitor his bowel sound to determine when to commence graded oral sip.
If you have a patient with heart failure, you are suppose to monitor his heart rate (apex pulse) more especially if he is on Digoxin
Yes, someone just reminded me that you can also use stethoscope during NG tube insertion* to ascertain that the tube is in situ. But sometime nurses pass NG tube without stethoscope.
If your patient is on chest tube, you are suppose to monitor his respiratory sound using your stethoscope and report when there is abnormal sound: When you have a patient with STEMI or MI, you are suppose to watch out for abnormal heart sounds such as S3 or S4 to ascertain when patient is going into cardiac arrest or arrhythmia.
Some time nurses do rectal washout examining the bowel movement especially in constipation that arise after surgery. Abnormal bowel sound could signal post op complications such as paralytic illus.
Some time nurses do rectal washout without examining the bowel movement especially in constipation that arise after surgery. Abnormal bowel sound could signal post op complications such as paralytic illus.
Our stethoscopes are not only for taking BP at the brachial artery.
Some nurses supervises patient resuscitation to mortality without using the stethoscope on any part of the body beside the brachial artery for taking BP.
Some nurses even fold their arms watching the Doctor messing up without doing anything and the patient relatives are also watching.
The relatives sees you as a mere technician who doesn't know what to do when somebody is dying...
That is why some relations who have such experience don't always want to waste their time calling the nurse when patient's condition change. They always shout on top of their voice "Doctor! Doctor! Doctor!" Even on films it happens.
Let me share my experience about a nurse and the stethoscope. Some time ago...
I use to hang a stethoscope around my neck when ever I am on the ward. I don't hang stethoscopes on trolleys, I hang them even when we are on ward rounds, on medication rounds. Even when doing procedures like rectal washout etc
Unfortunately a very senior nurse who was supervising me on afternoon duty came around to do the routine. She asked why I was hanging stethoscope and I answered that I am using it not only for BP.
And she said: "You want to pose as a doctor"
I was speechless,
And I was wondering if she knew the function of the stethoscope to a Nurse apart from taking BP. Nurses should appear like this on the ward.
You should learn other skills of patient examination apart from taking PB.
You should know the normal and the abnormal sounds of the heart, bowel, respiration etc so that when a house officer of placing a stethoscope at the wrong point you should know.
Always make yourself a valuable team member who can offer something not just receiving orders as you may call it.
Some of us are even ashamed of using the stethoscope on other parts of the patient because of lack of confidence. Don't be ashamed, when you do that and discusses your findings with the doctor, you earn respect from the doctor and the patient.
Hang your stethoscope around your neck when on ward ward round with doctors, Don't hang it on the trolleys they are not made for trolley.
You have a lot to do with stethoscope than a doctor.
Some people think when we are saying these things, we are envying doctor but I say to them that They are wrong we are only trying to be professionals.
We will talk about Nurses dressing code and where you shouldn't go with your uniforms as a nurse next time we meet.
- Thank you!
Be a professional Nurse
Be a confident Nurse
Be a smart Nurse
Be an intelligent Nurse
Written by Iroko Ajimoh