Wednesday, February 16, 2011

A Well Orchestrated Vital Signs

At my job, we check patient’s vital signs every morning: temperature, pulse, respirations, blood pressure and blood oxygen level. Most of the time our machines don’t work as well as expected but there was one instance a couple of weeks ago when it felt like every individual piece of equipment worked very well in concert with each other.
On a night when the planets did not exactly align due to extreme busyness – from early and frequent admissions and patient transfers from another unit, to the regular charge nurse being on vacation, one thing at least worked out very well towards the end of the night shift. Our blood pressure machine is usually buggy. By that I mean sometimes the battery doesn’t charge fully so in the middle of checking the patients, it just dies, or doesn’t detect a patient’s blood pressure on the first try.  But when all the equipment works in unison, it feels like a well oiled machine or even a well orchestrated musical piece. Here is what happened: I enter the patient’s room and ask him or her if I could check their vital signs. When they assent, I attach the blood pressure cuff on their arm, push a button to inflate it, then I stick the thermometer in the patient’s mouth. I leave it there and attach the pulse oximeter on the patient’s finger. About the time that I do that, the thermometer beeps to indicate the temperature so I withdraw it from the patient’s mouth while the pulse oximeter also finishes it’s reading along with the blood pressure machine which shows blood pressure and pulse. In the meantime I’m recording all of this information on a sheet of paper with the patient’s names on them. With no bugs in the equipment, all these take only about a minute before I see the next patient. So for the 12 patients I’m assigned to, all the vital signs were done in about 15 minutes because the machines worked so well together, and that includes the time I go from room to room. Wow! I wish that would happen all the time. I mean, who exactly would blog about a mundane task like checking blood pressures? But I just had to share the experience because it was something that doesn’t happen very often to me. I felt like a conductor leading an orchestra playing beautiful music where all the instruments blended well with each other.
Speaking further of vital signs, I recently observed one of my coworkers do orthostatic vital signs and was appalled to see that he didn’t know how to do it properly. He took the patient’s blood pressure in the standing position first, then sitting the second time. Well, orthostatic vital signs are supposed to be taken from a lower position first to a higher position (lying to sitting to standing) to see if there is a sudden and huge drop in blood pressure. After seeing my reaction, I hope he knows now the proper way of doing it.

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