As a first year student out in practice I’m often asked to “check the obs”. In practice this is one of the most fundamental parts of nursing care as observations show what’s going on inside the body.
The hardest clinical procedure to master? I would have to say manual blood pressure, as I found that this takes practice and a sensitive ear.
On one occasion I was shadowing the sister, so the pressure was on. I tried my best to make a good impression by asking relevant questions and looking interested.
I was observing the admission process and had to check the patient observations. But when I reached for the cuff of the blood pressure machine, sister handed me her stethoscope, and said “manual pressures are the best way.”
I smiled and took it. Suddenly I thought back to my theory and practical session where we discussed principles of observations and how to gain consent according to the NMC (2010). I had memorised the safe ranges according to the Royal Marsden (2011).Then I thought about how it had taken me ten minutes to find the brachial pressure when practicing at university.
Calming my rising panic, I composed myself and figured this could go either way - success or failure. All I could do was appear confident and take my time and hope to hear the Korotkoff sounds. As I approached sister I decided honesty was the best policy and said “I am a little out of practice.”
I secured the cuff and placed the stethoscope over the brachial artery closing the valve and slowly started inflating the cuff. I watched the dial rise and saw it bounce. I could feel both sister and the patient watching me, I concentrated and finally heard a thudding sound. This was the systolic pressure, I breathed slowly, released the valve, and as the sound disappeared I noted this as the diastolic pressure.
I’d done it. What a sense of relief - I had completed the manual blood pressure successfully.
From this experience I learned to have confidence in myself.
I now try to do manual blood pressures whenever I can. If I become out of practice my confidence will drop.
I’ve got to remember that I am a student and can only learn effectively if I am able practice my skills.
Nicola Pountney is a second year student studying adult nursing at Wolverhampton University.