My Duties as A CNA: Taking Vital Signs

As a CNA you will receive your work assignment and gather your equipment needed for the shift.  One of the first tasks that needs to be done is the taking of vital signs of your patients. Vital signs are the cornerstone to health assessment, giving the medical team insights to the overall health of our patients. The six vital signs are Level of consciousness (LOC), Heart Rate/Pulse (HR/P), Blood pressure (B/P), Respiratory Rate (RR), Temperature (T), O2 Saturation (O2 SAT).

There are a few things to remember as you enter a patient’s room and in time becomes part of you in a fluid movement. Depending on your shift, especially the night shift do not throw the lights on for it is disturbing to the patients. Address each patient station with the individual lights above their beds.

Prior to taking your vital signs remember to wipe off your equipment with the proper cloths per the facility you work at. Wash your hands prior to each patient’s vital signs.  If you are wearing gloves they need to be changed after each patient as well. You should get in the habit of washing your hands after the third or fourth patient even if you wear gloves.

Level of Consciousness is being able to make sure that your patient is alert and oriented. Don’t forget from your shift report you will already know which of your patients have difficulties from confusion, dementia, Alzheimer’s or possibly sedated for no interaction. Remember each patient is an individual.   Always introduced yourself to your patient and tell them what you are doing. One thing I always made sure to do is let them know the date and time of the day. Being in a hospital the days tend to blend together. Most facilities today have white boards at each patients station you can write your name, date, and patient diet.

Heart Rate/Pulse are important for the nurses to know especially for giving out medications. I always used the Na’s vital signs as my baseline. I took my own vitals when giving meds. Normal Heart Rate is 60-100 beats/minute.  Less than 60 is considered bradycardia meaning slow heart rate. Greater than 100 is tachycardia meaning to fast a heart rate. These findings are all individually based per patients and their issues of concerns for being in the hospital. Your clinical instructors will teach you the correct way to listen and feel for the heart rate and pulse. It is very good to hear and feel. Today a lot of equipment in the facilities are digitalizing. My way was with a stethoscope and sphygmomanometer. I always felt more of an accurate reading. Old school.

Blood Pressure is taken with a sphygmomanometer. It can be used on either arm. There have been times we needed to use a leg. Yes, it is not impossible to be done. Place the cuff above the crook of the elbow and ensure that it fits appropriately not to tight and not to loose. A normal Level of B/P 120/80mmHG. This is a guide each patient is different.

Respiratory Rate is how much air a patient is taking in or not. 12-20 breaths/minute is the normal level. Less than 12 breaths are to slow for some and can be caused by medications.  Greater than 20 breaths/minute is to fast. Patient may need oxygen or just helped to slow their breathing. Some patents become anxious when in the hospital and just need a little comforting and reassurance. They may be wearing oxygen masks or nasal cannulas. As a NA you can make sure the mask is on and that a nasal cannula is in the patients’ nostrils. Do let you team leader know the patients that needed to be helped with replacing. Sometimes the patient’s confusion may need guidance to the need for the oxygen. Your clinical instructor will teach you how to count and observe the respiratory rates. Part in hand with the RR is the Oxygen Saturation level. Normal is greater than 93%.  I always did the O2 Sats. But explained the necessity of keeping above 93%. Our patients were on cardiac monitors so it was easy for the NAs to review the saturation levels and report.

Body Temperature can be tested orally, under the arm pit or even rectal. Your team leader will tell you if she needs other than the oral way. Just remember if you do a Rectal temp the thermometers are differ from the oral ones. Most facilities have them color coded blue for oral and red for rectum. Just be aware. Body Temperature normal is 98.6* F (37*C). Hypothermia is less than 95*F (35*C). Hyperthermia is greater than 104*F (40*C). Remember the feel of the patient’s skin can also let you know what is going on with the patient. To hot, to cool or the color is off.

The best thing to remember is that each patient is an individual and will have different vital signs based on their disease process. Always report any abnormal findings immediately to your team leader so they may address the issue and take care of the patients needs. Therefore, promoting their health and well-being.

After completing your patients’ vital signs remember if necessary to put up siderails, have the call bell with in reach, place any personal items near the patient for easy reach. One of my pet peeves as a nurse was when the water pitchers were not filled for medication pass. Yes, I did fill a many a pitcher in my day.  If the person is not NPO (nothing by mouth) make sure they have water to drink.  Always ask before you leave is there anything else I can do for you.