Do you carry around your stethoscope?

4 I carried my stethoscope when I first started my job on the floor. I was being the "good new nurse" and did head-toe assx, check for PERRLA on a regardless of patient's neurostatus, checked for 4 points pulses, auscultated for breath sounds, APETM, etc etc, then I stopped using stethoscope completely for quite long time.

Especially at the ER, I feel that stethoscope was almost of no use. When I was on ER transition, I listened to breath sounds but soon recognized that it was almost waste of time mainly because almost everyone gets chest xray. But I started carrying stethoscope again recently and this is why. I feel that when I actually listen to the patients' lungs and breath sounds, it seems that patients trust me more, they like it more than me just coming in, hooking them up to monitor and asking mundane questions. That is actually the biggest reason I use my stethoscope now. In terms of outcomes, of course it serves no use because doc will order xray and know if there's effusion, atelectasis, or pneumo, but one, I like to be able to depend on skills instead of imaging tools to know what's going on, and two, patients react positively to that. I see that this is why docs put stethoscopes on patients "just as act" even though I know for sure he/she's not listening, but somehow that probably assures the patient.

Anyways, that's been my experience with stethoscopes. Do you carry yours and use them, do you think it actually matters? I don't but I use them for above reasons. What do you do?
Oh yeah, I definitely carry mine. It even has a little "sweater" around it so I can wear it around my neck at all times without my neck oils messing it up. There are always times that pop up that someone needs it - auscultating a heart beat for time of death, new NG/OG insert, change in breathing pattern, etc. in addition to q4h assessments. I can see why in the ER you might not need it as much, but if a patient doesn't have routine CXRs ordered, a change in lung sounds would be the only alert for newly developing fluid overload, effusions, and things like that. I would constantly be running in and out of the room for it if I didn't have it on me.

I am always befuddled by your posts. As a life long (well almost life long) ER nurse...I find listening to a patients chest imperative in assessment and treatment. I am confused by your "short cuts" of things you find....unnecessary.I can't for the life of me use my active imagination to comprehend that the use of the stethoscope is "just an act".So you have a trauma that comes in with chest trauma from the seat belt...you actually find it unnecessary to listen to lung sounds? What do you document then?If you were a nurse in a department I was working or in charge of...I would have to have a serious conversation about your assessment skills....or.......you just like starting controversy here.

No, in our transplant unit the patients all have their own crappy stethoscope in the room that we use for that admission and throw out when they're discharged. I keep my Littmann in my work bag and Lysol it and use it if I can't hear well or suspect there's more going on than what I hear.

Quote from Esme12I am always befuddled by your posts. As a life long (well almost life long) ER nurse...I find listening to a patients chest imperative in assessment and treatment. I am confused by your "short cuts" of things you find....unnecessary.I can't for the life of me use my active imagination to comprehend that the use of the stethoscope is "just an act".So you have a trauma that comes in with chest trauma from the seat belt...you actually find it unnecessary to listen to lung sounds? What do you document then?If you were a nurse in a department I was working or in charge of...I would have to have a serious conversation about your assessment skills....or.......you just like starting controversy here.

Nope. I've always worked L&D and don't even own one!(except the crappy one we got for free in nursing school)

Quote from Esme12I am always befuddled by your posts. As a life long (well almost life long) ER nurse...I find listening to a patients chest imperative in assessment and treatment. I am confused by your "short cuts" of things you find....unnecessary.I can't for the life of me use my active imagination to comprehend that the use of the stethoscope is "just an act".So you have a trauma that comes in with chest trauma from the seat belt...you actually find it unnecessary to listen to lung sounds? What do you document then?If you were a nurse in a department I was working or in charge of...I would have to have a serious conversation about your assessment skills....or.......you just like starting controversy here.

Just out of curiosity, what do you document for lung sounds then? I mean do you make it up or something?

How, exactly, do you determine wheezing via chest x ray? What about response to nebs or diuretics? Do you re-scan people after lasix?

I use mine daily at work and I am a postpartum nurse. However, if I am swamped and have to do a more focused assessment I will skip the auscultation parts of my assessment. I would only do this on mom that is a vaginal on her way out the door without any health hx or complications.

Btw- I do not chart anything I don't do.

Quote from blondy2061hDo you re-scan people after lasix?

Quote from tarotaleHaha no one is starting controversy. I'm not talking about trauma situation, I'm talking about your everyday sob, cp, abd pain, etc etc. I get what you are saying. But so what if pt wheezes or has rales? Does you knowing this or charting it really have an outcome or any effect? I'm not talking about stridors or intubation, just regular situations. Ya I can tell the doc the pt is wheezing but he probably already knows that and ordered bd. Please do tell, what does it change? That I know what the lung sounds like? So what, are you going to prescribe antibiotics?