4th Year - Clinical Essentials

[MDB74]

Analog watch with second hand considered gold standard for taking vitals in nursing.

LOL

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[CalliopeDVM]

Oh I looked it up to when he first mentioned it. But "second hand" doesn't say you have to have an analog watch. I am sure a digital one that reads seconds satisfies that requirement just fine.

Ahh, that's where you and I disagree. But I'll do a little more research......

 

[pinkpuppy9]

Oh I looked it up to when he first mentioned it. But "second hand" doesn't say you have to have an analog watch. I am sure a digital one that reads seconds satisfies that requirement just fine.

That made me look a few things up, wondering if there was actual research. I didn't find any.........but I did find the requirements of several nursing schools that specifically say "watch with second hand" among their dress code/equipment specifications.

Perhaps requiring a watch with a seconds hand is a way to ban smart watches (some are starting to look as inconspicuous as digital)? Those things can text, surf the web to an extent supposedly, etc. My school already has to strictly ban cell phones during our surgery labs because some students can't resist texting when they're monitoring anesthesia for example. I'm positive a 4th year would hear some words if they had a phone in hand during anesthesia too. They haven't brought up smart watches in our surgery lab yet, but we're no longer allowed to wear watches during exams.

I wear a Timex kids watch:

It has an elastic adjustable band, so it always fits (it seems I'm always in between buckle holes), it's water resistant, and it's easily washable when something gets spilled on it. It lasts forever unless you lose it, and it's inexpensive.

FWIW, I also can't count while watching a digital display of numbers.

I like this! I may pick one up for myself. I hate the feeling of the rubber/rubberized plastic band of my current watch and I'm also always in between buckle sizes.

 

[DVMDream]

Perhaps requiring a watch with a seconds hand is a way to ban smart watches (some are starting to look as inconspicuous as digital)? Those things can text, surf the web to an extent supposedly, etc. My school already has to strictly ban cell phones during our surgery labs because some students can't resist texting when they're monitoring anesthesia for example. I'm positive a 4th year would hear some words if they had a phone in hand during anesthesia too. They haven't brought up smart watches in our surgery lab yet, but we're no longer allowed to wear watches during exams.

I like this! I may pick one up for myself. I hate the feeling of the rubber/rubberized plastic band of my current watch and I'm also always in between buckle sizes.

That's funny because they let us let pull out our cell phones to count seconds in ICU or on hospitalized pets. Anesthesia you needed a watch for but they didn't care the kind. And if you are in MRI for anesthesia, you're using the MRI watch.

 

[KCgophervet]

A second hand vs digital displayed seconds makes LITERALLY NO DIFFERENCE other than how the user prefers to see it. Someone has trouble watching numbers while counting? Fine, go for the analog. But I have trouble seeing exactly where the thin little hand lines up with the numbers so I prefer a digital watch (and usually I just wait for it to hit 0, 15, 30, or 45 then count until it hits the next 15 second mark, easy peasy). This is a silly conversation.

 

[DVMDream]

A second hand vs digital displayed seconds makes LITERALLY NO DIFFERENCE other than how the user prefers to see it. Someone has trouble watching numbers while counting? Fine, go for the analog. But I have trouble seeing exactly where the thin little hand lines up with the numbers so I prefer a digital watch (and usually I just wait for it to hit 0, 15, 30, or 45 then count until it hits the next 15 second mark, easy peasy). This is a silly conversation.

I don't even wear a watch anymore. Living dangerously over here.

 

[KCgophervet]

I don't even wear a watch anymore. Living dangerously over here.

Are you even a real vet?!?!

 

[DVMDream]

Are you even a real vet?!?!

Nah, I just look pretty and say big words.

 

[pinkpuppy9]

That's funny because they let us let pull out our cell phones to count seconds in ICU or on hospitalized pets. Anesthesia you needed a watch for but they didn't care the kind. And if you are in MRI for anesthesia, you're using the MRI watch.

I think it's probably okay elsewhere in the hospital, just anesthesia is a big no-no for obvious reasons. Although I've been told that from a distance, there's no way to know that you're not texting or something if your holding a phone and looking at it. I feel like it would be a generational difference though. "All these kids always on their damn phones!" No, just using the timer function

A second hand vs digital displayed seconds makes LITERALLY NO DIFFERENCE other than how the user prefers to see it. Someone has trouble watching numbers while counting? Fine, go for the analog. But I have trouble seeing exactly where the thin little hand lines up with the numbers so I prefer a digital watch (and usually I just wait for it to hit 0, 15, 30, or 45 then count until it hits the next 15 second mark, easy peasy). This is a silly conversation.

I did a little googling and I found someone saying something about how an analog watch is "more accurate" because you can track the seconds hand as the minute changes over instead of waiting for all the numbers to change. So according to some people, there's a difference there that will somehow affect your counting accuracy, lol.

 

[CalliopeDVM]

I don't even wear a watch anymore. Living dangerously over here.

I don't either if I have techs doing TPRs -- depends on the clinic where I'm doing relief work. And if I forget to put my watch on when I need it, I will use my iPhone to measure a HR, but I use the analogue clock on the home screen (with a second hand), not the digital clock. I was so happy when they added a live clock with a second hand to the home screen! (When I do that, I always mention it to clients so they understand why I'm pulling out my phone. "I forgot to put my watch on!".)

 

[Caia]

Everything I've read agrees with this article. If you would like to know why digital is more precise than analog in terms of physics, have a look.

https://gizmodo.com/5983427/why-a-10-casio-keeps-better-time-than-a-10000-rolex

 

[LetItSnow]

I can't post links here, just search for "top nurse watches" none of are them digital. This is also the type of watch required at my alma mater. I won't have enough impudence to break moral set of standards of patients care.
Also it's easier to take vitals with analog watch.

That's fine, but a google search for "top nurse watches" doesn't define gold standard.

I'm not even saying that a preference for a sweep hand is 'wrong' - whatever preference you or someone else has is fine.

But you shouldn't be pretending there's a gold standard. There isn't. Whatever does the job is just fine.

And, quite frankly, I find it offensive that you imply I'm "impudent" and "break[ing a] moral set of standards for patient care." I provide a VERY high level of patient care.

And make up your mind: is it a gold standard or a "moral set of standards" (whatever that even is)?

 

[LetItSnow]

I am in this same boat. I basically listen for bradycardia, tachycardia, murmurs and arrhythmias. I will get an approximate rate but could really care less if the heart rate is 136 or 142... 140 is fine.

Exactly.

I care what the more-or-less exact rate is in a critical or hospitalized patient because trending information is very important for those. But in a mildly sick (or healthy) patient - I couldn't care less if it's 132 or 138 because that information doesn't change anything in the assessment (and therefore treatment) of the patient.

Of course, what do I know. Apparently I'm impudent and violate a moral set of standards in my patient care.....

 

[that redhead]

Exactly.

I care what the more-or-less exact rate is in a critical or hospitalized patient because trending information is very important for those. But in a mildly sick (or healthy) patient - I couldn't care less if it's 132 or 138 because that information doesn't change anything in the assessment (and therefore treatment) of the patient.

Of course, what do I know. Apparently I'm impudent and violate a moral set of standards in my patient care.....

If you would simply Google those standards I'm sure you could improve!

 

[LetItSnow]

If you would simply Google those standards I'm sure you could improve!

Thanks, TRH! I'll just have to try harder. I mean, I AM kinda impudent; can't deny that.

 

[cbarne01]

Does anyone have one of those clipboards with a bin for stuff? I loose things, any suggestions?

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[KCgophervet]

Does anyone have one of those clipboards with a bin for stuff? I loose things, any suggestions?

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I did for 4th year and it was a godsend. Kept a pair of bandage scissors, spare paper, so many pens, thermometer, pen light, injection caps, basically anything I could think of needing. And inevitably I used most of it. Bought mine at Walmart for like $5, it was bright pink but easy to find after being misplaced.

 

[pinkpuppy9]

I'm sure I can think of more things when I have more time but off the top of my head I really liked having the book "Small Animal Medical Differential Diagnosis": Amazon product (just to give you an idea). It was small and fit in my pocket- was good for refreshing my memory quickly when I'd get bloodwork back or something and needed to jog my memory before talking to a house officer. Also very handy for writing SOAPs.

I'm following this for shoe recommendations because I've just been wearing plain flats since clinics last year and I feel like I can be nicer to my feet!

Just picked up a copy for myself...$5 from a fourth year

I keep telling myself that I'll definitely be okay if I just surround myself with enough books to hide behind (and hopefully actually have time to use).

 

[Doktor Timo]

I was pretty minimalist in terms of what I carried as a student, mostly because I hated having a heavy lab coat loaded down with stuff hanging on my neck.

That being said, one thing that I still find essential: a small pocket calculator. Maybe I'm weird, but pulling out my smartphone and opening the calculator app when I need to make a quick calculation just seems incredibly tedious. Plus I like having physical buttons.