Why nurses should wear stethoscopes
Intended for healthcare professionals
Comment Previous     Next

Why nurses should wear stethoscopes

Virginia Beckerman Senior lecturer in children’s nursing, Swansea University

They are essential when performing respiratory assessment, yet most nurses do not wear this vital piece of equipment

When I joined the profession as a children’s nurse 20 years ago, wearing and appropriately using a stethoscope as a nurse was the norm – nay, expected.

Nursing Standard. 38, 7, 39-39. doi: 10.7748/ns.38.7.39.s18

Published: 05 July 2023

ns_v38_n7_18_0002.jpg

Picture credit: iStock

I was looking after children with a variety of respiratory conditions, as well as other conditions, which would often call for a respiratory assessment. I was required to handover and feed back to nursing and medical staff on the children’s progress, including their respiratory status.

An aid to fundamental nursing tasks

Since those early days, I have consistently worn and used a stethoscope as a tool to deliver safe care for children, young people and adults. Conducting a thorough respiratory assessment can be essential in recognising and responding to the acute medical needs of a patient, as well as understanding if the treatment being delivered is aiding their recovery.

Chest auscultation is as essential to respiratory assessment as knowing how fast a patient is breathing or their oxygen saturation level. Stethoscopes are also essential when taking manual blood pressure measurements and auscultating a heart rate. These are all fundamental nursing tasks, with which any nurse should be familiar.

When I worked as an NHS agency nurse in London from 2009-11, it became apparent that wearing stethoscopes was not the norm. In November 2021 I relocated back to the UK after ten years of nursing in my home city of Melbourne, Australia, and as a senior lecturer in children’s nursing and having commenced ad hoc clinical nursing again, I have noted this to still be the case.

I see and hear on a regular basis that nurses do not use a stethoscope, do not wear one and, perhaps most disappointingly, may not have the inclination to. I acknowledge that wearing a stethoscope may not always be clinically appropriate or necessary, such as when following certain infection control principles. Sometimes, as an alternative to stethoscopes being worn, they are placed at a patient’s bedside.

This aside, I find it jarring and difficult to understand when I hear that nurses should not wear stethoscopes. Among the reasons I have heard for this assertion is that we might be confused with doctors. Such a mistake could be easily corrected in the moment, just as one might correct the pronunciation of a name. Any other reason – for example, not being able to find one – could be invalidated just as swiftly, particularly if we are if we are aiming to provide holistic, safe, quality care.

The wearing of a stethoscope is not synonymous with a single profession. While it may have been doctors who first wore them, their use is no longer reserved for them. The stethoscope was invented in 1816 by physician Rene Laennec, and created due to the belief that it was inappropriate for a physician to put his ear to a female patient’s chest. Since 1816 other healthcare disciplines, such as physiotherapy, have used stethoscopes in clinical practice. I am not convinced that the suitability of these professionals wearing and using stethoscopes is called into question in the way it is for nurses.

Essential for keeping patients safe

I encourage any nurse in a clinical area to start wearing – and appropriately using – a stethoscope. This should be as innate to nursing as using any other essential piece of our professional equipment, such as a fob watch or pen torch.

Conduct regular respiratory assessments on the patients you are caring for. Know if the salbutamol you have administered has made any difference to the air entry in a child with asthma, or if the adult with pneumonia still has crackles and their air entry remains reduced. Have robust, constructive conversations with the medical team over the respiratory progress of patients, improving this dialogue and, in turn, the professional relationship.

‘I find it jarring and difficult to understand when I hear that nurses should not wear stethoscopes’

Consistent and appropriate use of a stethoscope throughout my nursing career has enhanced my ability to develop excellent respiratory assessment skills, which has led to improved care quality and safety for my patients. It has also improved my confidence in my communication skills and enhanced professional relationships with my nursing, medical and allied health colleagues.

How to perform respiratory assessment rcni.com/respiratory-assessment

Share this page