MEPS Policy

[Navy2011]

So this has been bugging me since reading about someone dying awhile back of asthma. At my visit to MEPS, my first BP reading was a 141 / xx. Instead of charting it, the nurse wrote it on a sticky and waited a half hour, at which time it was 139 / xx. (apparently 140 is the cutoff) Her superior noticed this and scolded her for violating procedure, but didn't make her change it and I was happily not DQed.

My questin is does this type of thing happen often? I am just bothered that people could be put at risk because proper procedures are not being followed.

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[Perrotfish]

Sooo your complaint is that MEPS didn't seem anal retentive enough?

 

[Navy2011]

So I guess that means its not common, which is good to hear. It was my only experience with MEPS so I had no clue if this was commonplace. No complaints, though, as it saved me the hassle of the waiver process.

 

[DredPiratRobrts]

On the flipside, I had to do flutter kicks during my ECG b/c I have a very low resting heart rate from years of endurance training/working out. Apparently it ruffles feathers when your numbers are outside the ideals. Having a resting HR below 60 was a problem. The answer = work out while I'm supposed to be at rest, rather than explaining that I'm a well trained athlete.

I just thought it was a funny way to deal with it. Apparently the bureocracy is such a pain in the *** that its easier to manipulate the numbers than to offer a perfectly reasonable explanation.

My opinion is that the process is a pretty fine mesh, people get bumped for waivers all the time and generally medical qualification is a pain. I dont think that they are turning a blind eye and passing people with big problems. The only thing I have heard of are the little manipulations that we're talking about. Stuff like that (systolic BP @ +1 mmHg) is not a big deal, the HM's recognize the somewhat anal rigidity of the cutoffs and have devised plans to overcome them (adapt and overcome right?). Besides, one BP reading is as good as another, it's a range.

I think the asthma situation you mentioned is an anomaly.

 

[73BARMYPgsp]

So this has been bugging me since reading about someone dying awhile back of asthma. At my visit to MEPS, my first BP reading was a 141 / xx. Instead of charting it, the nurse wrote it on a sticky and waited a half hour, at which time it was 139 / xx. (apparently 140 is the cutoff) Her superior noticed this and scolded her for violating procedure, but didn't make her change it and I was happily not DQed.

My questin is does this type of thing happen often? I am just bothered that people could be put at risk because proper procedures are not being followed.

To answer your question (sort of) the exact same thing happened to me. It was a little high the firt time, so guy went away, came back 5 minutes later and it was OK. So there you have it, with an N=2, it happens 100% of the time.

 

[FutureNavyFP]

So this has been bugging me since reading about someone dying awhile back of asthma. At my visit to MEPS, my first BP reading was a 141 / xx. Instead of charting it, the nurse wrote it on a sticky and waited a half hour, at which time it was 139 / xx. (apparently 140 is the cutoff) Her superior noticed this and scolded her for violating procedure, but didn't make her change it and I was happily not DQed.

My questin is does this type of thing happen often? I am just bothered that people could be put at risk because proper procedures are not being followed.

So, lets say you go to your civilian doctor's office and get your BP taken and it indicates 141/xx. Do they instantly write down a diagnosis of HTN and start you on treatment? Probably not. If they do anything, they will most likely have you sit down and relax for a few minutes and take it again. If its still high they will have you come back again for another reading before you are diagnosed. Is this putting your life at risk?

My guess is that the nurse taking the measurement realized the insanity of disqualifying someone based on ONE reading and tried to see if you would come down.

 

[Navy2011]

Maybe I wasn't as clear as I could be. I didn't have a problem with her doing it. In fact, I was eternally grateful. Just after the fact, it seemed to me that it wasn't her business to decide policy. Maybe it stands out to me because he boss balled her out in front of me.

Either way, people say I'm to anal so this probably another example of it.

 

[DredPiratRobrts]

So, lets say you go to your civilian doctor's office and get your BP taken and it indicates 141/xx. Do they instantly write down a diagnosis of HTN and start you on treatment? Probably not. If they do anything, they will most likely have you sit down and relax for a few minutes and take it again. If its still high they will have you come back again for another reading before you are diagnosed. Is this putting your life at risk?

My guess is that the nurse taking the measurement realized the insanity of disqualifying someone based on ONE reading and tried to see if you would come down.

Well said.

 

[Perrotfish]

Maybe I wasn't as clear as I could be. I didn't have a problem with her doing it. In fact, I was eternally grateful. Just after the fact, it seemed to me that it wasn't her business to decide policy. Maybe it stands out to me because he boss balled her out in front of me.

Either way, people say I'm to anal so this probably another example of it.

Yeah I gotta admit this isn't the effect this situation would have had on me. If I had seen that, after the fact it would seem like her boss it a huge jackass.

Doubly true for HPSP students who you know are going to get a waiver for anything short of a missing limb. Not giving you a second reading would just have been making more paperwork for everyone involved.

 

[73BARMYPgsp]

Sounds like she had enough brains to use judgement and discretion. Both have been replaced in American institutions by "policy."

 

[Navy2011]

Sounds like she had enough brains to use judgement and discretion. Both have been replaced in American institutions by "policy."

This is kind of what I was getting at. While I agree that being above or below 140 doesn't define you as being hypertensive, I think "policy" is a good way to ensure reliability and safety to the process. I could have still got a waiver, but I would have had to jump through some hoops that showed that it wasn't a problem. By doing this, it would have protected the military from liability and ensured that I was capable of doing what I signed up for.

I guess I'm in the minority here, but I feel like when people start shirking the rules because its a close call and they think it will be fine, they run the risk of creating problems down the road. What one person is willing to overlook, another might not.

With that said, I agree that we shouldn't live in a Brave, New, World where there is no free will. It just seems like the stakes are so high becuase of they physical rigors of the military that they should follow the rules just to be safe.

 

[Perrotfish]

Are you going in right now? Is there any chance I might have to work for you?

 

[73BARMYPgsp]

This is kind of what I was getting at. While I agree that being above or below 140 doesn't define you as being hypertensive, I think "policy" is a good way to ensure reliability and safety to the process. I could have still got a waiver, but I would have had to jump through some hoops that showed that it wasn't a problem. By doing this, it would have protected the military from liability and ensured that I was capable of doing what I signed up for.

I guess I'm in the minority here, but I feel like when people start shirking the rules because its a close call and they think it will be fine, they run the risk of creating problems down the road. What one person is willing to overlook, another might not.

With that said, I agree that we shouldn't live in a Brave, New, World where there is no free will. It just seems like the stakes are so high becuase of they physical rigors of the military that they should follow the rules just to be safe.

If "the stakes" were the primary criterion, why isn't everyone issued parachutes as walk on to an airliner? It's a 1 in a million shot, but you never know?

 

[Navy2011]

If "the stakes" were the primary criterion, why isn't everyone issued parachutes as walk on to an airliner? It's a 1 in a million shot, but you never know?

Aww, cmon. You mischaracterize my argument and then put it in the form of a ridiculous example that no one would agree with. I obviously don't think that everyone should be issued parachutes (although it would be cool), because of the cost relative to the benefit. Whereas making someone with boderline blood pressure take some extra steps does not really have much cost. It's like a TSA guy saying "I've screened 5000 ticking briefcases since I started working here and none of them have been bombs, I'm going to just let this one slide" (I can make crazy examples too). There is no incremental cost the checking the briefcase, but possible dire consequences.

I guess we're just going to have to agree to disagree. All I was trying to say was that the military obviously thinks that that a BP over 140 is a pretty good place to do a little digging to see if the person is in good health and I don't think an individual nurse at and invidivual MEPS station should decide that it isn't.

 

[73BARMYPgsp]

Aww, cmon. You mischaracterize my argument and then put it in the form of a ridiculous example that no one would agree with. I obviously don't think that everyone should be issued parachutes (although it would be cool), because of the cost relative to the benefit. Whereas making someone with boderline blood pressure take some extra steps does not really have much cost. It's like a TSA guy saying "I've screened 5000 ticking briefcases since I started working here and none of them have been bombs, I'm going to just let this one slide" (I can make crazy examples too). There is no incremental cost the checking the briefcase, but possible dire consequences.

I guess we're just going to have to agree to disagree. All I was trying to say was that the military obviously thinks that that a BP over 140 is a pretty good place to do a little digging to see if the person is in good health and I don't think an individual nurse at and invidivual MEPS station should decide that it isn't.

But wouldn't all this just be academic if it actually WAS policy when a BP like that is encountered at MEPS to wait a few a minutes and check it again? It probably is.