At a previous job in an extremely busy ED I was often criticized for "over assessing" my patients. Not being focused enough. My manager even told me once I should never listen to heart sounds. He posed the question,"What could you possibly hear that would change what you do?" I have a few answers to this question, but I'd rather hear more experi need nurses answers.
Dec 31, '16
by brownbook Pro
An ER is based on the triage system. Sorting and allocating treatment to a large number of patients in a timely manner based on their medical needs.
A quick assessment is done when you walk into the patient's room. They are sitting up, breathing "normally" on room air, talking to you, skin color "normal", vital signs normal. That tells you a lot before you have even touched the patient. Yes I know you can't chart any of that, you have to use medically correct terminology.
If a patient is complaining of chest pain the protocol is, (used to be, ACLS changes every two years), MONA, or IV/ O2/ monitor, or a combination of both. None of that includes listening to heart sounds!
Honestly I can imagine very few situations in a busy ER where a nurse, and even a doctor, would listen to heart sounds! The cardiac monitor and pulse ox are going to give the quick and dirty picture of the patient's needs?
Last edit by brownbook on Dec 31, '16
: Reason: grammar