[Roseyposey]

Originally Posted by linnywho

I am asking here because I am not sure where to post it. I am a med/surg nurse. Students from a local university are being asked to fill out a 13 page nursing assessment. Some of the questions on this form seem in appropriate.

This assessment is for a med/surg 2/3 class.

Students are doing clinical on a MACU unit, skilled nursing unit, etc.
Examples:
What is your sexual orientation?
Do you have sex?
If so, how is it?
How was your infancy, childhood, adulthood?
How many people live in your home?
What is the cost of your home?
<O></O>

I understand that part of nursing school is to get comfortable talking to people, but these questions are a little much. Do they teach you how to get this info., or do they literally think you will ask these questions as written? What does that mean "how is it?" (re: sex). Fulfillment, technique, orientation, what? I pride myself in being able to carry on a conversation with anybody, but I would not ask those questions as written. Maybe you could start with a simple are you married? Did you grow up around here? Are you docked points on your careplan if you don't get the answers to these questions? What if the patient refuses to answer? Does the floor educator or nm know that you guys are asking the patients these questions? I can foresee an instance in which their precious Press Ganey scores would be affected by a student asking a question that a patient perceives as rude.

[Daytonite]

Assessment is STEP #1 of the nursing process (the problem solving process we nurses use). I answer a lot of care plan questions and without a doubt one of the biggest problems that most students have is that they do not do a thorough assessment of their patients when they start out. From the assessment you glean out the abnormal items to do your problem solving (care plan) activities.

Sexuality, which is a component of social activity, is supposed to be a part of a comprehensive assessment. Many times it gets skipped over because the person doing the assessment isn't comfortable with the subject. I have to tell you though that when you find yourself working with a population of patients who are likely to have STDs you learn to ditch your embarrassment real quickly in order to learn who has cooties that you are going to be working with.

Also, part of ADL assessment includes their social and family connections. Questions about their family and finances is not out of line. The questioner needs to be tactful and ask these questions with sensitivity. Part of the assessment for my BSN program included an assessment of each patient's financial, emotional, interpersonal and cultural resources. You can give a patient all kinds of instructions for the care they need to follow up on, but if you don't know or understand some of their background and resources, they may never be able to properly carry out those instructions unless you taper them to what they are able to accomplish within their home environment. What's the point in instructing a patient to use this or that device at home if they can't even afford to buy it? You can't assume that every significant other is going to be cooperative in helping with home care. Some just won't. So, knowing something about their financial and personal situation is just being smart.<O</O
<O</O

I would not look at this assessment as crossing an ethical or moral threshold, but rather a fact finding tool and use great tact, sensitivity and discretion in asking the questions. The goal is always to collect as much data as you can about the patient. The more data you have, the better you can plan the patient's care.

[Zookeeper3]

Sexuality is a difficult subject to broach. I do with my cardiac patients as a screening too. (viagra use with nitrates and sexual dysfunction with beta blockers and such).

"several of your heart medications can affect your sexual functioning. Are you having these type of side effects? Have you tried viagra or that type of med to help?".

Now I only go there to assess if my frequent flyer or what not doesn't take his beta blockers because of sexual issues and we need a change or so on. Anything else... if not related specific to medical interventions or meds is not my place to go.... IMHO

[sistasoul]

Hello all,

I am in my 4th semester of N. school now and some of the stuff we are suppose to ask or get info on I would usually right Not applicable or be tempted to make it up. I would always be more worried about their medical needs than anything. If the patient brought up the subject that was fine with me, but there were so many other things to worry about learning other than someones sexual health. This is important in some circumstances, but not all. Patients that are fresh post-ops usually are only concerned with resting and being pain free. I will be so glad to be away from these nursing care plan craziness.
Just my 2 cents