Nurses not doing assessments - page 3

I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4... Read More

  1. by   chuck1234
    Quote from gucci rush
    Clarification I in no way meant to come off that all Filipino nurses don't assess I stated the 4 that I precepted with didn't and was just wondering if assessments were taught in their country. I also work with other filipino nurses who are very thorough and do their job well. I just couldn't believe that the nurses I was refering to didn't assess and didn't see anything wrong with it and some of these nurses also orient new grads. Like I stated before I know what I'm supposed to do I just hope nothing bad happens to their patients that could of been prevented.
    Some nurses also graduated from nursing programs in the U.S., well...they were taught the assessment skills were important....perhaps, it is life saving skills as they were taught. However, they are just as bad as the nurses you stated. This seems to me the cause of the problems is not whether they were taught or not, but some other problems might have been contributed of that problem. Hopefully, a viewer of your thread will be able to answer your question.
  2. by   withasmilelpn
    Happens all the time, drives me crazy! Look at your patient and know why they are there please. Document on what you saw! I hate when A&O patients say noone else has done so and so. Very scary!
  3. by   caliotter3
    Laziness, indifference, and negligence are not taught in any nursing program anywhere. People deteriorate in their job performance while on the job. This is also an indicator of the quality of supervision that occurs there as well as the possibility of way too much responsibility for the number of personnel or any number of other factors. Providing poor care, while being just plain unconscionable, is very risky. There are many patients and patient family members who are quite in tune with what should be happening. I am not referring to the picky ones who can never be pleased. Who would want to risk being called to task in the form of formal complaints or worse yet becoming the target of a lawsuit? This is something those four nurses should think about. Unfortunately, unless something adverse happens to one of them, they will probably go on for years with shoddy work practices. I feel sorry for both their patients and their co-workers.
  4. by   pebbles
    I have seen a LOT of nurses who don't do "real" assessments, or are lazy.

    They listen only to the anterior chest, if they listen at all. They don't check the feet for edema. They don't LOOK at the skin on the back and buttocks.

    I have had patients tell me that I was the first nurse to listen to their chest.

    I had a senior (10+ years experience) nurse who was lazy as heck generally, TEACH me how to take shortcuts when i was a new grad. "If the 02 sat is greater than 94, then write that the chest is clear".... ???!!!!

    Trouble is, to do a really thorough assessment, you have to ask the CNA for help to turn the pt, etc. Many of our nurses find it too inconvenient or are not comfortable, or our support staff is too cut to the bone and the CNA's are busy..... And maybe people need to have the stuffing scared out of them when they are new, about all the stuff you can miss and what can happen to a pt when you don't do a thorough assessment. ......
  5. by   Spidey's mom
    I guess I'm pretty lucky to be working in a rural setting. We have 2 RN's or one RN and one LVN and then one CNA.

    As the CNA does vitals, the nurse responsible for that patient goes in also. So, I do an assessment then - you can see the patient's skin as they get up on the scale. Assess L/S front and back. Check periph pulses and edema. Etc.

    steph
  6. by   XB9S
    Quote from gucci rush
    I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4 different nurses that I worked with and not one of them did an assessment didn't listen to the heart, lungs, abdomen,didn't touch the patient with a stethoscope. I couldn't believe it. How can you chart and give report to the oncoming shift that the lung sounds were clear when you didn't even listen. I am happy that I was taught better and know better. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.
    In the UK we are not taught to listen to routinely heart and lung sounds, I have only learnt during my Nurse Practitioner MSC, usually this level of examination is something medics or nurse practitioners do. Nurses do assess patients but in differently to how it sounds you do in the US.
  7. by   LDJRN
    okay...this topic leads me to another question...i work 12 hour night shifts on the weekend, so the nurse i give report to is the same nurse i get report from when i return. the nurse i usually get report from is... well, i just don't trust anyone's assessment but my own (you know what i mean? exception: "hey, come give me a second opinion on this?"). i rarely give my assessment findings in report when they're different. is this wrong?

    lord, save me. i'm so evil...
  8. by   SharonH, RN
    Quote from gucci rush
    Clarification I in no way meant to come off that all Filipino nurses don't assess I stated the 4 that I precepted with didn't and was just wondering if assessments were taught in their country. I also work with other filipino nurses who are very thorough and do their job well. I just couldn't believe that the nurses I was refering to didn't assess and didn't see anything wrong with it and some of these nurses also orient new grads. Like I stated before I know what I'm supposed to do I just hope nothing bad happens to their patients that could of been prevented.

    So if you already knew that there were other Filipino nurses who were very thorough then why did you ask if assessments were taught in their country? If some Filipino nurses are thorough and others are not (just as with American nurses) then can't you pretty much rule out the theory that they were not taught assessments in their country? Think about it.


    There is also an irony to your questions. Nurses who are Asian/Pacific Islander are more likely to have a BSN or higher degree(72.7%) than White nurses(46.7%) or Black nurses(52.4%).
  9. by   Spidey's mom
    Quote from ldjrn
    okay...this topic leads me to another question...i work 12 hour night shifts on the weekend, so the nurse i give report to is the same nurse i get report from when i return. the nurse i usually get report from is... well, i just don't trust anyone's assessment but my own (you know what i mean? exception: "hey, come give me a second opinion on this?"). i rarely give my assessment findings in report when they're different. is this wrong?

    lord, save me. i'm so evil...
    so, what do you talk about in report if you don't give your own assessment?

    of course you should give your own assessment.

    things change during a shift - lung sounds change. bowel sounds change. people get better. people get worse.

    steph
  10. by   msdobson
    Quote from SharonH, RN
    So if you already knew that there were other Filipino nurses who were very thorough then why did you ask if assessments were taught in their country? If some Filipino nurses are thorough and others are not (just as with American nurses) then can't you pretty much rule out the theory that they were not taught assessments in their country? Think about it.
    Yeah! How dare her asking such question!


    Quote from SharonH, RN
    There is also an irony to your questions. Nurses who are Asian/Pacific Islander are more likely to have a BSN or higher degree(72.7%) than White nurses(46.7%) or Black nurses(52.4%).
    Which, of course, means absolutely nothing. The mere fact of one obtaining a BSN degree is NOT an indicator that that nurse is a) a more intelligent nurse b) a more intuitive nurse c) will actually do full assessments on his/her patients d) etc...etc...etc...

    The ONLY thing these numbers prove is that 3/4 of Asian nurses are BSNs, while white and black nurses are more evenly spread out (LVN, ADN, RN cert., BSN, NP, PA) than Asians.

    Statistics have no bearing on the topic of this conversation. And using the numbers game offends the intelligence of everyone involved.
  11. by   SharonH, RN
    Quote from msdobson
    Yeah! How dare her asking such question!
    Well why did she ask? If she has worked with some Filipino nurses who do in fact do assessments, then why, after working with 6 of them who probably represent .00000001 percent of all Filipinos, would she start to wonder if they are taught to do assessments. That doesn't make any sense. Why even go there? If I work with 4 White American nurses who can never drop a Dobhoff or get a Foley in or almost any other basic nursing skill(and I used to work with 4 such ladies), I don't start to wonder if White American nurses are taught how to do those things. They were just 4 bad apples! This is the type of thinking that leads to stereotyping and scapegoating.

    Quote from msdobson
    Which, of course, means absolutely nothing. The mere fact of one obtaining a BSN degree is NOT an indicator that that nurse is a) a more intelligent nurse b) a more intuitive nurse c) will actually do full assessments on his/her patients d) etc...etc...etc...
    I never said it was an indicator of those things. But the OP is questioning their education and the fact that they tend to be more highly educated than their American counterparts is ironic. Beyond that I won't get into a BSN debate with you so don't waste your time.
  12. by   P_RN
    No degree debate here OK?

    I have unfortunately seen this happen right on my own floor. I have seen RNs who seemingly never got out of their chair the entire shift. I also have seen doctors "pretend" to listen to chests but had the earpiece of the steth. hanging around their necks.

    My best advice would be to call them on it every time. Be nice but firm. "You didn't listen to their chest?" or

    "What did their lungs sound like I don't believe I saw you listen." or....whatever. You are protecting their patient.
  13. by   msdobson
    Quote from SharonH, RN
    Well why did she ask?
    Seems to me she asked because she wished to know if the practices taught to Filipino nurses who take their education IN the Philippines, rather than Filipino nurse who take their education in the U.S., differed in substance. It was a fair question, but of course there is ALWAYS someone who wants to throw out the "race" or "stereotype" card right away. Congrats.

    [quote=SharonH, RN;2228844]If she has worked with some Filipino nurses who do in fact do assessments, then why, after working with 6 of them who probably represent .00000001 percent of all Filipinos, would she start to wonder if they are taught to do assessments.

    See above.

    Quote from SharonH, RN
    That doesn't make any sense. Why even go there? If I work with 4 White American nurses who can never drop a Dobhoff or get a Foley in or almost any other basic nursing skill(and I used to work with 4 such ladies), I don't start to wonder if White American nurses are taught how to do those things. They were just 4 bad apples! This is the type of thinking that leads to stereotyping and scapegoating.
    Because YOU immediately start thinking "racial." SHE wanted to know about "different geographical" educational practices. She wanted to know HOW or IF the training of NURSES was different in the U.S. as opposed to the Philippines.

    Quote from SharonH, RN
    I never said it was an indicator of those things. But the OP is questioning their education and the fact that they tend to be more highly educated than their American counterparts is ironic. Beyond that I won't get into a BSN debate with you so don't waste your time.
    You made your views on that subject abundantly clear by posting that. Everyone here who has ever read my posts knows that I am a HUGE supporter of having MULTIPLE avenues into the nursing field. And NO, I won't be drawn into the fight either. However, everyone has the right to their own opinion, and you have the right to yours.

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