Head to toe assessment in 5 minutes?

  1. We just started on HTTA in lab & our instructor said she feels by 4th term we'll be able to do them in 5 minutes. Considering they expect us while students to take the pulse for a full minute, count respirations for a minute, & listen to the lung sounds for a minute, how are you to get everything else done in 2 minutes? Heck, at times it takes me 5 miutes just to get a valid BP.
    I believe I remember someone posting a website that helps with this. I believe it even said somethig like Assessment in 5 minutes. Anyone recall it?
    Dixie
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  2. 24 Comments

  3. by   cardiacRN2006
    How long do they expect you to listen to bowel sounds, lol!

    Have you asked your teachers this exact question? That leaves you 2 minutes to complete a head to toe, if you do the pulse, lungs and respirations (and not including the bowel sounds)...
  4. by   onduty23
  5. by   Daytonite
    midcom. . .you accomplish it all by learning to multi-task. it takes time and experience. you'll get it eventually! here's the weblink you asked for:
    http://www.mededcenter.com/module_vi...+118#headtotoe


    here's a student clinical worksheet i've been working on. it includes review of systems information you might find helpful
  6. by   MALE*RN*777
    As with anything it depends what type of patients you have on your shift. If you have fairly healthy patients that can move/turn, cooperate, talk to you then I could see that but 5 mins is a stretch. If you are treating the body, mind and spirit then how do you assess these without asking questions and if you have a patient who loves to talk then sometimes trying to get away is a challenge. Condense your assessment and miss something major then you'll never hear the end of it. Do it and do it right... You will find ways and eventually get faster but doing it right is the most important thing. JMO
  7. by   midcom
    Quote from cardiacRN2006
    How long do they expect you to listen to bowel sounds, lol!

    Have you asked your teachers this exact question? That leaves you 2 minutes to complete a head to toe, if you do the pulse, lungs and respirations (and not including the bowel sounds)...
    I didn't ask her but intend to do it "one on one." I'm training to be a LPN so won't be doing intitial assessments but still feel that 5 minutes is a bit fast. They expect us to be thorough, even removing shoes & socks to check for edema etc, check heads for lesions (& lice), the whole list and as someone else posted there is the social and mental aspect too. I remember taking my mother to the doctor. She was very meticilous about her health history so when asked anything she could tell you all you'd ever want to know. Unfortunately, lots of it was just a waste of time for the nurses & doctors. She'd go on & on. Her 5 minute assessments were probably 45 minutes.

    Dixie
  8. by   Achoo!
    Wow that's quick. We had 10 minutes and quite a few went over. I remember saying to my mock patient" let me just check my sheet to make sure I got everything.." DING! " I guess I got everything- times up " LOL
  9. by   midcom
    Thank you! That was the site I had seen. And Daytonite, thank you. The worksheet is really good.
    Dixie
  10. by   nurse4theplanet
    As a student, I wouldn't make 5 mins my goal...practice makes perfect and with experience you will become quicker...but don't rush yourself and miss something important!

    I remember my first physical assessment in school. I was so disorganized, scared to death that I was going to hurt my pt (don't even know why...I was just doing an assessment?! lol), and fumbled around with everything from the bp cuff to my own stethoscope...even the pen and paper I was using to record everything! haha...and the order I went in was so haphazard...whatever came to mind...I must have went back in the room 20 times to get information that I missed! I was really terrible! It's funny as crap now, but I was so horrified then.

    Anyway, I have drastically improved with time and experience. But I still take more than five minutes to do a complete physical assessment. However, I also work in ICU and I am a new grad so I am very very meticulous and my patients require alot more attention.

    Take enough time to do it right! Don't rush! Good Luck to you!
  11. by   margaretptz
    I too wish to thank you Daytonite. Once again you have provided impeccable information. I thank everyone else for their comments too, they are very reassuring.
    Anywhooo to add to the difficulty I will be doing my very
    first head to toe Friday after 2 weeks in ADN classes and our clinical instructor has said we may not take any forms into the patients room. We are expected to do a full assesment inclucing health history, family history, social history etc. Is this really something that is doable?
    Another question, how accepting are patients of answering all these questions from a student when they have already gone through the whole thing in their doctor's office, the admitting office and with their primary nurse. I recall many times, a sa patient, when I just wanted to ask the doctor or nurse to read the history as I was tired of repeating myself time and again.
    Thanks for any input from any and all.
    Signing off as one very freaked out student nurse
    Margaret
  12. by   trellimana
    Our CI doesn't want us to take any forms into the room either, but we're not expected to do it in 5 minutes! Also, our instructor informed us that she expects us to have to go back into the room more than once because we're probably going to forget something, so that takes a little of the pressure off. She swears in time we'll have no problem not taking forms into the room and still remembering everything... I'm definitely not there yet!
  13. by   midcom
    Quote from trellimana
    Our CI doesn't want us to take any forms into the room either, but we're not expected to do it in 5 minutes! Also, our instructor informed us that she expects us to have to go back into the room more than once because we're probably going to forget something, so that takes a little of the pressure off. She swears in time we'll have no problem not taking forms into the room and still remembering everything... I'm definitely not there yet!
    Well, at least we get to take a cheat sheet into the room. They gave us a document today that basically listed what we need to check (everything!) and said we could put it on the table & consult it while doing the HTTA. Said not to be embarrassed to admit to the patient that we were not that experienced & needed the help of a list.

    Dixie
  14. by   not now
    According to my 3rd semester med/surg instructor: "It'll take a while but you'll soon learn to start your head to toe as soon as you walk in the door. You knock and say hi then look down at the foley bag, then look up to the IV pole, then shake their hand and assess orientation by simple conversation as you..." I loved her. She made us feel so comfortable always saying "It's OK to not know the answer." Too bad I can't have her in 4th semester.

    As for the assessment sheets. We are allowed to bring them in the room with us if we need to.

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