Physical Assessment

  1. We have been introduced to physical assessment over 2 - 1 1/2 hour lectures. This is all the information we get (besides textbook obviously) and we are expected to be able to do a complete head-to-toe physical assessment by next Tuesday. I have a couple of issues.....#1, I have never had a doc - much less a nurse - do an assessment on me like the kind we are expected to learn in a week. #2 - even the instructors have said "this isn't enough time....if you were going to the local university you would be taking this as a course over the whole semester...but since you're not we have to cram it into a week!" #3 - when we check-off we will not know until right before what body system to be responsible for and we cannot take our 'cheat sheet' in on the check-off.

    This is mostly a vent - but at the same time, is this normal? Are other students being expected to do this in-depth of an assessment? Are there any nurses out there that actually do these in-depth assessments? There must be for them to be requiring us to learn so much (in a short time)....but as I said before, never even had a doc assess me like this.

    Thanks for letting me air my frustrations
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  2. 26 Comments

  3. by   SNLiz
    I would say this is fairly common in an ADN program. We learned how to do an assessment in short order and had to show them we could do it in a couple of weeks. I remember practicing on any available body. That is the best advice I can give. You will learn further assessment techniques in your subsuquent classses and you will generally feel alot better about them then. Just do what they what they want and how they want you to do it. Good luck on blessing number three....I am looking for blessing number 563 right about now!
  4. by   Tweety
    It is unusual to have to learn it that fast.

    No, we don't do that kind of assessment daily.

    HOWEVER, you do have to know how to focus your assessment, for instance on a gallbladder walkie talkie patient I'm not going to check for pupillary response, but I'm going to do the adominal assessment much as you're learning. For a pneumonia patient I might not be that thorough with the abdomen, but I'm going to do a cardio/resp. assessment much as you're learning, for a stroke patient I'm going to do a through neuro assessment.

    That's not to say we don't do head to toe, we do, but we are more thorough in the areas we have to.

    So you have to learn to do the whole thing thoroughly.

    Good luck.
  5. by   Megsd
    Quote from Stdy2BaNurse
    We have been introduced to physical assessment over 2 - 1 1/2 hour lectures. This is all the information we get (besides textbook obviously) and we are expected to be able to do a complete head-to-toe physical assessment by next Tuesday. I have a couple of issues.....#1, I have never had a doc - much less a nurse - do an assessment on me like the kind we are expected to learn in a week. #2 - even the instructors have said "this isn't enough time....if you were going to the local university you would be taking this as a course over the whole semester...but since you're not we have to cram it into a week!" #3 - when we check-off we will not know until right before what body system to be responsible for and we cannot take our 'cheat sheet' in on the check-off.

    This is mostly a vent - but at the same time, is this normal? Are other students being expected to do this in-depth of an assessment? Are there any nurses out there that actually do these in-depth assessments? There must be for them to be requiring us to learn so much (in a short time)....but as I said before, never even had a doc assess me like this.

    Thanks for letting me air my frustrations
    Ouch! That's rough. When I started physical exam class I basically agreed with you -- I have never, ever seen anyone be that thorough with me. Ever. When we brought that up to the instructor, we were basically told that it's important to be familiar with how to do a complete assessment because you will need to do assessments on the areas pertinent to your patient, so you need to know how to assess everything, even though you'll probably never assess everything at the same time.

    I am fortunate to have a whole quarter to learn physical exams system by system. As overwhelmed as I am by just all the steps in the skin assessment, I can't fathom trying to learn the whole process in such a short amount of time. Good luck on that!
  6. by   WDWpixieRN
    Quote from Stdy2BaNurse
    We have been introduced to physical assessment over 2 - 1 1/2 hour lectures. This is all the information we get (besides textbook obviously) and we are expected to be able to do a complete head-to-toe physical assessment by next Tuesday.

    #3 - when we check-off we will not know until right before what body system to be responsible for and we cannot take our 'cheat sheet' in on the check-off.

    This is mostly a vent - but at the same time, is this normal? Are other students being expected to do this in-depth of an assessment?
    We got assessments in lecture, then a 60-minute or so demo in the lab, then were given 4 days to be prepared for a checkout via the same system -- pick a card with either cardio, resp, or gastro on it. It was kind of brutal, but I'm beginning to get the feeling that a lot of these fundamentals are somewhat about just being thrown in to the fire. We also started clinicals this week and I have yet to make a real bed or give a bedbath...I'm a bit worried about being expected to do this like a pro when I get in to a room!!

    Good luck...just hang in there and take it one step at a time, one day at a time....and STUDY!!!

    (this is what the majority of the students in our class feel like!! )
  7. by   FNPhopeful
    You can do it! Its just memorization. I was just as freaked as you- we had about a week to prepare. But honestly just memorize the systems and what to look at. I made flash cards of each system and then wrote them down over and over and over again, until I could recall it. There's really only about 5 or 6 things per system to note. Everyone is nervous and freaked! Just memorize as much as you can.
  8. by   HeartsOpenWide
    My test is on Tuesday too. We had more than a week, I am in a University but we do not get a whole semester to learn it, more like three weeks(Well three weeks to learn it all and a day to practice, we still have to do the abdominal and muscleskeletal assessment lecture tomorrow and then I have to weekend to practice head-to-toe). We do get to have a cheat sheet for peaking but if we look too many times to fail. I think that even if you do not have to look at it it is nice to know it is there. Like the old saying, if you bring your rain coat it will not rain but if you forget it it will....
  9. by   Daytonite
    i'll have to remember this when responding to posts where people want to know the differences between aa and bsn programs. for my bsn program we had a separate class on assessment with a lab.

    i recommend that you grab every warm body you can and who will let you and go through the steps of doing a physical assessment on them this weekend. as others have said, you will learn as you go along in your program. here are two links that might be helpful for you as well:

    http://www.mededcenter.com/module_vi...+118#headtotoe - this is a great guide to physical assessment. it is called head to toe assessment in 5 minutes (well, maybe a little longer than that) that was originally posted on this thread http://allnurses.com/forums/f205/hel...ls-139193.html by scmomof3.

    http://go.dbcc.edu/hhps/nursing/file...3282d58319.pdf - a nice, simple physical assessment guide list from daytona beach community college nursing program in a pdf file.
  10. by   traumaQN
    We haven't gotten that far yet, but I can tell by the syllabus we only have a week.

    They give us a demonstration and then we practice in lab. My problem is that lab only lasts an hour and by the time we do our skills check for the week, there is only about 20 minutes to practice new skills before the next check off. And our lab is used by the LPN, 2nd year ADN, and medical assistants so it is always full and you can't just go in and practice when you want.
  11. by   WDWpixieRN
    Quote from RNgrad2008
    We haven't gotten that far yet, but I can tell by the syllabus we only have a week.

    They give us a demonstration and then we practice in lab. My problem is that lab only lasts an hour and by the time we do our skills check for the week, there is only about 20 minutes to practice new skills before the next check off. And our lab is used by the LPN, 2nd year ADN, and medical assistants so it is always full and you can't just go in and practice when you want.
    Ditto for my program....by the time we have the practicum, we only have one true open lab time for practice....lab's not open on the weekend and then we have checkouts starting on Monday afternoons. There is VERY limited time for practice.

    I think Daytonite, as usual, has the best perspective on this...you grab people...my family got a little weary of me asking them to let me check their blood pressures....but it is just memorization and practice....I haven't checked the links, but I'm guessing that what's posted above will be a HUGE help....if you think checkouts are bad, just wait until they put you in front of a live human being and say, "Go".....without a "cheat sheet".....

    The word that keeps recurring over and over in my class the past 4 weeks is OVERWHELMED....and 2nd, 3rd, and 4th semester students have confirmed that that's what 1st semester is all about.

    Dig in and do it....I can pretty much bet that that's what the students in your upper classes had to do to get where they are....if they did, you can!!
  12. by   Daytonite
    wdwpixie. . .believe me, the tables will be turned later when all your relatives will be calling you up for an opinion or advice from you for every little ache, pain or weird body experience they are having. Too bad you use that on them as leverage for now, but it's coming, I guarantee it.
  13. by   nanay
    Hi

    Thank you DAYTONITE for the links. Especially the 5-minute or more physical assessment from the mededcenter link.

    I believe its going to be very useful when i start my clinical rotation next month. Although im done with my physical assessment skills, i find the link very thorough and helpful.

    Again, thank you.:wink2:
  14. by   Ausculapius
    Yep, its pretty tough to remember all the steps of a physical assessment.

    I have tried to solicit family members and such to practice on, however I have been unsuccessful. Though, in my lab we have done ZERO Physical assesment skill testing. Instead, we have focused on administering meds and checking vitals. This is fine by me! I'm more worried about giving someone the wrong med/dosage in clincal than doing a not-so-great physical.

    Besides, I really wonder how often a true head to toe physical is done in any healthcare facility. When I had to get one done for my nursing school admissions my Doc only did the abdominal portion and just checked off the rest of the list as fine. Go figure.

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