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.
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?
The school is also asking students to palpate the liver. This brings up an entirely different issue related to patient safety. I am afraid that a student could cause a rupture in an alcoholic patient or worse. I am not even sure if a student is allowed to perform such a procedure. I have never done that and would assume I would need a doctor's order if I did.
<o></o>I am getting a copy of the assessment tomorrow from a student and taking it to my unit manager. But I wondered if these questions were now considered the norm for nursing school now? Or do others feel the students are crossing an ethical or moral threshold asking these sorts of things?
Jan 29, '08
Are you sure they are asking those questions so bluntly? At my school we were required to assess if the patient has any current sexual problems (which isn't simply about having sex, ex: Has this illness or surgery affected the way you feel about yourself as a man/woman), who lives with them that can help with ADLs or home maintenance (help shopping, cooking, cleaning, etc), how do you view your future, do you feel anxious (there may be underlying anxiety issues that need to be delt with), etc. We as nurses need to assess our pts completely and this includes mentally and socially. These questions are given to help nursing students develop their assessments skills on more than just the physical level. And remember they have thoses nasty careplans to do! And so much is involved with those. A patient may have a concern with certain things, but may be embarrassed to ask about it. Certainly these nursing student should not be asking these questions SO BLUNTLY! That would raise concern. I had clinicals with a girl that did ask things in an inappropriate way - she didn't pass clinicals! They need to be practicing therapuetic communication with these questions as well. And of-course there are many times that not all of these questions apply - they need to figure out the appropriate times to ask these.
The only questions I see that you listed that are completely inappropriate is how much their home is and what their sexual orientation is. That's no one's business!
Hope this other perspective helps.
Last edit by onyx77 on Jan 29, '08
Jan 29, '08
I would tend to diagree - sexual orientation can have an impact on the patient's needs. (Many newer textbooks have sections on this topic, especially in the context of new families, etc.)
ETA - We were flat out told we would be unable to palpate a healthy liver, and were not encouraged to attempt an unhealthy one.
Last edit by MNmom3boys on Jan 29, '08
: Reason: added to response...
Jan 29, '08
I am a student, and I wouldn't ask those questions unless they came up in the course of a normal conversation or if they were directly related to the patient's diagnosis. If my instructor insisted we ask, I would be tempted to just make up an answer for her. Also, liver palpation is considered an advanced practice procedure in my school.
So far as I understand it, you are still the RN for the patients, and you get the final say about what the students can do. If you are uncomfortable about letting them palpate livers, just tell them you don't want them to because you consider it advanced practice.
Last edit by vashtee on Jan 29, '08
Jan 30, '08
I also am a student and assignment sheets like that mostly are guidelines to help gather information for care maps/plans and/or charting. You must pick what questions pertain to your patients situations. There are 50 ways to ask for one piece of information and the assignment sheet will NEVER list all 50 for each topic listed. Thats where the practice of communication skills and learning to deal with different types of people come into play. I highly doubt that the students were to ask those questions in a blunt manner. I think its just a guideline to follow although I dont know about that "what is the cost of your home" question. If it was inherited, it still has a cost--I dont understand that question at all.
As for liver palpation, we were shown how to do it but--I agree with everyone else-that IS for advanced practice professionals.
Last edit by Hydakins on Feb 9, '08
Jan 30, '08
When I was in nursing school, we asked patients similar questions as part of our patient assessment tools (aka care plans
). We were required to ask these questions when interviewing the patient. First we asked the patient's permission to interview them, and if they felt uncomfortable answering certain questions, we just documented that they didn't feel comfortable answering. It really wasn't a big deal. I NEVER had a patient that verbalized a problem with me asking about sexual orientation, # of sex partners, safe sex practices, or any other question.
Also, we were taught how to palpate the liver as part of our complete head to toe assessment. I've never actually done it in a clinical setting (only in lab on fellow students), but I wasn't aware of any rule stating only MDs, PAs, and NPs could do it.
Last edit by NewbieEDRN on Jan 30, '08
: Reason: typo