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Most Liked Comments

  • 23

    I hadn't even finished your post without having thought : STAFFING!!!

    Why is it so obvious to us, but not them?!? Maybe selective 'elephant blindness'?

  • 22

    Is there a reason why you think nurses do not fall under the umbrella of "clinicians"?

    All RNs perform comprehensive assessments.

  • 21

    Being a great nurse and a great employee can be diametrically opposed.

  • 18

    I think you are not clear on what you are asking. It's about FOCUS. We ALL perform thorough assessments, but they may vary by SPECIALTY. We focus on varying systems based on our specialties and what is the focus. And it's not a one-time thing. We are continually assessing and re-assessing our patients throughout their stay, or in my case their treatment, in dialysis.

  • 18

    Quote from Lemon Bars
    Ah, so JBudd you are saying that a head to toe assessment of each patient by their nurse is common at the start of every nursing shift? I never observed this as a nurse aide - I suppose I was too busy rushing around gathering vital signs and toileting patients.

    And klone you are saying you do a detailed healthy history when a new patient enters prenatal care. I see.

    Assessments by hospital nurses are ongoing and not necessarily at the beginning of the shift. As was stated hospital floor nurses will focus on what they need to. I work ortho and I'll focus on the extremity but also listen to the lungs and belly for complications. I won't drag out a penlight and check their pupils if they are alert and oriented. Also if they are a walkie-talkie, I'm not going to make them turn over to check their sacrum. Throughout the day we're observing our patients, assessing vitals, etc. I'm sure the nurses in the hospital you worked at did this sort of thing.

    Also, when a patient is admitted we take a history, or in my case the patients that are admitted to the pre-op unit have this done, but I review their history.

    We're prescribers of nursing treatments, but not medications. We are smart enough to recognize when a patient needs a medication, say like a diuretic, or a procedure like an EKG when they are complaining of chest pain, but we operate under the direction of a doctor/NP/PA that can prescribe what we recommend. It's a collaborative thing.

    All that said, the assessments and physicals you learn to do in your BSN program aren't always the reality for the practicing RN...but you need to know how to do it all in order to focus. You need to be able to get out that otoscope and check out a complaint your patient might have, you need to know those heart sounds, lung sounds, how to do a good neuro assessment on someone with mental status changes during your shift, etc.

    Good luck.

  • 17

    To the OP:
    You must first learn what to do, in order to understand when not to do it.

    Everything that you learn allows you to build your ability to perform high level critical thinking, which is the hallmark of a Registered Nurse.

    You Will get to use the detailed seemingly-benign information that you are learning. It will be the baseline information that you draw upon when you have to put the big picture together, later.


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