How often do you listen to lung sounds?

[safarirn]

I am kind of new to this school nursing thing. I am getting A LOT of coughs & colds right now. My office is tiny & I only have 2 cots. Do you listen to lung sounds when a student is afebrile, looks good & is only complaining of a cough or a sore throat? Do you listen only if they look pale or have a temp and or you can hear audible breath sounds?

Today I had a long line of kids waiting to see me. Everyone with out a temp & just mild complaints was pretty much just sent back to class. I feel like I probably should have done more, assessed them more, given them more attention, but I was in a hole & my diabetics were there for testing & it was all happening at the same time.

I'm just not feeling good about the job I did today. Am I being too hard on myself? Do you always listen to lungs? As a hospital nurse listening to lungs, heart tones, bowel sounds... etc was part of each & every assessment. But school nursing is different, I know. What do you do with afebrile coughs & cold complaints?

Have you ever had a day like this, where you feel like you didn't do enough?

No one has complained, no problems at all. I am just really feeling disappointed in myself.

Thanks for letting me vent

[TwinStars]

Hi safarirn,

You're being too hard on yourself. I check lung sounds on my known asthmatics or when a student complains of sob. If a student is afebrile, looks good and has minor complaints...they're back to class. You sound like you're doing a great job.

[tleigh7097]

I would be interested in a good website for lung sounds. Any suggestions?

[TwinStars]

hi tleigh,

check out this site

basic lung sounds

[Purple_Scrubs, BSN, RN]

I think you did just right. A known asthmatic gets a close assessment. If I can hear junky breath sounds with my bear ear, I am going to listen to them. If they are afebrile and look/sound ok, they are back to class. Now, if the teacher sends them back a second time and says they are just coughing their head off in class, that warrants a closer assessment and probably a call home.

Look at it this way, when you have 500+ people you are responsible for, and anywhere from 20-40+ patients per day (if your school is like mine), plus the scheduled meds and procedures, then you MUST do focused assessments or you would be there all day and night! And yes, looking the kid up and down and checking temp is a focused assessment. I think you did absolutely fine! We will always want to do more, but we do what we can with the hours we have in the day!

[SchoolNurseBSN]

Don't beat yourself up. There are only so many hours in a day. Definately, always listen to your asthmatics (known or suspected)! Listen to more when you have time, especially if you need the practice.

Some days....I will check BP and vision for everyone who comes in for a headache. The next - when I have standing room only and kids are throwing up in every available trash can- I do a temp and a quick history!