Acceptable questions for nursing students to ask?

AmericanRN · Jan 30, 2008

Wow

Those questions are invasive to me. Maybe it is the wording. I don't mind being ask about my sex life or orientation from the NP that I see but I know her already and have an established relationship and she doesn't word anything like that.Nor would she ask me "how it was". I could see that being relevant if I or another patient came in with a complaint of pain during intercourse or something like that but on a med/surg floor me thinks not.

I would be tempted to be sarcastic on some of those like the infancy question....beats me how mine was, ask my parents I don't remember it. Also be careful of the orientation question like you mentioned.

How many students would be able to handle "swinger" being said to them when everyone assumes all sexual orientation is either heterosexual, homosexual, or bi? Something to consider because that is an orientation as well. Just wonder how many people could really manage to not register shock, or judgment if that was said to them.

Far as palpating livers I say your school is asking for someone to be knocked senseless or sued. Although I start clinicals in April and am a student myself there are some things I don't want any students doing on me and palpating my liver is on my list, just like IMR's are now on my no way list when a student injected my depo shot in my sciatic nerve a year ago.

Now if I had to take something subcutaneously I would let a student do that on me. But some stuff I'm not answering or allowing unless I have an established relationship with my provider already.

ta-sscns · Feb 1, 2008

I am currently a senior nursing student and I can remember having for fill out similar worksheets with very similar questions. I felt as though they were a little too personal but our instructors said that it was just part of life and part of getting an acurate health history. It was supposed to help us identify risk factors and make suggestions for change. We didn't actually tell the patients that they needed to change their life styles, but we had to come up with diagnoses and care plans based on the data collected.

As far as palpating the liver...I don't believe that you need a Dr.'s order to do that...I have never been told that. As a student, all we have been told is that there are certain circumstances where it shouldn't be done, but not always.

student456 · Feb 1, 2008

We were taught to deep palpate livers

We were never told in my assessment class that it was only for advanced practice...

I wonder why some schools teach it this way and others tell you that you arent allowed to deep palpate?

AmericanRN · Feb 1, 2008

We were taught to deep palpate livers
We were never told in my assessment class that it was only for advanced practice...
I wonder why some schools teach it this way and others tell you that you arent allowed to deep palpate?

That is a good question and something schools need to get together on with the hospitals they are doing clinicals with. I wonder if the variation has to do with individual states/provinces laws and if the federal rulings are some type of gray area left up the states or what.

I also wonder if it depends on whether the school is a community college or a 4 year or private vs state run. I

guess I should start asking around. Either way certain stuff has the potential for some nasty litigation in some areas so something needs to be done either way to make sure that everyone is on the same page with each other.

psychnurse1998 · Feb 4, 2008

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.
Examples:
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.
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?
Thanks,
Linny

The questions are so ludicrous, I am surprised some news station hasnt learned of that questionaire. I think Rush Limbaugh would get lots of mileage out of it. It almost sounds like a questionaire printed by a company peddling Viagra or someone that wants your home when you move on to the hereafter. "is the sex good"? I can what the next question would be. I wonder how parent from a fundamentalist church would feel if their teen daughter was asked that question?

EricJRN, MSN, RN · Feb 4, 2008

Do you have a CNS, educator or director that would be willing to contact the school's clinical instructor? That might be the best way to address the questions, rather than making individual students feel like they're being pulled in two separate directions.

jjjoy, LPN · Feb 11, 2008

Our ridiculously long and unrealistic patient assessment form was similar to that. I don't remember the specifics, but it was four pages long and for any given patient only about 1/4 was relevant to the issue the patient was admitted for. But we had to fill the whole thing out as thoroughly as possible. I'd let them know that this was a student requirement and that they could choose to not participate at any point. That is in reference to the multitude of questions and full physical assessment we were supposed to do, not the relevant patient care and assessment needs.

I think the idea was to drill it into our heads not to only focus on the medical diagnosis of the patient and but to also remember to address psychosocial issues and/or keep alert for other health concerns/symptoms. It felt a bit like overkill to me. And meanwhile, we never formally learned how to do focused assessments.

psychnurse1998 · Feb 11, 2008

Our ridiculously long and unrealistic patient assessment form was similar to that. I don't remember the specifics, but it was four pages long and for any given patient only about 1/4 was relevant to the issue the patient was admitted for. But we had to fill the whole thing out as thoroughly as possible. I'd let them know that this was a student requirement and that they could choose to not participate at any point. That is in reference to the multitude of questions and full physical assessment we were supposed to do, not the relevant patient care and assessment needs.
I think the idea was to drill it into our heads not to only focus on the medical diagnosis of the patient and but to also remember to address psychosocial issues and/or keep alert for other health concerns/symptoms. It felt a bit like overkill to me. And meanwhile, we never formally learned how to do focused assessments.

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Sorry but something is wrong here. I think nursing educators are showing poor judgment if they dont modify what appears to be intrusive questions. My first reaction, after disbelief, would be NUNJA...hope everyone knows what that means..and its not the NUNJA turtle.. Perhaps an alternative would be a check box. Stating..the following information is of a very personal nature, do you feel comfortable talking to a staff member about sexuality issues. Added maybe. the facility feels it can give you more invididualized care if we know your sexual orientation or sexuality problems. If someone wants to know how my love life, I feel I have a right to ask the same question back.

But I do think its important to some how let the client know, what information is available before hand. I dont know that that has to be done on a direct basis, as it could be done by a brochure or other less direct way of educating a client.

Roseyposey · Feb 11, 2008

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.
Examples:
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?

I understand that part of nursing school is to get comfortable talking to people, but these questions are a little much. Do they teach you how to get this info., or do they literally think you will ask these questions as written? What does that mean "how is it?" (re: sex). Fulfillment, technique, orientation, what? I pride myself in being able to carry on a conversation with anybody, but I would not ask those questions as written. Maybe you could start with a simple are you married? Did you grow up around here? Are you docked points on your careplan if you don't get the answers to these questions? What if the patient refuses to answer? Does the floor educator or nm know that you guys are asking the patients these questions? I can foresee an instance in which their precious Press Ganey :bowingpur scores would be affected by a student asking a question that a patient perceives as rude.

Daytonite, BSN, RN · Feb 12, 2008

assessment is step #1 of the nursing process (the problem solving process we nurses use). i answer a lot of care plan questions and without a doubt one of the biggest problems that most students have is that they do not do a thorough assessment of their patients when they start out. from the assessment you glean out the abnormal items to do your problem solving (care plan) activities.

sexuality, which is a component of social activity, is supposed to be a part of a comprehensive assessment. many times it gets skipped over because the person doing the assessment isn't comfortable with the subject. i have to tell you though that when you find yourself working with a population of patients who are likely to have stds you learn to ditch your embarrassment real quickly in order to learn who has cooties that you are going to be working with.

also, part of adl assessment includes their social and family connections. questions about their family and finances is not out of line. the questioner needs to be tactful and ask these questions with sensitivity. part of the assessment for my bsn program included an assessment of each patient's financial, emotional, interpersonal and cultural resources. you can give a patient all kinds of instructions for the care they need to follow up on, but if you don't know or understand some of their background and resources, they may never be able to properly carry out those instructions unless you taper them to what they are able to accomplish within their home environment. what's the point in instructing a patient to use this or that device at home if they can't even afford to buy it? you can't assume that every significant other is going to be cooperative in helping with home care. some just won't. so, knowing something about their financial and personal situation is just being smart.

i would not look at this assessment as crossing an ethical or moral threshold, but rather a fact finding tool and use great tact, sensitivity and discretion in asking the questions. the goal is always to collect as much data as you can about the patient. the more data you have, the better you can plan the patient's care.

Zookeeper3 · Feb 14, 2008

Sexuality is a difficult subject to broach. I do with my cardiac patients as a screening too. (viagra use with nitrates and sexual dysfunction with beta blockers and such).

"several of your heart medications can affect your sexual functioning. Are you having these type of side effects? Have you tried viagra or that type of med to help?".

Now I only go there to assess if my frequent flyer or what not doesn't take his beta blockers because of sexual issues and we need a change or so on. Anything else... if not related specific to medical interventions or meds is not my place to go.... IMHO:twocents:

sistasoul · Feb 14, 2008

Hello all,

I am in my 4th semester of N. school now and some of the stuff we are suppose to ask or get info on I would usually right Not applicable or be tempted to make it up. I would always be more worried about their medical needs than anything. If the patient brought up the subject that was fine with me, but there were so many other things to worry about learning other than someones sexual health. This is important in some circumstances, but not all. Patients that are fresh post-ops usually are only concerned with resting and being pain free. I will be so glad to be away from these nursing care plan craziness.

Just my 2 cents