Assessments

[Cricket183]

I'm a RN, although not currently working.  I caught Covid in July 2020 from work and ended up in ICU in respiratory failure.  The fallout from that and long covid symptoms have left me unable to work.  I had not planned on retiring at 56 but that's what it currently looks like.  
 I've been hospitalized multiple times since Covid for various things and am currently in the hospital with pneumonia.  I've been here a couple of days, and with the exception of the ER, not a single nurse has done an assessment on me.  They've checked vitals but no one has listened to my heart and lungs or checked for swelling or anything else.  I've noticed this before on other admissions but it was more hit and miss, not everyone!   Frankly, it's extremely disturbing.  Thoughts?  Has anyone else noticed this trend?

[Oldhagersucks, BSN, RN]

The hospital is on a budget. So they contract teledocs from different state during night shifts. 

[Tenebrae, BSN, RN]

Oldhagersucks said:

Well you should address that with the charge nurse or manager in the hospital. And you said you're a nurse before, you can suggest or let them know your symptoms since you assessed yourself already . If you're too concern about that why don't you go back to bedside nursing and be the leader there . 

perhaps you could read OP's post properly

You missed the portion where they said they were permanently disabled due to medical conditions arising from covid. 

IMO nurses should always endeavour to practice in such a manner that if anyone was observing they have nothing to fear.

If a nurse is tense about outside observations, perhaps they need to work on their practice

[FAB_RN, BSN]

Things have only gone from bad to worse after COVID. I would suggest you demand to speak with either the manager or house supervisor and ask them why they're clearly not staffing appropriately. 

[mdsRN2005, ASN, BSN, RN]

delrionurse said:

It's not right in any way but how many patients does the nurse have and what is the acuity? In these hospital nowadays, nurses are bombarded at the beginning of their shift with unaddressed problems, unstable patients and admissions/discharges. Those assignments need to be addressed with the charge nurse and managers. 

 

 

The charge nurses have no control over staffing, and sadly the nurse managers don't have much more.  Without upper admin giving them the funds, their hands are tied.  It's a scary situation.  

Cricket183 said:

Indeed it is.  And I will be discussing it with leadership.  Very sad.

I think you definitely should.  Let us know how it goes.  

[IndecisiveRN97]

I used to be a hospital sitter for two years before becoming a nurse and you'd be surprised how many nurses don't do assessments. They just came and gave pills. I was curious about it since I was in nursing school but never said anything to anyone. And now that I'm a nurse I wondered how they even went about doing that. I was also in the ER a year ago due to syncope and the nurse did not do a physical assessment either, just asked questions. I can understand doing more focused assessments in the ER but at least listen lungs and heart sounds. 

[Cricket183, BSN, RN]

IndecisiveRN97 said:

I used to be a hospital sitter for two years before becoming a nurse and you'd be surprised how many nurses don't do assessments. They just came and gave pills. I was curious about it since I was in nursing school but never said anything to anyone. And now that I'm a nurse I wondered how they even went about doing that. I was also in the ER a year ago due to syncope and the nurse did not do a physical assessment either, just asked questions. I can understand doing more focused assessments in the ER but at least listen lungs and heart sounds. 

I agree.  You don't necessarily need to do a complete head to toe assessment every time on every patient and there's a lot you can assess by observation-mental status, moves all extremities, skin color, etc. but heart, lung, and bowel sounds can only be assessed by a stethoscope and they are major things that should be assessed every shift.  Things can change rapidly!  Vital signs can look stable on a patient with heart issues or pulmonary issues because are bodies are wonderfully adept at compensating to keto homeostasis-until suddenly  they're not!  And especially since I was in with pneumonia severe enough to require supplemental oxygen-how do you not listen to the lung sounds?  
I get that nurses are busy and overwhelmed and sure-we end up cutting corners at times to get everything done but this is one area where  don't think corners should be cut.  

[delrionurse]

IndecisiveRN97 said:

 I can understand doing more focused assessments in the ER but at least listen lungs and heart sounds. 

Again not saying it's right in any way, but I believe part of it is burn out. How many times do you have to assess pedal pulses in ER or a different unit when someone is there for a broken finger? This is administration not doing their job by not looking out for the nurse and not cutting down on charting. Some of the charting systems are tedious. 

[IndecisiveRN97]

delrionurse said:

Again not saying it's right in any way, but I believe part of it is burn out. How many times do you have to assess pedal pulses in ER or a different unit when someone is there for a broken finger? This is administration not doing their job by not looking out for the nurse and not cutting down on charting. Some of the charting systems are tedious. 

I agree. Thats why I'm saying focused assessments are more important in the ER. So who really cares about your pedal pulses if your fingers are broken. But some nurses/healthcare professionals may agree that you can find out other things about the patient if you assess them as a whole. But definitely staffing ratios needs to be rectified.