Can a nurse working "swing" shifts do both a day and night shift assessment?

[Bruce_Wayne, ASN, RN]

Question:

Say a normal shift is 7 to 7. What if a nurse works 11a to 11p on a heavy admit day- can that nurse do the admit assessment when the patient gets there and do a "night shift" assessment after 7p and then when report is given at 11p the receiving nurse is not responsible for a shift assessment?

Just wondering; trying to figure out some creative staffing solutions.

[RNewbie]

Whenever I pick up pts mid shift, I complete my own assessment even if it was done by the off going nurse. I think this is standard practice. Some charting systems have a place where you can go in and choose "no changes" from previous assessment. This is good if you agree with the previous assessment and there are no changes but I never use that. I actually go through and chart a new assessment.

[Vespertinas]

There is no way a nurse who comes on for a shift (anything greater than 4h in my opinion) can avoid the responsibility of documenting an assessment. And that sounds unfair to the day RN: heavy admissions and 3 assessments on one patient? (assuming m/s)

[ukjenn231]

I think every nurse should do an assessment when they assume care of the patient, even if it is a focused assessment. How are you going to speak to changes in the condition? In my facility you cannot use "no change" if you did not do the assessment that you are saying is unchanged.

[RNKPCE]

You must do your own assessment when you assume care? Another nurse doing an assessment even 1 hour before you has nothing to do with your assuming responsibility for that patient. Most 12 hours shifts would need to do at a minimum 2 assessments. The first one should be comprehensive the second one could be more focused. So for an MI patient complete head to toe initially and then heart sounds, lungs sounds, gross neuros, edema, and skin for second assessment. Remember this is a minimum of twice in a 12 hour shift, critical care would be more often, or in a CHF patient you maybe listening to lungs every couple hours.

[blondy2061h, MSN, RN]

I do an assessment when I get a patient, whether that's at 7am when I arrive, at 1pm when they're admitted, at 2pm when they're transferred to us, or at 3pm when I pick up a patient from the 8 hour shifter leaving. I update my assessment throughout the time I had the patient, and I chart on things like pain and nausea every 4 hours, but I don't do a complete assessment again.

[Morainey, BSN, RN]

Do your nurses only have to chart assessments twice a day? Our facility does them for every shift, 11-7, 7-3, and 3-11. I come in for 7p-7a and more often than not the nurse that worked 7a-7p only documented an assessment during that 7-3 period. This can make things hectic, because I will be trying to finish the 3-11 assessment before 11 so it doesn't look like the patient wasn't charted on for 12 hours. Let me just emphasize that I am talking about the act of charting in the medical record, and of course I assess my patients at the start of my shift - I just might not enter the assessment until later.

[delilas]

I think it goes by your hospital protocol; on my floor, it only specifies that one be done by each nurse during their shift, and reassessed as necessary, IE, changing condition.

Besides when covering lunches, I will never take on a patient without assessing them. I don't care if the nurse before me assessed them six times, and the last time was 30 minutes ago; I'm going to chart a full head to toe assessment that is mine​.