Comprehensive Health Assessment & History

[goingCOASTAL]

Going back to school after 15 years to complete my BSN ... can't wait till it's done! LOL!! Currently taking a Health Assessment class, and I have this nagging question that keeps growing in the back of my head as I work with my volunteer (or should I say ... working ON my volunteer!) on doing my health assessment assignments.

Generally, it can take an hour or two just to perform the COMPLETE clinical assessment assignments on the section we have just covered ... and there are like 5-6 sections for this semester. So, it has me wondering ... if I'm doing an admission history and assessment on the Acute Care floor I manage - and I do it correctly (by our facility policy), it can take me 30 minutes or an hour depending on the patient.

However, what I'm learning in this class is more exhaustive than I've ever experienced before. Some of it I remember from my ADN classes, but some of it is still new to me. I think I'm pretty good at assessments, but if it's taking me an hour or more to complete (and my other classmates) one of these exhaustive assessments at school (and I multiply that by how many sections are in this class) ... how long are we REALLY supposed to take to do assessments in a hospital setting? And, would it be reasonable to expect hospital nurses to do assessments that take more than an hour or two or three? Could I really be "liable" if I failed to do the "scratch test" while assessing the abdomen?!?!? Or if I failed to assess motor function of the VII cranial nerve?!?!?

I'm beating my head (figuratively) as I return to my homework!!! LOL

[jlr820]

The "real world" answer is that you aren't going to do EVERY assessment parameter on EVERY patient EVERY time. True, you are learning this information so that you can be comfortable/competent with the technique, and can do the assessment if it is needed. Your assessments will, to an extent, be tailored to the client and the reason for hospitalization. Thus, if the client is admitted for abdominal pain secondary to a bowel obstruction you probably are not going to do the cover/uncover test, or Rinne/Weber, etc. They simply are not relevant for THIS client. So, your focus will be on the area of chief complaint, and you will "screen" the other body systems and go more in depth if you detect something abnormal. Thus, each system IS assessed, but the depth of assessment will vary. Also, as you do assessments, you will become more efficient (and therefore faster) with them.

[classicdame, MSN, EdD]

class time is where you learn all the scenarios. In real life you would look for clues that would cause you to delve further. For instance, if my face looked saggy on one side, consider testing for Cranial nerve VI dysfunction. I believe you are expected in an acute care setting to at least consider all systems then determine if more information is needed.