Do new grads learn complete physical assessment in todays world???

Palliative Care, DNP · Jan 10, 2017

If you are already gone then include that info in the good old patient satisfaction survey. Tell them that you are concerned for the safety of other patients as you work in healthcare and know what should have occurred.

Sour Lemon · Jan 10, 2017

I just spent 4 1/2 days in the hospital for a 6 1/2 mm kidney stone blocking my left kidney. They put the stent in last Monday as an emergency procedure to get the kidney to flush out the CT dye. but because of infection, I needed to stay a while. After being off Plavix for a week they did the lithotripsy this morning. The entire time, not a singe nurse touched me except for a 4 hr float pool nurse, who quickly listened to my lungs in 2 places, my heart for about 4 seconds and my belly in 2 places for about 2 seconds each and was done.
Is this normal???
What should I do about it???
Are nurses not taught to do assessments anymore???
who do I go to and what is the difference between a complainer, a disgruntled employee (I used to work at this hospital) being a good healthcare advocate, or being a concerned citizen???
HELP

Unfortunately, is does seem to be fairly "normal". People often just copy what the person before them charted. I remember accidentally charting "wheezing" once for a new admission. When I came back four days later, he was still "wheezing" although he never had been in the first place.

I do admit to doing more focused assessments, at times. If I have a twenty year old patient hospitalized with a toe wound, no history, and a same-day chest x-ray, I'm probably not going to spend too much time listening to his lungs ...maybe just a quick fly-by.

AJJKRN · Jan 10, 2017

I do a quick head to toe on every patient the same way every time no matter what they're admitted for so a major bowel still gets basic neuros done from me.

I would see if there is an "action line" type of phone/computer service to place complaints that is offered along with filling out your survey.

You know that this is not acceptable practice and I would be concerned if just a few nurses skipped a few things when they were assessing you but for the culture to be that wide spread is just jaw dropping...you were admitted to a hospital floor not being treated in the ED where a focused assessment is acceptable and practical!

NICUismylife, ADN, BSN, RN · Jan 10, 2017

I'm a new grad. I was taught to do full assessments. I do a full assessment every day on every patient, even if I already had the patient before, but my ratio has never been higher than 2:1.

I have had the same experience as you when I was hospitalized on a med-surg floor. I was there for 3 days, not a single nurse performed a full assessment, and I don't even remember focused assessments to be honest! When I was visiting family in the ICU though, I saw assessments happen frequently--full and focused, hourly even! Again, the ratio was 2:1.

I have to wonder how much of it is due to unsafe staffing ratios and/or higher acuity on med-surg floors. On another recent thread, the RN said she had 9 patients and one was such high acuity that she didn't get in any assessments on her other patients.

I wouldn't jump straight to the conclusion that the lack of a full assessment is due to an educational flaw. There are too many other variables involved.

AJJKRN · Jan 10, 2017

I'm a new grad. I was taught to do full assessments. I do a full assessment every day on every patient, even if I already had the patient before, but my ratio has never been higher than 2:1.
I have had the same experience as you when I was hospitalized on a med-surg floor. I was there for 3 days, not a single nurse performed a full assessment, and I don't even remember focused assessments to be honest! When I was visiting family in the ICU though, I saw assessments happen frequently--full and focused, hourly even! Again, the ratio was 2:1.
I have to wonder how much of it is due to unsafe staffing ratios and/or higher acuity on med-surg floors. On another recent thread, the RN said she had 9 patients and one was such high acuity that she didn't get in any assessments on her other patients.
I wouldn't jump straight to the conclusion that the lack of a full assessment is due to an educational flaw. There are too many other variables involved.

My patient ratios are 5-6 (rarely 6) on Med-Surg and 3-4 (rarely 4) on stepdown. My Med-Surg get my full assessment at the beginning of the shift and a focused with any changes during my shift per hospital policy. The stepdown get a full every 4 hours per policy and a focused with any changes.

And as I stated in that thread mentioned, I would NEVER work in acute care setting with those ratios!

Libby1987 · Jan 10, 2017

I wouldn't complain about that particular omission in care unless the problem began with the nurses not assessing.

If the opportunity was there and they just didn't take it, then yes I would state this on the survey.

If the problem began with an understaffed unit and the nurses were over faced then no, I wouldn't complain about their lack in care IF it seems they prioritized for the benefit and safety of the whole the best they could. What I would report is their obvious unsafe understaffing if that is what I observed.