Assessment Skills

[cari rn]

Am going to be new to Emerg soon. Wondering if all you experienced ED nurses can talk about your assessment skills, namely, how you specifically approach your assessment, how to "assess the pt in 2 minutes" and what this means, etc. I feel fairly confident assessing peds pts, as this is all my backround is, but I'm feeling nervous (and excited) about working in an adult emerg. Any tips will surely be appreciated by all!

Thanks!

[RunnerRN, BSN, RN]

I assess differently when I'm working w kids or adults. Adults, unless I get that kick in my stomach, get the focused assessment. You can tell alot by the way they speak and skin tone. If I have someone w abd pn and I'm doing bowel sounds, I automatically move up and do a quick lung listen. I check a radial pulse on everyone.

Kids are different to me. Unless it is a basic injury, and kid is acting normally per parents, I do pretty much a full assessment. Heart sounds, lung sounds, (I forgo the bowel sounds unless there is an abd c/o), peripheral and central cap refill, fontanel for infants, etc. My favorite question to ask mom and dad - "is he/she acting like himself?" A kid who has been puking all day that is playing with the WR toys is a much lower risk than the kid laying there in mom's lap (obviously).

[treborhon]

I'm with the other ones above. Not sure what you mean by a 3 min assessment. We do focused, sometimes across the room assessments. I also agree with Bill, you'll develop that "extra sense" that may make you look at another system, but that comes with time. I teach my preceptees 1 thing that may help. You will develop this with time: Just by looking and talking to someone for 10 seconds you'll decide 1 of three things.

the pt is OK, the pt is not OK, or the gray area, We're Ok now, but we may not be in a few minutes. It's the latter that seperates the outstanding ER nurse, from just a good one.

now i understand..Thanks....Sorry for my unclear question....Thanks again

[treborhon]

thanks to all who answered my question...