dumb question

Nurses General Nursing

Published

I am a first semester nursing student. We are learning how to do a head to toe assessment, but my question is, when do we do them? When we are first coming on shift? When there appears to be a change of some type? Instructors have given lots of info on the how, but not the when. Thanks.

Specializes in SICU, trauma, neuro.

I typically do mine early in the shift, and do focused assessments 1) if I suspect a problem or 2) as ordered -- for example, neuro checks q 1 hr.

Specializes in Acute Care, Rehab, Palliative.

Lots of times I do it while I am in the room, either doing the vitals or giving their meds. You can talk to them to assess orientation, ask them about their pain, how they slept or how their day was, take a quick peek for edema and how they are moving around, etc. Most of the time they are not even aware you are assessing them. Sometimes if I need to do a focused assessment I will do it after med pass.

Specializes in Neuroscience.

You will assess every patient when you walk in the room. Full assessments will depend on your orders. I do a full assessment when I bring in medicine for the first med pass. Sometimes the patient has special orders for more frequent focused assessments. As someone else said, Q2 neuro or Q2 NIH assessment is common (in neuro nursing)

Assessment is the foundation of your nursing care. You'll get better, you'll find yourself quickly looking at veins and ankles when you're at the grocery store, and you'll find yourself popping off a list of possible causes without even a second thought. This is a good thing!

Your assessment as a nurse will never take as long as the assessments you do now in nursing school. What you learn in nursing school is a comprehensive assessment that is forcing you to consider the whole body, which you're not used to doing. Learn and master it, because it will be the most important skill you have at the beginning of your nursing career.

Specializes in Psychiatry, Oncology.

When it is my first shift with my assigned patients, I do a thorough head to toe during the first med pass. When/if it is my second/third/sometimes fourth shift with the same patients I can usually do a quick assessment to see if there are any changes vs previous day/night when I walk in to say hello and write my name on the board.

Nursing student here too. During clinicals most nurses seem to do them after receiving report, maybe while doing thir first med pass. When there is a change, the assessment is usually focused on that area/body system.

+ Add a Comment