Nurses not doing assessments

msdobson · May 31, 2007

Nursing programs in the Philippines train their students specifically to work in American facilities.

Well. There's an eye-opener. :eek:

viena · May 31, 2007

I've worked with many Filipino nurseswho have excellent assessment skills, if not always the best temper or bedside manner.
From the beginning of our training, we are taught that if it wasn't documented, it wasn't done. Unfortunately, over the years I've encountered many nurses who think the opposite is true: As long as you document it, that means you did it. Did you ever wonder how the pt was turned q 2 hr when the nurse rarely left the station?

You are right if its not written it did not happen unfortunately this is not always the case as you said I think its imperative that during the shift change or endorsement to be safe from liability we have to be alert and document the status of the patient when we received everything if we could

SharonH, RN · May 31, 2007

I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4 different nurses that I worked with and not one of them did an assessment didn't listen to the heart, lungs, abdomen,didn't touch the patient with a stethoscope. I couldn't believe it. How can you chart and give report to the oncoming shift that the lung sounds were clear when you didn't even listen. I am happy that I was taught better and know better. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.

Try not to assume that the reason someone does or does not do something is due to their race/ethnicity/nationality. I have worked with many American-born and American-trained nurses who were lazy and lacking in basic nursing skills. Be responsible for your own practice first and spend this time as a new employee learning the ropes at your new facility before you waste time being judgmental and overly critical. Did you spend every single second with these nurses? Is it possible that they did an assessment when you were not around? You may be surprised at how things turn out.

angel337, MSN, RN · May 31, 2007

Try not to assume that the reason someone does or does not do something is due to their race/ethnicity/nationality. I have worked with many American-born and American-trained nurses who were lazy and lacking in basic nursing skills. Be responsible for your own practice first and spend this time as a new employee learning the ropes at your new facility before you waste time being judgmental and overly critical. Did you spend every single second with these nurses? Is it possible that they did an assessment when you were not around? You may be surprised at how things turn out.

thanks for pointing that out, because i have worked with plenty of white nurses that did the same thing. where are work some of our best nurses are filipino.

babydoll99_99 · May 31, 2007

thanks for pointing that out, because i have worked with plenty of white nurses that did the same thing. where are work some of our best nurses are filipino.

Let's not be too quick to jump on the OP about her bringing up that these nurses were Filipino. She stated that she was ignorant of what they did in school and asked a question. Did either of you stop to think that maybe if the answer had been "No, they don't learn that." the Op was planning on educating them to be better nurses.

Since the answerwas Yes, the OP now has other options. She can ask the nurses directly if they assessed a patient, or even ask them to "show her how it is done on this floor."

I hate how people are so quick to say "you said (insert race/nationality) *shock* Awe*! Really she was just asking a question and a simple yes or no answer was warrented.

/soap box

UM Review RN, ASN, RN · May 31, 2007

I also believe that there are many times when nurses do not assess their patients.. and not only nurses but DOCTORS!!!!! One time my patient had a very irregular rhythm and I couldn't find anything in the progress notes about it.. Doc had already seen her a few minutes before and charted in his progress notes that she had a regular rate and rhythm.... well we then got an EKG to find she was in rapid a-fib.....

This can happen. I've seen it. Patient will literally be SR one moment maybe some PACs, then pops right off into AF w/ RVR.

UM Review RN, ASN, RN · May 31, 2007

. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.

I think they are taught correctly. I also work with a number of Filipino nurses. IMO, they have excellent skills and assess frequently.

decartes · May 31, 2007

Why hate?

Let's not be too quick to jump on the OP about her bringing up that these nurses were Filipino. She stated that she was ignorant of what they did in school and asked a question. Did either of you stop to think that maybe if the answer had been "No, they don't learn that." the Op was planning on educating them to be better nurses.
Since the answerwas Yes, the OP now has other options. She can ask the nurses directly if they assessed a patient, or even ask them to "show her how it is done on this floor."
I hate how people are so quick to say "you said (insert race/nationality) *shock* Awe*! Really she was just asking a question and a simple yes or no answer was warrented.
/soap box

bklynborn · May 31, 2007

I love the charting on the invisible foleys that are "patent"

KulRN · May 31, 2007

I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4 different nurses that I worked with and not one of them did an assessment didn't listen to the heart, lungs, abdomen,didn't touch the patient with a stethoscope. I couldn't believe it. How can you chart and give report to the oncoming shift that the lung sounds were clear when you didn't even listen. I am happy that I was taught better and know better. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.

This really saddens me....I am a Filipino and it affects me when I hear things like this....I, on the other hand.....take assesment seriously! When I am getting report from the outgoing nurse, I start my assesment there ( we give bedside report) and once I get all my report I go back and reasses each of my patient....some people think it's crazy and a waste of time if you do HEAD-TO-TOE assessment...but I DO! I want to know my patient in and out! There were few incidents where I found things that previous nurses didn't see that were very important....and I've sent patients to Tele or PCU because of this incidents! A charge nurse that I work with jokingly ( I hope) comments that when we work together half of the time we have transfers.....I comment back and say " Hey, what can I do I'm just doing my job and I see things other nurses didn't see"....I take my job seriously! Assessment and reassement is very crucial!

miko014 · May 31, 2007

This scares me - there has been more than one time where I go in and do my assessment and pts (who have been there for days, mind you) say, "oh, nobody has done all that before". Yikes! I've also had pts ask me, "wait, are you my doctor or my nurse?" and when I say nurse (which, of course, I always tell them when I first meet them), they are surprised about me doing an assessment, whcih leads me to believe that maybe people aren't doing it. But I don't know whether they do or not.

I work with at least one nurse who charts for the entire shift at the beginning - her q2h checks (we have little boxes for like, resps regular/unlabored, etc) and everything. If she sends a pt to the unit or someone dies or something, her charting is going to be a big problem for her. But she has been a nurse forever and that's just the way she does it. That scares me too!

Sometimes I wonder if nurses even look at pts - I've heard stuff in report like, "it says on my sheet that he has an NG, but I don't know if he does or not." I mean, an NG is pretty obvious, isn't it? All you have to do is walk in the room for that one. My favorite was a few weeks agp - I had had a confused pt for a couple of days, and I got back for my last day of the stretch, and when I went to chart on him, I saw that it said he had a SW in his right hand. I was like "no, he took that out and they said not to bother restarting it becasue we didn't need it..." so I went back in and looked again just to make sure I hadn't missed it. He had no IV access (hadn't for days), but they had been charting it like it was there all along! NOT GOOD!

chuck1234 · May 31, 2007

I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4 different nurses that I worked with and not one of them did an assessment didn't listen to the heart, lungs, abdomen,didn't touch the patient with a stethoscope. I couldn't believe it. How can you chart and give report to the oncoming shift that the lung sounds were clear when you didn't even listen. I am happy that I was taught better and know better. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.

I graduated from a college in the U.S. and I am working in the city and this provides me a chance to work with whites, blacks, Asians, Hispanic nurses. I think this is part of the reality. Sometimes I see white nurses are doing horrible job than the rest, and sometimes blacks are doing the same thing. Asian and Hispanic are doing what you said. But when you look at the patient ratio....12 patients to 1 nurse. Even 8 to 1 is still too much, especially in the Med-Surg Unit. I am totally agree with you, it is not the way is....however, most nurses--white, black, Asian, or Hispanic--don't do anything until the patients are experience some forms of distress. It is sad...and this is the reason why I hate going to hospital when I am sick.