Nurses not doing assessments

Nurses General Nursing

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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.

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Specializes in Corrections, Cardiac, Hospice.
:nono: VERY scarey
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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
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.
Nursing programs in the Philippines train their students specifically to work in American facilities, so these nurses learn the same assessment skills that you have learned. Perhaps they are not doing assessments out of pure laziness.
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I wonder what these nurses were telling you during the orientation? Be glad that it jumped out at you so quickly in your employment there. You now know how extra careful you are going to have to be. But yes, I've worked around nurses that not only didn't assess, they didn't do a lot of the nursing care. You have to be aware that you can not make another person do their job up to par, even if you were to report them. Makes for more work and careful documentation on your part. And probably a lot of prayer, that no patients suffer and you get the blame.

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This is not acceptable.

If you are certain please talk with a clinical nurse specialist (CNS), your manager, or other RN in authority.

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Specializes in OB, M/S, HH, Medical Imaging RN.

Reminds me of a nurse currently seeing alot of our HH patients. The patients have been complaining that he/she is so quick, in and out the door, no vitals signs, listening to lungs, etc....

Interestingly enough his/her charts reflect full assessments with vital signs. Oh so wrong!

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Specializes in NICU.

I think this happens more often than any of us know. There are some very dishonest nurses out there... For example...

This morning I went into assess my patient. I was told in report that she had a rectal tube. Well I looked at the bag an it was empty. Hmm I thought... So i looked under her sheet and there was poop everywhere. I called in the assistant to assist me. We turned her to find that not only was there poop everywhere... but the rectal tube was in her lady parts!!!!!! I checked the chart to make sure she didn't have a fistula or something... I took it out... got a new one and actually put it where is was supposed to go...

The 3rd shift nurse recieved her as a transfer the evening before... and charted how the rectal tube was intact all night.....

I found out when I gave report today that the other 3rd shift nurses remember her saying that the rectal tube came out during the transfer and she was going to go replace it.....

I'm sorry but how does this happen??

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.....

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Specializes in Emergency Room.

the only explanation is laziness. in the ED we do more of a focused assessment pertaining to why the patient is there. for instance i do not listen to lungs if a person is there for an ankle sprain. but obviously if a patient is more acutely ill you are supposed to and should do a head to toe exam. i have also noticed many nurses chart inaccurate findings and not do assessments. very scary.

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I think this happens more often than any of us know. There are some very dishonest nurses out there... For example...

This morning I went into assess my patient. I was told in report that she had a rectal tube. Well I looked at the bag an it was empty. Hmm I thought... So i looked under her sheet and there was poop everywhere. I called in the assistant to assist me. We turned her to find that not only was there poop everywhere... but the rectal tube was in her lady parts!!!!!! I checked the chart to make sure she didn't have a fistula or something... I took it out... got a new one and actually put it where is was supposed to go...

The 3rd shift nurse recieved her as a transfer the evening before... and charted how the rectal tube was intact all night.....

I found out when I gave report today that the other 3rd shift nurses remember her saying that the rectal tube came out during the transfer and she was going to go replace it.....

I'm sorry but how does this happen??

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.....

I'm sorry but I laughed at all of that! That is just so ridiculous! I mean like you said... how in the HECK does that happen? Did someone mistake it for a catheter or what? Whoever was responsible for that pt definitely needed a bit more instruction from someone!

Whenever I happen to float down in the ER or anywhere that I am required to "triage" the incoming patients, I am sure to do a complete exam (not head-to-toe). I listen to their heart, lungs, blood pressure, get pulse, previous medical history, any meds they're currently on and what not if. If they're there for pain, I always examen/palpitate the area (if applicable) and do my best to determine whether or not something is broken, twisted, sprained or busted. Based on that, I create the report/chart, sign off and it's the MD's, PA's or NP's point from there.

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Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

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?

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I wonder how "these nurses" would feel if they were sick in a hospital and their nurse would "fake" assessments and therefore they might not get the medication or treatment they need or maybe even worse..DIE.. But I'am sure that thought never crosses their mind.

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Specializes in Emergency.

Just for my :twocents: , I know plenty of nurses that all went to school together and graduated together and all practice nursing differently. One of the best nurses on our floor is Filipino. I think the age old adage "all nurses are not created equal" applies here.

Good for you for noticing where their practice is lacking. I know you will not follow their example. Take the best and leave the rest (in a memo to your clinical manager for skills day sign off :))

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