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Discussion

Help with Skin Assessment

How do I assess patients' entire bodies without it being awkward? Many of mine so far have refused help with bathing because their wives were there and would help them. This is my med surg clinical. I am not used to telling people I need to see their private parts.

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Well, so far, I've just assessed skin as I'm doing other things. I assess backs and chests as I listen to their lungs and apical. I assess stomachs as I listen for bowel sounds. I assess arms and legs as I check for turgor and IV sites and peripheral pulses. The rest? If they refuse, they refuse. You cannot force a patient who is uncomfortable with it.

Now I haven't started clinical yet (next week!) but I would think that you need to at least look at bony prominences to make sure the patient isn't experiencing any skin break down, especially for those at risk. Do you need to help with bathing or perineal care? No. But you need to do your job with the other areas right?

I have yet to have a pt have issues with skin checks. If I have a walkie talkie I just ask them to turn over so I can assess their skin to make sure they have no issues, its just a matter of fact approach.. We do foley care frequently on my unit and many are awake and alert, I just tell them what Im doing and why, never much issue.. Is it uncomfortable for them, of course. I make it short and sweet and to the point and done in no time. You will become more comfortable as you talk to your pts and become more comfortable with what you are doing...

Helping them to the commode, to the chair etc is also a great way to check also :)

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