How frequently do you do physical assessments in psych?

[beachgirl17]

I am considering changing my path and looking into psych nursing. Right now, I am a floor nurse and used to having physical assessments charted at least every 12 hours. I was wondering how often physical assessments are done in psych (I am talking inpatient). I tried to search for this, but did not come across the frequency of it. I am just curious. Thank you. :)

[elkpark]

It varies greatly -- I've not done physical assessments on a regular basis for years and years, but the facility at which I work prn now just started a new routine within the last couple of months where we do a fairly complete basic physical assessment on all clients on every shift. (The nursing staff is v. unhappy about this and trying to get it changed.)

[lucianne]

When I worked inpatient we pretty much did general physical assessments only on admission unless someone was medically compromised.

[Meriwhen, ASN, BSN, MSN, RN]

They are physically assesseed on admission, then daily. If a patient's medical status is fragile, we assess them more frequently...but every single patient gets at least one assessment a day.

I should add that the daily assessments aren't as in-depth as a med-surg assessment is, because most of our patients are reasonably healthy. So we're not whipping out the stethoscope to listen to every single set of lungs that comes our way or checking every inch of skin for breakdown...but we will if someone complains of SOB or we know someone's confined to a wheelchair, or we can see something is wrong.

[JaneyW]

You may want to look at your nurse practice act for your state. In CA, nurses are required to assess (no specifics as far as how thorough) each of their patients at least once every shift. Results of this assessment must be documented. Maybe that assessment can be a psych one?

[beachgirl17]

Thank you for your responses. I appreciate it.

[elkpark]

You may want to look at your nurse practice act for your state. In CA, nurses are required to assess (no specifics as far as how thorough) each of their patients at least once every shift. Results of this assessment must be documented. Maybe that assessment can be a psych one?

That's a v. common requirement (most, if not all states have similar language in the NPA), but the NPA doesn't dictate the specifics of what, specifically, must be included in the "assessment" and it varies depending on the clinical setting. I have always done a psychiatric nursing assessment of all my assigned clients (including asking them about any physical problems/complaints), every shift, in psych settings and that is what we were doing before at my current facility. Now, we are listening to heart, lung, and bowel sounds, blanching fingernails, checking pupil reflexes, etc., on every client, every shift -- highly unusual in a psych setting, in my experience (25 years in three different states ...)

[aloevera]

we do an assessment on admission........then pts. are seen by MD for a more thorough assessment..............when we chart each day we do a quick assessment, but that is it.........if medically warranted, we do a consult to the MD...............not much physical assessing at my facility........

[ok2bme]

We do a physical assessment upon admission.

After that, we do focused physical assessments when applicable. For example, one of my patients has debilitating neuropathy and was sedentary prior to treatment, he has a pressure ulcer and I do wound care every shift. Another patient had N/V today, I did an abdominal/pain assessment. I frequently check the lungs who is prone to upper respiratory infections, etc. etc.