How long does it take you to do a head to toe assessment?

[lelafin]

Hey everyone! Quick question: how long does it usually take you to do a general head to toe assessment in a long term care type setting?

I'm finishing up my first semester of clinicals (fundamentals) and I'm kind of freaking out over how much time the care of just ONE patient seems to take me. I'm wondering if I'm spending too much time on the assessment or if there is something else I'm too slow with.

I was just reading another post where someone was saying that they have so much extra time in clinical! It seems like my whole class was barely finishing with patient care by 1400 after running ragged since 0700 (we had to do total care with bedbaths, showers, feedings, meds, etc on top of assessment and vitals plus any dressings or other orders). A lot of times we were not doing documentation correctly just because we were rushing so much at the end just to jot everything down as fast as possible. I get that it's mostly an organization problem and I've gotten progressively better, but I'm so worried about med surg next semester when I'm going to have 2-3 patients! I'm just wondering if anyone has some tricks/tips on how to be more efficient and how long a typical assessment should take, and etc.

[AOX4RN, MSN, RN, NP]

Ten minutes and that's about 9 minutes longer than the RN assigned to them takes!

[art1stic]

To reduce your time ask the patient question right away, any sob? Difficulty breathing? Chest pain? Last bowel movement? Passing gas?( as you move down your body systems.) Just do a quick head to toe focused assessment. If they didn't come in for an MI. Obviously your not going to spend time listening to bowel sounds for a full minute if they're been passing stool and passing gas. Look at your patients admitting diagnosis pmh to guide you on what you have to focus on

Group your tasks, while your taking vitals, do your quick focus assessment. Then teach your patent if they feel any new onset of symptoms or increased pain. Do this for your next patient, sit down and do a quick narrative then prepare for meds.

[NurseLoveJoy88, ASN, RN]

At first 5-7 minutes... now only 2-3 minutes. As soon as you walk in you have already begun your assessment.

[lelafin]

wow okay.... that's good to know. We are being taught that we have to listen for bowel sounds regardless but maybe that's just because they want us to get the hang of the head to toe process instead of just a focuses assessment. The biggest problem I've had time-wise is listening to posterior breath sounds because all of my patients so far had really bad contractures and could not support themselves at all for me to get back there.

Also most of my patients were non-verbal or with dementia so I took longer assessing all the normally verbal responses about pain/elimination patterns/etc.

[BluegrassRN]

As an experienced nurse, 2-3 minutes tops. I always listen to heart, lung (ant and post), and bowel sounds, and palpate abdomen as well as pulse in lower extremities/check for edema. While I'm assessing I'm asking questions: Any chest pain, SOB, cough? Any nausea? BM today, and was it normal for you? Any problems with urination? If their answer is out of the ordinary, I explore that in greater depth. I note how they move, how they handle taking pills, and what they say to assess neuro function. Functional assessment is obtained by noting how they move in bed, how much assistance they need with ADLs, etc. Any grimacing noted with palpation or movement? Explore it further. If you're paying attention, you'll get to the point where a thorough assessment doesn't take longer than a couple of minutes.