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Discussion

Learning outside the scope of RN practice?

I am finishing up my sophomore year in a BSN program. One of the classes this semester was a lab of physical examination and health assessment. It was a lot of fun, but we are being taught outside of (what I understand as) the RN scope of practice. We were doing full-on physical examinations and mock diagnosises. We had videos to watch to reinforce the material, and it is all MDs doing the videos. As an RN will I be actually determining diaphragmatic excursion? Percussing for splenic enlargement? Bronchophony and egophony? We are being taught head to toe assessment which I have only had my doctor do at a full physical, never an RN. Is this the norm at nursing schools?

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    You learn full, head-to-toe, assessment skills in nursing school. Assessing splenic enlargement, breath sounds, etc., is not diagnosing an illness, it is simple physical assessment. Depending on where you end up working in nursing (in what specialty/setting), you will probably not be doing full physical assessments in that level of detail, but more focused assessments of particular body systems, but it's appropriate and "normal" for you to be learning all of this in school.

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    Thank you for the reply, it helped to put it all in perspective.

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    I am so glad that you are able to take advantage of such a valuable course. When I was in grad school (MSN) I had an opportunity to take gross anatomy "lite" at a med school - for real! - and have never regretted it. It helped me to achieve a much deeper understanding of A&P than I ever believed possible; a great foundation for critical care nursing.

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    I had problems with discerning my job vs. another discipline when I was in school. It will make more sense when you do it, but for now I can say that the full assessments are MORE LIKELY to be done by nurses than MDs in a hospital setting. They are in and out. You are there 8-12 hours. You do not have to know what the disorder is that is causing the symptom or sign, just know that it is not normal and needs to be reported.

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    Yes you are taught everything and will you ever do that type of a assessment probably not. If you go into neuro yes will need to know how to check all the cranial nerves. So that's why we are taught everything.

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