New student having troulble with assessment of client

[dslothour]

I just began my first semester of clinicals about two weeks ago. I have been able to pass 9 out of 12 of the first skills needed to enter the clinical setting. We started to do clients assessments this week but I am having trouble finding pulses!! It is very frustrating and makes me doubt my abilities as a future nurse. Also when trying to remember what to do next and remember the BP, pules rate and resp I get worried and my mind goes blank and I forget everything I just took. I'm wondering if this is just nerves or am I not cut out for this?

[atlnurse477]

I believe practice still makes it perfect! You just need more of it and I'm sure everything will just be a piece of cake for you! Don't let these petty things discourage you!

[LittleLiz8235]

For my very first checkoff during my first semester, we were supposed to check each others blood pressure with the grad assistant listening on a dual tube stethoscope, and then report what we got. Well, my turn came around and I could not hear a THING! She almost failed me but finally let me go with a B. I was so upset that I cried, and I felt like I would never make it if I couldn't even find a basic BP! Now I'm in my 3rd semester of nursing school and I have to laugh to myself when I think Of it. You will be amazed at how far you've come in such a short amount of time. Things that once seemed hard will become second nature. So no stress :)

[mjo07]

I am sure it is just nerves. My advice to you is to practice on everyone you know! I have been taking bps and checking pulses on my husband my kids...even my dog...lol! Use your family and friends. I bet they would be happy to be your guinea pig :)[/quote']

Great Idea!

[NICUmiiki, DNP, NP]

Did anyone on a mobile device giggle at how the title of this post appeared?

Why yes I did.

[nurseprnRN, BSN, RN]

For my very first checkoff during my first semester, we were supposed to check each others blood pressure with the grad assistant listening on a dual tube stethoscope, and then report what we got. Well, my turn came around and I could not hear a THING!

Common problem, and often modeled by actors who don't know any better in medical dramas. The eartips of your stethoscope must be pointed anteriorly, towards the tip of your nose, because that's the anatomy of your ear canals. If you point them backward (towards the pinna, which is a misleading landmark :) ) the holes in the tips will be up against the wall of the ear canal and BINGO! no sound at all.

[eatmysoxRN, ASN, RN]

As someone mentioned above, pulses are much easier to palpate when you push harder and release slowly until you feel it. Radial is toward the thumb and between two tendons. Brachial is toward the inside of the antecubital area (what you put your stethoscope over when you take a BP... If you have trouble taking a blood pressure finding this pulse before starting makes hearing it much easier). Dorsalis pedis pulses are easiest to find if you start mid foot up from the middle toe. Posterior tibial pulses are similar to radials.. Grading a pulse is also important. Saying strong or weak is not as objective as stating 1+ or 2+. Practice on yourself and anyone you can get your hands on. Try to palpate pulses bilaterally simultaneously (except the carotid of course). With practice, you'll find pulses without difficulty.

Another thing to remember is that some people have to have pedal pulses dopplered. If you can't find it, ask the patient if they have ever had that done.

As far as remembering things goes, either go head to toe or go by system. Look up head to toe assessments on here or Google. Remember to look, listen, then feel, especially with bowel sounds and the abdomen.

Good luck!

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~