Nurses not doing assessments

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KulRN

75 Posts

I work with at least one nurse who charts for the entire shift at the beginning - her q2h checks (we have little boxes for like, resps regular/unlabored, etc) and everything. If she sends a pt to the unit or someone dies or something, her charting is going to be a big problem for her. But she has been a nurse forever and that's just the way she does it. That scares me too!

I'm not quite sure what you meant by this....but I too chart a lot but I only chart what I saw, heard and what I did....and it all depends on the situation too....I try to do my rounds every 2 hours and sometime more often depending on my patient's status...and I document...and at the end of my shift I report everything..there were few occassions where the previous nurse documented a wound as a pressure ulcer and finding out during my FULL ASSESMENT (patient report) that it was a wound not related to a pressure ulcer...and yeah, the other day night RN reported to me that the patient had an HL to her left A/C and when I asked the patient where it was...patient said "they never put one in" (this patient is A/O)....

gucci rush

13 Posts

Clarification I in no way meant to come off that all Filipino nurses don't assess I stated the 4 that I precepted with didn't and was just wondering if assessments were taught in their country. I also work with other filipino nurses who are very thorough and do their job well. I just couldn't believe that the nurses I was refering to didn't assess and didn't see anything wrong with it and some of these nurses also orient new grads. Like I stated before I know what I'm supposed to do I just hope nothing bad happens to their patients that could of been prevented.

chuck1234

629 Posts

Specializes in Nurses who are mentally sicked.
Clarification I in no way meant to come off that all Filipino nurses don't assess I stated the 4 that I precepted with didn't and was just wondering if assessments were taught in their country. I also work with other filipino nurses who are very thorough and do their job well. I just couldn't believe that the nurses I was refering to didn't assess and didn't see anything wrong with it and some of these nurses also orient new grads. Like I stated before I know what I'm supposed to do I just hope nothing bad happens to their patients that could of been prevented.

Some nurses also graduated from nursing programs in the U.S., well...they were taught the assessment skills were important....perhaps, it is life saving skills as they were taught. However, they are just as bad as the nurses you stated. This seems to me the cause of the problems is not whether they were taught or not, but some other problems might have been contributed of that problem. Hopefully, a viewer of your thread will be able to answer your question.

withasmilelpn

582 Posts

Specializes in Rehab, LTC, Peds, Hospice.

Happens all the time, drives me crazy! Look at your patient and know why they are there please. Document on what you saw! I hate when A&O patients say noone else has done so and so. Very scary!

caliotter3

38,333 Posts

Laziness, indifference, and negligence are not taught in any nursing program anywhere. People deteriorate in their job performance while on the job. This is also an indicator of the quality of supervision that occurs there as well as the possibility of way too much responsibility for the number of personnel or any number of other factors. Providing poor care, while being just plain unconscionable, is very risky. There are many patients and patient family members who are quite in tune with what should be happening. I am not referring to the picky ones who can never be pleased. Who would want to risk being called to task in the form of formal complaints or worse yet becoming the target of a lawsuit? This is something those four nurses should think about. Unfortunately, unless something adverse happens to one of them, they will probably go on for years with shoddy work practices. I feel sorry for both their patients and their co-workers.

Specializes in Trauma acute surgery, surgical ICU, PACU.

I have seen a LOT of nurses who don't do "real" assessments, or are lazy.

They listen only to the anterior chest, if they listen at all. They don't check the feet for edema. They don't LOOK at the skin on the back and buttocks.

I have had patients tell me that I was the first nurse to listen to their chest.

I had a senior (10+ years experience) nurse who was lazy as heck generally, TEACH me how to take shortcuts when i was a new grad. "If the 02 sat is greater than 94, then write that the chest is clear".... ???!!!!

Trouble is, to do a really thorough assessment, you have to ask the CNA for help to turn the pt, etc. Many of our nurses find it too inconvenient or are not comfortable, or our support staff is too cut to the bone and the CNA's are busy..... And maybe people need to have the stuffing scared out of them when they are new, about all the stuff you can miss and what can happen to a pt when you don't do a thorough assessment. ......

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

I guess I'm pretty lucky to be working in a rural setting. We have 2 RN's or one RN and one LVN and then one CNA.

As the CNA does vitals, the nurse responsible for that patient goes in also. So, I do an assessment then - you can see the patient's skin as they get up on the scale. Assess L/S front and back. Check periph pulses and edema. Etc.

steph

allnurses Guide

XB9S, BSN, MSN, EdD, RN, APN

1 Article; 3,017 Posts

Specializes in Advanced Practice, surgery.
I am RN with 6 years experience and never have I seen anything like this. I am a new employee at a hospital in California with majority of the nurses are Filipino. I was on orientation and I had 4 different nurses that I worked with and not one of them did an assessment didn't listen to the heart, lungs, abdomen,didn't touch the patient with a stethoscope. I couldn't believe it. How can you chart and give report to the oncoming shift that the lung sounds were clear when you didn't even listen. I am happy that I was taught better and know better. My question is in other countries are they taught different because we all know here in the US that assessing your patient is the first thing you are taught to do in school.

In the UK we are not taught to listen to routinely heart and lung sounds, I have only learnt during my Nurse Practitioner MSC, usually this level of examination is something medics or nurse practitioners do. Nurses do assess patients but in differently to how it sounds you do in the US.

LDJRN

23 Posts

Specializes in LTC, Med-Surg.

okay...this topic leads me to another question...i work 12 hour night shifts on the weekend, so the nurse i give report to is the same nurse i get report from when i return. the nurse i usually get report from is... well, i just don't trust anyone's assessment but my own (you know what i mean? exception: "hey, come give me a second opinion on this?"). i rarely give my assessment findings in report when they're different. is this wrong?

lord, save me. i'm so evil...

SharonH, RN

2,144 Posts

Specializes in Med/Surg, Geriatrics.
Clarification I in no way meant to come off that all Filipino nurses don't assess I stated the 4 that I precepted with didn't and was just wondering if assessments were taught in their country. I also work with other filipino nurses who are very thorough and do their job well. I just couldn't believe that the nurses I was refering to didn't assess and didn't see anything wrong with it and some of these nurses also orient new grads. Like I stated before I know what I'm supposed to do I just hope nothing bad happens to their patients that could of been prevented.

So if you already knew that there were other Filipino nurses who were very thorough then why did you ask if assessments were taught in their country? If some Filipino nurses are thorough and others are not (just as with American nurses) then can't you pretty much rule out the theory that they were not taught assessments in their country? Think about it.

There is also an irony to your questions. Nurses who are Asian/Pacific Islander are more likely to have a BSN or higher degree(72.7%) than White nurses(46.7%) or Black nurses(52.4%).

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

okay...this topic leads me to another question...i work 12 hour night shifts on the weekend, so the nurse i give report to is the same nurse i get report from when i return. the nurse i usually get report from is... well, i just don't trust anyone's assessment but my own (you know what i mean? exception: "hey, come give me a second opinion on this?"). i rarely give my assessment findings in report when they're different. is this wrong?

lord, save me. i'm so evil...

so, what do you talk about in report if you don't give your own assessment?

of course you should give your own assessment.

things change during a shift - lung sounds change. bowel sounds change. people get better. people get worse.

steph

msdobson

492 Posts

So if you already knew that there were other Filipino nurses who were very thorough then why did you ask if assessments were taught in their country? If some Filipino nurses are thorough and others are not (just as with American nurses) then can't you pretty much rule out the theory that they were not taught assessments in their country? Think about it.

Yeah! How dare her asking such question! :uhoh3:

There is also an irony to your questions. Nurses who are Asian/Pacific Islander are more likely to have a BSN or higher degree(72.7%) than White nurses(46.7%) or Black nurses(52.4%).

Which, of course, means absolutely nothing. The mere fact of one obtaining a BSN degree is NOT an indicator that that nurse is a) a more intelligent nurse b) a more intuitive nurse c) will actually do full assessments on his/her patients d) etc...etc...etc...

The ONLY thing these numbers prove is that 3/4 of Asian nurses are BSNs, while white and black nurses are more evenly spread out (LVN, ADN, RN cert., BSN, NP, PA) than Asians.

Statistics have no bearing on the topic of this conversation. And using the numbers game offends the intelligence of everyone involved.

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