Nurses not doing assessments

SharonH, RN · May 31, 2007

Yeah! How dare her asking such question!

Well why did she ask? If she has worked with some Filipino nurses who do in fact do assessments, then why, after working with 6 of them who probably represent .00000001 percent of all Filipinos, would she start to wonder if they are taught to do assessments. That doesn't make any sense. Why even go there? If I work with 4 White American nurses who can never drop a Dobhoff or get a Foley in or almost any other basic nursing skill(and I used to work with 4 such ladies), I don't start to wonder if White American nurses are taught how to do those things. They were just 4 bad apples! This is the type of thinking that leads to stereotyping and scapegoating.

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...

I never said it was an indicator of those things. But the OP is questioning their education and the fact that they tend to be more highly educated than their American counterparts is ironic. Beyond that I won't get into a BSN debate with you so don't waste your time.

P_RN, ADN, RN · May 31, 2007

No degree debate here OK?

I have unfortunately seen this happen right on my own floor. I have seen RNs who seemingly never got out of their chair the entire shift. I also have seen doctors "pretend" to listen to chests but had the earpiece of the steth. hanging around their necks.

My best advice would be to call them on it every time. Be nice but firm. "You didn't listen to their chest?" or

"What did their lungs sound like I don't believe I saw you listen." or....whatever. You are protecting their patient.

msdobson · Jun 1, 2007

Well why did she ask?

Seems to me she asked because she wished to know if the practices taught to Filipino nurses who take their education IN the Philippines, rather than Filipino nurse who take their education in the U.S., differed in substance. It was a fair question, but of course there is ALWAYS someone who wants to throw out the "race" or "stereotype" card right away. Congrats.

If she has worked with some Filipino nurses who do in fact do assessments, then why, after working with 6 of them who probably represent .00000001 percent of all Filipinos, would she start to wonder if they are taught to do assessments.
See above.
That doesn't make any sense. Why even go there? If I work with 4 White American nurses who can never drop a Dobhoff or get a Foley in or almost any other basic nursing skill(and I used to work with 4 such ladies), I don't start to wonder if White American nurses are taught how to do those things. They were just 4 bad apples! This is the type of thinking that leads to stereotyping and scapegoating.
Because YOU immediately start thinking "racial." SHE wanted to know about "different geographical" educational practices. She wanted to know HOW or IF the training of NURSES was different in the U.S. as opposed to the Philippines.
I never said it was an indicator of those things. But the OP is questioning their education and the fact that they tend to be more highly educated than their American counterparts is ironic. Beyond that I won't get into a BSN debate with you so don't waste your time.
You made your views on that subject abundantly clear by posting that. Everyone here who has ever read my posts knows that I am a HUGE supporter of having MULTIPLE avenues into the nursing field. And NO, I won't be drawn into the fight either. However, everyone has the right to their own opinion, and you have the right to yours.

P_RN, ADN, RN · Jun 1, 2007

O K........no degree debate AND no "color" debate. This should go without saying, but let's not get this thread closed due to the above. OK???????

Be nice.

msdobson · Jun 1, 2007

O K........no degree debate AND no "color" debate. This should go without saying, but let's not get this thread closed due to the above. OK???????
Be nice.

It's okay, P_RN. I'm out of it. I've had my say (and unfortunately lost my temper). My apologies to the members.

P_RN, ADN, RN · Jun 1, 2007

Good to hear it. Thanks

SharonH, RN · Jun 1, 2007

Seems to me she asked because she wished to know if the practices taught to Filipino nurses who take their education IN the Philippines, rather than Filipino nurse who take their education in the U.S., differed in substance. It was a fair question, but of course there is ALWAYS someone who wants to throw out the "race" or "stereotype" card right away. Congrats.

Er, she made it an issue by stating that the reason she was questioning the education system in the Phillipines was because of 4-FOUR-nurses that she worked with that allegedly didn't do assessments. She admitted that she had worked with Filipino nurses who DID do assessments but because she ran into 4 who did not, then the entire educational system is to be questioned? It was absolutely not fair, NOT fair at all. And I'm sorry that you and P_RN got so nervous because of my analogy but I was trying to make a point which you very deftly missed. Congrats yourself.

P_RN, ADN, RN · Jun 1, 2007

Not at all nervous, just want to keep the flow mellow and smooth. The "issue" has been resolved now. Many times people mis-speak when they address a forum. Please make allowances.

miko014 · Jun 1, 2007

Okay, enough with the Filipino thing. I don't care if they were from Canada, USA, Egypt, or Mars. This is a very good thread! It's not a race issue, it's a patient safety issue. Pretend she never said the "F" word (haha) and let's talk about the real issue - nursing assessments!

Kul - not sure exactly what you mean since the quote thing didn't work right, but I'll give it a shot:

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)....
Our assessment flowseet has spaces for the hours across the top, and the assessment along the side. For example, for evening shift, I would put say, 1600 as my initial assessment time and fill out the boxes (apical reg, resps reg/unlabored, clear to auscultation, on room air, denies pain, has a foley and an NG etc etc). After that, each 2 hours, I go back and reassess - not a full assessment, just that resps are still reg/unlabored, still on room air, still has foley, etc. I would do that at 18, 20, and 22. The nurse I am talking about does that at the beginning of the shift. So even though it is only 1600, she has already charted all of her 2200 information. If something changes - say the pt passes away at 1800, it's going to look pretty bad if her charting says that the resps are regular (or irregular, or labored, or whatever) at 2200. Does that make more sense? Charting without doing? Falsifying charting? I guess I would just call it "charing in advance", which, of course, is a . I know this is long-winded - I just hope it makes sense!!!

bethem · Jun 1, 2007

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.

Same in Australia. The only time I have seen nurses routinely assess heart and lung sounds is in ICU. I had a patient recently who became acutely SOB and desatted from 97% to 92% within 15 minutes (while 92% isn't awfully scary, the quick drop bothered me) and the doc was really taken aback that I had grabbed a steth and had a quick listen to the chest to see if there was anything weird going on. Otherwise we only have stethoscopes around to do manual BPs.

chuck1234 · Jun 1, 2007

Post# 26 gucci rush stated that "wondering if assessment were taught in their country. I also work with other filipino nurses who are very thorough and do their job well." Again, in post# 1, gucci rush stated that "My question is in other countries are they taught different because we all know here in the U.S. that assessing your patient is the first thing you are taught to do in school."

It is very interesting to see that gucci rush brought out the argument and then she gave the contradictory answer to her owe argument.

If that wasn't what other countries have taught, then how come some of gucci rush's coworkers did their job well as stated in post# 26. Apparently, they were taught about what to do. Otherwise, gucci rush has to change the original statement. It is very important not to attack your own argument, as I was taught in English 101.

Anyhow, I think it is not only one specific group of people who are doing it. Black, white, Asian and Latino nurses are doing the same thing. Whether they graduated from colleges in other countries or colleges in our own backyard. I think the problem is caused by some other problems rather than they were taught in school or not.

student456 · Jun 1, 2007

i dont understand how aussie and uk nurses arent taught to routinely assess heart and lung sounds!?!. How do you protect the pt as we all your own self if the pts condition deteriorates...what baseline would you have then? How would you know if the lung sounds are clear upon auscultation or if there are crackles...or if their heart sounds suddenly are abnormal?