Physical Assessment

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Specializes in HH, MedSurg, Oncology, Orthopedics, Pacu.

Ugh....I feel like such a loser! We had our Physical Assessment check-offs today and I got so nervous that I let one little thing throw me off and I failed! I practiced this assessment over and over again and I just don't know what happened. Only a few students in my class ended up passing so that did make me feel a "little" better, but it was still upsetting, nonetheless.

I am asking all of you seasoned Nurses and later-semester Nursing students for some advice on how to calm my nerves before check-offs so that I don't flub-up again and NOT pass. I'm a perfectionist and this really upsets me that I did not do well. ANY advice you guys could give me would be GREATLY appreciated! Thanks!!!!:)

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Specializes in CVSICU, Cardiac Cath Lab.

I'm halfway done with my ABSN (just so you know my experience!), and the best advice given to me after I failed a skill check was SLOW DOWN! A competent nurse thinks before she speaks/ acts and taking a moment to check yourself will really help avoid needless mistakes caused by nerves.

I can tell you that forcing myself to slow down and pause has really helped me get past the nerves..

Good luck!!

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Specializes in Perinatal, Education.

Breathe and slow down. You will need to start forgiving yourself or this will continue.

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Specializes in HH, MedSurg, Oncology, Orthopedics, Pacu.

Thanks so much for your quick reply! And it does make me feel better to know that someone with your experience has also failed a check-off! I certainly do need to slow down and take a deep breath. I was so caught up in wanting to get the check-off done and over with that I know that I rushed through it and got myself all flustered. I will continue to just take it easy during my practice runs and hopefully I will make it through the second round with no problems! Thanks again!

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Practice practice practice.... you will not learn the assessment skills from a book or by watching a video. You need to get friends, family and fellow students to be your patient and act out a realistic scenario. Trust me... it works.

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Practice practice practice.... you will not learn the assessment skills from a book or by watching a video. You need to get friends, family and fellow students to be your patient and act out a realistic scenario. Trust me... it works.

This.

Also, when you're practicing, find a routine that's comfortable for you, and do your assessment the same way each time. Get into the habit of doing the assessment the same way every time, and you'll be far less likely to forget anything.

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Specializes in HH, MedSurg, Oncology, Orthopedics, Pacu.

I cannot THANK all of you enough for all of your replies and awesome suggestions!!!

The one main thing that threw me off during the check-off was there was a tube attached to the "patient's" face and it was a tube I had never seen before but for the purposes of the check-off, I was required to verbalize what it was and to check it/analyze it. I got so thrown off and nervous from not knowing what this tube was that I totally crumbled under pressure! I just wish I had been more prepared for that and I might have actually passed. I think this is what ended up throwing off a lot of the students as well.

Any suggestions for this kind of scenario for tubes, etc? Would Youtube be a good resource? Thanks!

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Specializes in being a Credible Source.

Try to get out of "student-being-tested" mode and just *think* about what you're doing. It really is a mindset that can be developed with practice.

Make sure you breathe and consciously take your time.

Also, when you're practicing, be sure you explain to your partner/dog/teddy bear/pillow just what you're doing each step of the way and - out loud - the things that you're looking for.

Here's a little vignette from my first-year-nurse experience: I was doing day surgery prep and had to start an IV after having blown like 5 in a row on different patients. I was so nervous and uptight but I just put myself in the role of expert and thought about what that expert would do... they'd go at a steady pace, they'd casually glance up into the hall to see who was coming by, they'd talk quietly and calmly the patient as they were getting their stuff together... I forced myself to play-act the expert role and, by golly, I got the IV in without any trouble... and that began a whole string of successes in venipuncture.

It's really about mental discipline and emulating in behavior the actions of the seasoned experts - along with actually knowing your material.

I don't know if this made any sense at all but this is how I approached nursing school and have been handling my professional growth over the last year (almost) in my transition from complete rookie to competent practitioner.

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I graduate next week with my AAS in Nursing. We were all really nervous for our Critical Care assessments (not only a critically ill patient, but the hardest instructor I ever had was grading me.) So anyway, I partnered up with a couple of classmates, and we watched each other do assessments on each other's patients in the ICU and then critiqued each other (we did this the morning we were going to be graded). So it was fresh in our minds, and it was practice for both the person doing the assessment, and the person watching them.

Also, just go slow and be organized in your method. We were taught in Med/Surg to literally do our assessments head-to-toe, but our Critical Care instructor preferred us to go by body system, which ended up being easier for me in the long run (even though I had to "re-learn" how to do my assessment). If you do your assessments consistently on every patient you have, it will become second nature. Practicing at home on family members or your kids or whoever is good, too. Personally, I liked practicing on patients because all the equipment that we had to be familiar with (chest tubes, vent, etc) was there, b/c we had to discuss all that stuff, too.

Also, if you see a piece of equipment (tube or whatever) that you are unfamiliar with, I would be honest and say so. You can still state the placement of the tube, gauge (if you can see it), etc, and ask the instructor about it. Our instructors would be ok with that if it was truly something we hadn't been taught. Also, if you know who you're doing an assessment on, talk to the nurse who has that patient. I'd do that before I'd YouTube something, b/c some patients can have the same equipment for different purposes, and the nurse should be able to tell you details for that patient in particular.

Good luck!

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Specializes in Trauma, Teaching.

I'm with the others, slow down and just go step by step.

If none of you knew what the mystery tube was, it could have been a test to see if you were willing to ask questions or just try to BS your way through. I (as an instructor) would much rather have a student who admits they don't know something than one who fakes it and potentially puts the pt in danger.

I tell my students to practice what we learned each week at home, on their SO, the cat, the dining room table (makes for interesting percussion:D ). If you can auscultate a cat, pts that follow directions are a breeze!:cool:

Slow enough to be thorough, systematic enough not to miss things.

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