Physical Assessments: Do Any Nurses Do Them

Nurses General Nursing

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It has become apparent to me early in my nursing career that many RNs are no longer performing thorough PA at the beginning of the hand off of care. Not one single nurse during my orientation as a new grad had a stethascope around their neck to ausculate lung, heart, bowel sounds. Not a single RN palapated a patient's abdomen or pedal pulses. When I started at a a new hospital as a new grad, my preceptor said to me as she observed me assess a patient "wow, that was a good and thorough physical assessment." I'm thinking to myself, this is what I was taught to do as a basic skill during my nursing school days at UIC.

I work on a tele unit and I am one of the few RNs who actually have a stethascope and calipers. Am I missing something? I know how important it is for a s/p lap cholect. patient to have bowel sounds but how can you assess bowel sounds if you don't have a stethascope. Asking a patient if they have passed gas is subjective. I need hard data.

So my question is, am I wasting my time physically assessing my patients? Granted I do a focused assessment based on their accuity and needs, but I will still inspect the feet of all my patients. Am I doing something wrong? Do I need to reprioritize? I really need some help here because I'm a little confused after all of the time spent at UIC on physical assessment. I don't want to falsify documentation when the computer prompts me if I heard bowel sounds or not.......

I do a complete assessment on each pt each shift. I find it sad when a pt asks "what are you doing" when I check pedal pulses, cap refill, assess the skin on the buttocks etc. Especially sad when the pt has been in the hospital for a couple of days and this is new for them. It really irks me when I hear an RN say the pt would not allow me to check his skin for breakdown!! It is all in the way you phase it and it has to be done. Never assume just because they are a walky-talky there is no breakdown. There is no excuse for not completing a physical assessment.

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